Several countries in East and Southern Africa (ESA) region are in or at high risk of debt distress, repaying three times more than they invest in health. Donor commitments are also at risk. This report highlights the impact of tax, debt, and development assistance on HIV and health investments, offering updated data and solutions. Using granular country data, they call for increased international support, tax collection, and debt relief, and emphasize urgent reforms in global financial architecture and SDG financing.

Adjusted for inflation, eastern and southern Africa will need to mobilize $10.5 billion in 2024 to fund the HIV response. This will climb to $15.84 billion by 2030. The greatest financing needs are in Ethiopia, Mozambique, South Africa, South Sudan and United Republic of Tanzania, which will all need to mobilize at least $1 billion in resources annually in 2030 to fund HIV prevention and treatment services.