I’m a woman living with HIV – UK aid cuts are a betrayal to women and girls in sub-Saharan Africa
A.As a woman living with HIV, I need not remind you of the life-changing importance of access to HIV prevention and treatment services, or the devastation caused by their absence. I personally know the fear and anxiety when trying to access clinics and medications.
I also know the hope that comes with scientific and medical breakthroughs, and the despair of remaining beyond the reach of those who need it most. So I find myself mourning all the opportunities that will come after the devastating £900 million cut in the UK’s bilateral aid to Africa.
Prior to these announcements, previous cuts from donor countries were already taking effect. Reports from friends and family in South Africa describe people struggling to access HIV medications, medical appointments being canceled and vulnerable communities being hit the hardest. At the same time, HIV testing and prevention services were withdrawn; Community testing sites are closing, prevention services are disrupted, and people are losing access to tools that stop new infections before they occur.
As the number of tests decreases, more people remain unaware of their status, infections go undetected, and their risk of transmission increases. These cuts are not abstract policy choices; They are effectively undoing decades of hard-won progress in HIV treatment, testing and prevention, and are directly putting the lives of those, especially those with few alternatives, at risk. Even from a medical science perspective, we are closer than ever to ending AIDS as an epidemic.
It’s a confusing paradox: While funding is being cut, we are also in the midst of a transformative medical breakthrough. Lenacapavir, a long-acting, injectable HIV prevention drug, is the closest we have come to creating an HIV vaccine. This discreet and permanent protection, applied only twice a year, not only eliminates dependence on daily pills and the associated stigma, but also reduces the mental burden on key high-risk groups such as women and girls who need preventive protection. In groundbreaking trials in South Africa and Uganda, there were no new HIV infections in women taking lenacapavir. African women and girls were not only participants in these studies, but also central to their success. This is a clear indication that inclusive, locally-based science works.
However, despite their central role in the development and success of lenacapavir, women and girls are at risk of being denied the benefits of lenacapavir. Women and girls in sub-Saharan Africa carry a disproportionate burden of HIV, accounting for roughly two-thirds of all new HIV infections in the region. These women and girls have compounding factors that increase their risk; Overlapping issues such as economic insecurity, gender-based discrimination and violence mean that not only are they at higher risk of contracting HIV, but the negative effects are also worsened.
Of course, a scientific discovery alone is not enough. Confining lenacapavir to laboratories or high-income markets out of reach of women and girls who need it is a failure of purpose. Allowing this to happen while the same women and girls are participating in trials to make the drug viable is a profound betrayal of justice and equity.
The importance of political choices emerges here. UK Official Development Assistance (ODA) is mitigating the risk of jeopardizing a historic opportunity to prevent women and girls in sub-Saharan Africa from contracting HIV. Lenacapavir has countless life-saving medical functions, but its impact will only be realized if the funding and partnerships that support its delivery are maintained.
Lenacapavir has been made more accessible, affordable and scalable thanks to Unitaid, a multilateral organization that receives significant funding from the United Kingdom. The UK investment supported Unitaid’s efforts with the South African government to produce generic lenacapavir locally, which is essential for sustainability. Producing medicines closer to communities in need ensures a reliable supply, reduces dependence on distant markets, lowers costs and creates resilient health systems. This approach, combined with strong delivery systems and stigma-free services, does more than prevent HIV: it strengthens health infrastructure, nurtures local expertise, and positions countries like South Africa as regional hubs for life-saving innovations.
England has a choice to make. After years of championing global health and supporting scientific innovation, he now faces retreat at a crucial moment. The decisions the UK makes will determine whether this breakthrough reaches the women and girls who need it most. Science has surrendered. African women made this possible. Now the political leadership needs to ensure that women benefit. Supporting the UK’s ongoing investment in Unitaid and its partnerships is not just an act of generosity, it is a smart investment in global health, regional resilience and the lives of millions of people. It is a choice between action and inaction, between leaving innovation on the shelf and leaving it in the arms of women who need it.
History will remember this moment for whether we allowed this breakthrough to reach those it was designed to protect, not for itself. The UK can ensure lenacapavir delivers on its promise or step back and risk countless lives being lost while the science awaits.
Yvette Raphael is co-founder and chief executive of Advocacy to Prevent HIV and AIDS (APHA) in Southern Africa.
This article was produced as part of The Independent. Rethinking Global Aid project
