An unprecedented funding crisis is threatening decades of progress in the global HIV response. In 2024, official development assistance (ODA) financed nearly 80 percent of HIV prevention programmes in low- and middle-income countries, but that funding has declined dramatically.  

Despite important successes at mobilizing domestic resources in some low- and middle-income countries to offset the impact of ODA cuts, the scale and speed of the funding changes have already had a devastating impact on both treatment and prevention programmes. New domestic resources are mostly focused on sustaining life-saving treatment programmes, while countries are also trying to save money by integrating HIV interventions into broader health services. Both those trends mean that HIV prevention programming is particularly at risk – especially for marginalized key populations that enjoy less political support and that often suffer stigma and discrimination in health service settings and communities. Such a short-term trade-off is not sustainable, as the required investment in treatment will skyrocket if new infections are not kept under control. 

HIV prevention delivers excellent value for money. For example, the use of pre-exposure prophylaxis (PrEP) among women in South African has shown to reduce lifetime HIV risk from 40 percent to 27 percent and increases life expectancy, with an incremental cost-effectiveness ratio of approximately US$2,700 per year of life saved. With advanced long-acting prevention options like twice-yearly injectable PrEP (lenacapavir) poised to enter African markets at lower costs, upfront investment in prevention can avert future infections, reduce lifetime treatment burdens and safeguard economic productivity.

The HIV epidemic is global but the burden of disease remains highest in Africa, especially in the southern region. South Africa records approximately 150,000 new infections annually and has 7.8 million people living with HIV, while Zimbabwe and Malawi report 1.3 million and 980,000 people living with HIV, respectively. In this region, adolescent girls and young women are particularly affected, but HIV incidence (that is, the risk of acquiring an infection) is highest among certain key populations. In 2024, South Africa  funded over three-quarters of its overall HIV response domestically, but a large majority of funding for prevention with key populations came from international donors. Malawi and Zimbabwe remain even more dependent on external financing. These developments underscore the pressing need for increased funding for prevention and strengthened, targeted and community-led HIV prevention strategies that prioritize those most affected and expand access to tailored services.

The Power of Prevention project  

Against this backdrop, UNDP, with support from the Gates Foundation, has launched the Power of Prevention project to strengthen national efforts to ensure that HIV prevention for key populations remains a central part of political and funding agendas in southern Africa. The initiative builds on UNDP’s longstanding partnerships with governments and communities on HIV issues related to key populations, legal and policy environments, and sustainable financing. 

The Power of Prevention project responds to a simple truth – prevention tools alone are not enough. Legal and policy environments, financing, community demand and community leadership determine whether prevention efforts succeed or fail. In recognition of this, in January 2026, UNDP awarded 22 grants to key population-led organizations who are driving change in South Africa, Malawi and Zimbabwe. The grants support community groups to focus on three mutually supportive strategies. 

Enabling policy and community-centered prevention ecosystems

Key population-led organizations understand their communities’ needs better than anyone. HIV prevention is not only a medical challenge, but also a legal, social, and structural one. Stigma and discrimination continue to block access to services, undermining even the most advanced prevention technologies. Key population-led organizations will advocate for enabling policy ecosystems and the removal of structural barriers that restrict access to HIV prevention services. This includes promoting accessible preventive services, inclusive national guidelines, and differentiated service delivery models of care. 

Key population-led political and financing advocacy

Key population groups often lack access to decision-makers and the resources to influence national budgets. Grantees will work with each other and with UN partners to advocate for HIV prevention, including long-acting PrEP, as a sustained political and domestic financing priority. They will engage decision-makers across health, finance, and political sectors to secure increased national budget allocations and identify alternative financing mechanisms. Through coordinated advocacy, accountability, and demand generation, this priority responds directly to shrinking donor support by repositioning HIV prevention as a cost-effective national investment essential to epidemic control and long-term health system sustainability.

Evidence generation for policy dialogue

Over the past decade, the power of community involvement in evidence generation and policy dialogue has been demonstrated repeatedly, including through initiatives known as “community led monitoring”. Unfortunately, recent funding cuts and political dynamics put that work at risk. The Power of Prevention project reverses this dynamic by investing in community-led data collection and documentation. Through peer-led learning and South-to-South collaboration, organizations will generate community-led evidence to inform advocacy and document effective prevention approaches.

Across the three countries, grantees will generate community accountability data and policy analyses to inform budget and legislative engagement; strengthen dialogue with health authorities and parliamentarians to integrate LA-PrEP into sustainable financing frameworks; and train healthcare providers to deliver stigma-free, key-population-inclusive services. At the same time, they will mobilize community networks to identify service gaps, build advocacy roadmaps, and amplify community voices in national and subnational policy spaces. 

At a moment of significant funding declines and service disruptions, the Power of Prevention project will help secure the future of the HIV response, by centering community leadership, sustainability, and equity in prevention efforts.

List of the Power of Prevention grantees in Malawi, South Africa and Zimbabwe

Disclaimer: Mentions of specific partners, companies, or products do not imply endorsement or recommendation by UNDP. The views expressed by partners, or on their websites, do not necessarily reflect those of the United Nations, UNDP, its staff, or member states. UNDP does not warrant that information provided by partners is complete or accurate and shall not be liable for damages resulting from the use of such information.

Malawi

1. Community Health Rights Advocacy (CHeRA) 
2. Female Sex Workers Association (FSWA) 
3. Malawi Network of People Living with HIV/AIDS (MANET+) 
4. Malawi Network of Religious Leaders Living with or Personally Affected by HIV and AIDS 
5. Optimum Foundation 
6. The Voice Organization

South Africa

1. Access Chapter 2 
2. Free State Rainbow Seeds 
3. Lesbian and Gay Community and Health Centre
4. Lesbian/Gay/Bisexual/Transgender (LGBT) Well-being (OUT) 
5. Shaine Griqua Advice and Development Centre 
6. SISONKE 
7. Social, Health & Empowerment Feminist Collective of Transgender Women 
8. South African Network of People Who Use Drugs (SANPUD)
9. SWEAT 
10. The Fruit Basket

Zimbabwe

1. Association of LGBTI People in Zimbabwe (GALZ)
2. Hands of Hope Organization 
3. Intersex Community of Zimbabwe (ICoZ)
4. Sexual Rights Centre 
5. Women Against All Forms of Discrimination 
6. Zimbabwe Civil Liberties and Drug Network (ZCLDN)