Written By Idoko Philip
Editor’s note: This reflection highlights recurring themes from ICASA 2025 discussions. Where specific figures are not cited here, the focus is on the broader implementation lessons and policy actions needed to secure continuity of HIV prevention and community-led services in Nigeria.
Education as a Vaccine attended ICASA 2025 at a time when Nigeria’s HIV response is being forced to answer a difficult question: what happens to prevention gains when external funding shifts without warning?
That question was not theoretical at the conference. It showed up in country conversations about paused activities, delayed commodities, strained frontline systems, and communities left carrying the burden when programmes slow down. The takeaway for Nigeria was clear. Sustainability is no longer a future goal. It is today’s work, and it must be treated as a national implementation priority.
Across ICASA, one message kept returning. Countries that are protecting progress are doing three things consistently. They are increasing domestic financing, strengthening accountability for results, and integrating HIV prevention into broader primary healthcare in ways that reduce fragmentation and cost.
For Nigeria, this is where transition must become more than a phrase. It must become a plan with rules, budgets, and consequences. Domestic resource mobilization cannot sit only in strategy documents. It needs multi-year commitments that are publicly trackable, protected within budgets, and linked to prevention and sexual and reproductive health outcomes, especially for adolescents and underserved groups.
ICASA also reinforced a practical truth. Integration is not just a technical preference. It is how health systems survive when money tightens. When HIV services, STI care, hepatitis, TB, SRHR, and NCD screening are delivered through stronger primary healthcare platforms, fewer people fall through the cracks and resources go further. But integration only works when it is backed by the basics: reliable commodities, functional referrals, usable data, and quality assurance that does not disappear during shocks.
Still, the most important lesson from ICASA 2025 was about power and participation. Sustainability will fail if communities remain invited guests rather than part of the structure. Community-led services are often the first to be cut when funding becomes uncertain, even though they are the ones reaching people who rarely show up at facilities. Nigeria’s transition approach has to protect these services by design, not by appeal.
Senior Program Officer Idoko Philip and Program Assistant, Modupe Koledoye at ICASA 2025
This is why social contracting matters, not as a concept, but as an implementation tool. When designed for Nigeria’s context and properly funded, social contracting can secure community-led prevention and accountability work as part of the health system, not as a temporary project.
Education as a Vaccine’s Transition Initiative Program, supported by Frontline AIDS, is built around this shift. It supports community-inclusive transition advocacy and helps communities engage government actors at national and subnational levels to demand transparent financing, integrated services, and accountability that delivers.
ICASA 2025 did not just highlight risks. It also offered a direction. Nigeria can either manage disruption repeatedly, or use this moment to lock sustainability into policy and practice. The choice will determine whether prevention gains are protected for the long term, and whether communities remain at the margins or become part of the foundation.
