A Journey of Hope: Malawi’s Fight to End AIDS

In the heart of in Malawi, Evelyn Siula’s life was forever changed. After the heartbreaking loss of her husband, Evelyn made a decision that would alter the course of her future: she got tested for HIV. The diagnosis was positive. Initially, the news was devastating, but what followed was nothing short of transformational.

Evelyn became not just a survivor, but an advocate, showing others that HIV is not the end of the road but a new chapter in life. Today, she stands as a symbol of hope, resilience, and the power of change, not just for herself but for many people living with HIV across Malawi.

Her story is part of a larger narrative of Malawi, a country once ravaged by HIV and AIDS, now standing tall as a beacon of hope in the global fight against the epidemic. Through strong partnerships, unwavering determination, and innovative strategies, Malawi is defying the odds, working toward the day when no one will be left behind in the battle against HIV.

A Nation’s Determination: From Crisis to Leadership

Malawi was once one of the hardest-hit countries by the HIV epidemic, with new infections reaching over 56,000 annually in 2010 and an adult prevalence rate exceeding 10%. However, thanks to a comprehensive national response and invaluable partnerships, the country has made incredible strides in the fight against HIV. Through a collaborative effort between the government, UN agencies, international donors, and local organizations, Malawi has reduced new HIV infections by 76% due to widespread access to HIV treatment and behavior change, bringing the number of new cases to approximately 13,500 annually as of 2023.

Today, Malawi has achieved 95%, 91% and 87% of the UNAIDS 95-95-95 target, which aim to ensure that 95% of people living with HIV know their status, 95% of those diagnosed receive treatment, and 95% of those receiving treatment achieve viral suppression. With over 1 million Malawians receiving life-saving antiretroviral treatment, the future looks brighter, but challenges remain. Adolescents’ girls and young women, and key populations continue to face higher risks, and the fight is far from over.

Strengthening the Fight

In a show for support and recognition of the incredible success of the AIDS response in Malawi, Winnie Byanyima, UNAIDS Executive Director and Gilbert Houngbo International Labour Organization Director-General convened a High-Level Panel Meeting in Malawito re-strategise on the future of the global AIDS response. Her high-level visit had two clear objectives: first, to develop recommendations that would guide the UNAIDS Joint Programme, and second, to reinforce political and financial support for the global AIDS, as the world works on the next Global AIDS Strategy, and the 2026 High-Level Meeting on HIV and AIDS as milestones towards ending the AIDS epidemic by 2030 and sustaining the gains beyond.

"Malawi and its people are resilient and leaders in the fight against AIDS," Byanyima remarked. "In spite of the numerous challenges the country faces including perennial floods and droughts, Malawi’s AIDS response remains a beacon of success. But the next phase is crucial. We need to ensure that the national response is resilient and fully funded and bring game changing tools such as long-acting injectables for HIV prevention and treatment to people who need them.”

Her visit was a reminder that Malawi’s progress in this fight is not just national, it is a global effort, and the country’s success serves as an inspiration for others around the world.

World AIDS Day: A Nation United for Change

On 1 December 2024, Malawi commemorated World AIDS Day with a powerful gathering in Zomba. The theme, “Take The Rights Path: Together We Remember, Together We End AIDS,” captured the essence of Malawi’s response to the epidemic—one built on unity, collaboration, and shared purpose.

Hon. Khumbize Kandodo Chiponda, Malawi's Minister of Health, addressed the gathering, sharing a prevailing message: "Our progress has been possible only through the strength of our partnerships. We must continue working together, addressing the gaps, and reaching those who are most vulnerable." She went on to highlight innovative solutions, such as the introduction of long-acting injectables for HIV prevention, which hold the potential to revolutionize the fight against HIV in Malawi.

However, the minister also issued a call for more sustainable funding: "Only 12 percent of our health budget is funded by the government. The rest comes from international donors. For long-term success, we must find ways to ensure the sustainability of our progress."

