Written by Philip Idoko and Bernard Otu Assim-ita
From August 5–7, 2025, stakeholders across government, civil society, and development partners gathered in Lagos for the 7th National Council on AIDS (NCA) under the theme “Advancing the HIV Sustainability Agenda in the Changing Global Policy on Aid.” Hosted by the National Agency for the Control of AIDS (NACA) with support from the Lagos State AIDS Control Agency (LSACA), the Council emphasized a defining truth: Nigeria must urgently transition from donor dependence to a resilient, people-centered, and country-owned HIV response.
The urgency of this transition is global. The UNAIDS Global AIDS Update 2025 warned that declining funding threatens to reverse decades of progress, while the IAS HIV Science Conference in Kigali called for domestic investment and health system integration. Against this backdrop, the NCA offered Nigeria an opportunity to set out its roadmap for 2025–2028.
Sustainability is not an abstract policy phrase. It is the difference between a mother in Lagos having uninterrupted access to her ARVs, or a young person in Benue walking miles to find a clinic with no test kits.
“Sustainability begins when states and local governments no longer see HIV response as a donor-driven programme, but as a core part of their public health mandate, that means concrete budget lines, integration into state health insurance schemes, and leveraging existing community structures.”— noted Idoko Philip, Senior Program Officer, Education as a Vaccine.
This means financing HIV locally, but also embedding it within broader health systems. HIV cannot be siloed; it must connect with mental health, sexual and reproductive health, and primary care, ensuring that services are accessible, efficient, and part of a holistic approach to health.
A recurring theme at the Council was the role of communities, not as beneficiaries, but as co-owners of the response.
“Civil society, PLHIV networks, and faith-based organisations must move from the periphery to the centre of programme design, implementation, and accountability,” Philip emphasized.
This includes social contracting, reactivating support groups, and institutionalising community-led monitoring. True sustainability is about more than service delivery. It is about governance, accountability, and ensuring communities themselves sustain the demand for services long after external funding declines.
Commitments are being made. President Bola Ahmed Tinubu’s approval of a $200 million for health intervention fund, ₦4.8 billion for HIV treatment packs amongst many others. But sustainability will be measured not by announcements, but by timely disbursements, visible programme impact, and strengthened local supply chains.
As Philip Idoko highlighted, “Transition will not succeed without predictable domestic financing and enabling policies. We must strengthen local production of health commodities and enforce anti-discrimination laws so that gains in access are not undermined by stigma or structural barriers.”
At Education as a Vaccine (EVA), these national conversations mirror our programmatic reality. Through the Transition Initiative funded by Frontline AIDS, we are working to ensure adolescents, young people, and key populations remain at the center of Nigeria’s HIV response as donor support shifts as part of sustainability efforts to sustain our wins from an earlier funded United for Prevention project which highlighted sustainability in action by bringing together young advocates, Civil society and community led organisations,health providers, and policymakers to drive prevention programming that is community-owned, multi-sectoral, and accountable.
Nigeria’s HIV response stands at a crossroads. The NCA has charted a roadmap, but implementation will determine whether this transition is truly sustainable. The challenge is clear:
- States must move from commitment to action.
- Communities must shape and monitor delivery.
- Policymakers must embed HIV firmly into the health system.
The mother who depends on uninterrupted ARVs, the young man seeking non-judgmental testing, the community support group keeping each other alive. These are the real faces of sustainability.
The next phase of Nigeria’s HIV response is not just about survival. It is about building a stronger, more equitable, and enduring system. One that ensures no one is left behind as donor support declines.