Transition Initiative

In the wake of unprecedented cuts to global HIV and sexual and reproductive health and rights (SRHR) funding, we have launched the Transition Initiative to ensure the long-term survival and sustainability of vital services across five countries in Africa.

WHY THE PROGRAMME IS NEEDED

The funding landscape for HIV and SRHR services has shifted dramatically, with an unprecedented reduction in financial support. In particular, the decision by the U.S. government to cut back on foreign aid, including PEPFAR, has jeopardised the delivery of crucial HIV and SRH services to those most in need. By March 2025, over 83% of USAID programmes were shut down, severely disrupting HIV and SRHR service delivery.

For the Frontline AIDS partnership, the fallout has been immediate and devastating. Many of our partners have had to close programmes and clinics, with life and death consequences. Nearly half of our partners have been forced to stop their work, leaving 1.6 million people without access to lifesaving HIV and sexual reproductive health services.

The cuts have particularly targeted specialised programmes for LGBTQ+ people and other key populations including sex workers and people who use drugs, as well as adolescent girls and young women, and survivors of gender-based violence. Critical HIV prevention services have been gutted, and family planning, which complements HIV prevention, is explicitly barred from programmes still funded by the U.S. government.

WHAT THE PROGRAMME IS DOING

The Transition Initiative, launched in May 2025, to empower communities and civil society organisations to shape the transition of HIV services from donors to government systems, programmes, and structures. 

The Transition Initiative aims to build a future where local communities are at the centre of HIV service delivery, with governments as strong, accountable partners, ensuring access to prevention, treatment and care for all. 

The Transition Initiative is dedicated to: 

• Restoring and strengthening HIV and SRHR services for the most marginalised populations including key populations, young women and girls, and survivors of gender-based violence.  

• Supporting existing civil society advocacy coalitions, including those established under our United for Prevention programme, who have access to national decision-making spaces and a track record of successful collaboration with government for service delivery integration and financing for HIV. 

• Ensuring HIV prevention services are included in any transition plans, particularly for key populations and vulnerable groups. 

• Focusing on long-term solutions, such as pushing for an increase in domestic financing for health, advocating for the integration of HIV and SRHR services into universal health coverage (UHC) frameworks, developing social contracting mechanisms which enable governments to contract NGOs to deliver services, and exploring other innovative financing approaches. 

• Aligning with ongoing global efforts, including the UNAIDS Sustainability Roadmaps, to advocate for long-term financing and policy change. 

HOW AND WHERE THE PROGRAMME IS WORKING

The Transition Initiative will initially prioritise five countries: Kenya, Malawi, Nigeria, Tanzania and Uganda. These countries have already experienced a sharp reduction in HIV funding, particularly in critical prevention services. By leveraging the existing civil society coalitions and advocacy work in the five countries, the Transition Initiative is designed to support the transition of HIV and SRHR services from donor funding to government-led systems.

The Transition Initiative is funded by the Swedish International Development Cooperation Agency (Sida) and will run until the end of 2025.