The Role of the UN: An Unwavering Support in the Fight

The United Nations has been a steadfast partner in Malawi’s fight against HIV, working through the Joint Programme on HIV/AIDS to drive progress in prevention, treatment, and care. Thanks to this collaboration, a substantial portion of Malawi's population now benefits from life-saving antiretroviral therapy, critical in reducing HIV transmission and achieving viral suppression. Yet, the UN’s contributions extend beyond treatment. Its role encompasses providing strategic direction, normative guidance, actionable data, sustainable financing, and fostering an enabling legal and policy environment to ensure health systems reach the most vulnerable.

Through evidence-based initiatives like DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe), the UNAIDS Joint Programme has empowered young women and girls to protect themselves from HIV. Social protection programs and cash transfers have further strengthened these efforts. Tailored interventions for key populations, including sex workers, address stigma and discrimination, ensuring equitable access to essential services.

The UN's technical expertise has also been instrumental in mobilizing resources. Programmes funded by the Global Fund to Fight AIDS, Tuberculosis, and Malaria are underpinned by UNAIDS' support in proposal development. Similarly, the strategic information provided by UNAIDS informs the planning of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

"Our work ensures that the UNAIDS Joint Programme is strongly reflected in the UN Malawi Sustainable Development Cooperation Framework," says Rebecca Adda-Dontoh, UN Resident Coordinator for Malawi. This integrated approach underscores the UN’s unwavering commitment to combating HIV and fostering a healthier, more inclusive Malawi.

Financing the Fight for an AIDS-Free Future

The Global Fund has been a cornerstone of Malawi’s HIV response, channeling critical financial resources to expand prevention, treatment, and care services. Since its inception, the Global Fund has disbursed over $1.1 billion to Malawi for HIV, Tuberculosis, and Malaria programmes, driving transformative improvements in health outcomes nationwide. This sustained investment has helped Malawi achieve significant milestones, such as providing life-saving antiretroviral treatment (ART) to people living with HIV. These efforts have increased viral suppression rates, reduced transmission risks, and improved the quality of life for countless individuals and families.

The Global Fund’s impact is further amplified through strategic partnerships with key donors like PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief), which has contributed over $5 billion to Malawi's HIV response. In addition to funding, PEPFAR provides technical expertise and programmatic support. Collaborations with local organizations, community-based health workers, and international NGOs ensure that resources reach marginalized populations, including those in remote rural areas. These partnerships have built a resilient response capable of addressing both immediate and long-term challenges in the fight against HIV.

However, significant challenges remain. Approximately 85% of Malawi’s national AIDS budget depends on donor funding. Coupled with the country's high indebtedness and constrained fiscal space, this reliance poses risks to the sustainability of the HIV response. As Malawi advances toward universal health coverage, the long-term success of its AIDS response hinges on closing funding gaps. It is vital for partners to maintain their commitment, strengthen collaboration, and secure sustainable financing to preserve and accelerate the progress achieved so far.

Looking Forward: Sustainable Solutions for a Healthier Future

The next phase of the fight against HIV in Malawi will require both innovation and resilience, especially that Malawi suffers from climate induced droughts, floods and financial shocks setting back social and economic progress including in areas such as immunization and cholera prevention. As the global community shifts focus to sustainable development, the country is working to ensure that HIV remains a priority, with a continued focus on reaching those who are most at-risk and ensuring that no one is left behind.

A Future Full of Hope

For Evelyn Siula, the journey from diagnosis to advocacy has been life-changing. She looks at the future with hope, not just for herself but for all Malawians. "This is not just about fighting HIV; it is about creating a Malawi where everyone, regardless of their status, has the HIV prevention and treatment choices that suit them and has the opportunity to thrive," she says.

Malawi’s fight against HIV may not be over, but with each passing day, the country moves closer to an AIDS-free future. Together, through innovation, partnerships, and unwavering resolve, Malawi is showing the world that an AIDS-free generation is not just a dream—it can become a reality.