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Meeting the Moment: ICAP Convenes Over 200 Stakeholders to Safeguard HIV Services Amid Global Funding Challenges

Jun 26, 2025 | News

With HIV programs across sub-Saharan Africa facing unprecedented funding disruptions, ICAP at Columbia University convened over 200 delegates from 21 countries for two high-level strategic planning meetings in Johannesburg aimed at protecting and sustaining HIV services and hard-won progress in preventing vertical transmission of HIV from mother to child. 

The first meeting—organized by ICAP’s Coverage, Quality, and Impact Network (CQUIN) from June 10 – 12, 2025—convened representatives from ministries of health, national networks of people living with HIV, donors, implementing partners, and civil society under the theme “Meeting the Moment: Transforming the HIV Response in a Time of Change.” The meeting focused on understanding member countries’ emergency responses to the abrupt funding withdrawal to maintain service continuity across national HIV programs while laying the groundwork for resilient and sustainable HIV programming.  

A woman stands at a clear podium, speaking into a microphone. She holds a small device and appears to be presenting, with a projected slide visible in the background. The setting is formal and professional.

Wafaa El-Sadr, ICAP’s global director, giving her remarks

“There have been sudden, profound changes in the past few months with major implications for recipients of care—both adults and children—and HIV programming overall,” said Wafaa El-Sadr, MD, MPH, MPA, ICAP’s global director, underscoring the urgency of the moment in her presentation at the CQUIN meeting. “This moment compels us to come together and think carefully about how to preserve the gains and keep momentum in HIV care.” 

 

 

Responding to Crisis with Country-Led Action 

The three-day CQUIN meeting emphasized the importance of strategic, government-led, and community-driven prioritization of HIV services, community engagement, and data-driven decision-making in maintaining the quality of HIV programs amid funding instability and gaps. 

Maureen Syowai, MBChB, MSc, CQUIN and HIVE interim project director, affirmed CQUIN’s role in supporting member countries through the crisis. “CQUIN’s goal of achieving the impact of improved health outcomes and systems efficiencies has not changed, and with the CQUIN 2.0 Pivot, the network is currently re-emphasizing the idea of sustainable impact,” she said. “In addition, with this changing funding landscape, we’re expanding joint learning and helping countries reimagine their HIV response through a sustainability lens.”  

In March 2025, CQUIN pivoted its support to helping countries in the network think through providing quality, sustainable HIV testing, prevention, and treatment services at scale, without major donor funding. CQUIN developed and used four tools to gather information across the network. This information was synthesized to identify best practices, track adaptations, assess common challenges, and define technical assistance needs. The country findings also influenced the meeting agenda and design.  

In plenary sessions at the meeting, delegates shared real-time lessons from recent disruptions, including the impact of the U.S. government’s stop-work order, medication stock-outs, procurement challenges, and shifting donor timelines. The parallel sessions focused on prioritizing HIV services, rethinking monitoring and evaluation, planning for the integration of services and systems into routine health care, and streamlining service quality assessments across programs and settings. 

  • Two women sit at a conference table with microphones and water bottles, speaking and listening. Behind them, a sign reads, “A long and healthy life for all South Africans.”.

    Left: Clarice Pinto, WHO, and Anna Grimsrud, IAS

  • A man stands and points at a laptop screen while two seated colleagues look on attentively at a round table with laptops, water bottles, headphones, and glasses during a conference or workshop.

    Cote d'Ivoire Country delegates in a break out session

  • A man with glasses and a conference badge stands and gestures while speaking to two seated colleagues in a modern meeting room. One woman listens attentively, and another man has his back to the camera.

    CQUIN's Regional Clinical and Quality Improvement Advisor, Onyekachi Ukaejiofo, facilitating group exercise with country teams at the Quality for All focus session

  • A woman stands and speaks to a group of seated people in a conference room. A flip chart and a timer on a screen are visible in the background. Participants are listening and some have laptops open.

    A parallel session at the meeting

  • A man sitting among a group of people at a conference raises his hand to ask a question, while others around him are looking down or listening attentively. "EXIT" signs are visible on the wall behind them.

    Peter Ehrenkranz, Gates Foundation, during a panel/audience discussion

  • A group of five people sit around a table with laptops and devices, engaged in discussion at a conference. One man stands beside the table, while others focus on their work. The setting is a modern, well-lit conference room.

Cameroon’s Ministry of Health shared how it mobilized domestic resources by convening stakeholders and drafting a national mitigation plan. “Once we received the stop-work order, we brought all stakeholders together to create the Cameroon mitigation plan for a sustained HIV response,” said Joseph Fokam, the permanent secretary at the Cameroon National AIDS Control Committee. 

In Rwanda, community advocates pushed for increased domestic financing, with support from private sector actors. “This crisis is also an opportunity to elevate community priorities and reframe how we build lasting systems,” said Deo Mutambuka, executive director for the Rwanda Network of People Living with HIV. 

During the CQUIN meeting, country teams began critically thinking through and determining their national prioritized HIV treatment interventions. “These real-life experiences have been instrumental in shaping our country’s strategy,” added Dr. Fokam. “The meeting has been very insightful.” 

Zooming In: Ending Vertical Transmission in a Time of Crisis 

With country-prioritized HIV treatment interventions drafted, attention shifted on June 13 to one of the most vulnerable groups in the HIV response – pregnant and breastfeeding women and their infants. The HIV Impact Network for Vertical Transmission Elimination (HIVE) convened the second meeting, “Sustaining Vertical Transmission Prevention Amid Global Health Uncertainties,” with its focus on safeguarding HIV services for pregnant and breastfeeding women and their infants during the ongoing funding disruptions. 

A large, diverse group of people poses for a group photo inside a modern building with tall windows. Some are seated in front, while others stand closely together on the stairs behind them.

Country teams, PEPFAR agencies, WHO, UNICEF, and implementing partners shared strategies for protecting vertical transmission prevention (VTP) services. 

Discussions focused on safeguarding four priority actions: identifying and linking of pregnant and breastfeeding women with HIV to care and treatment services, expanding their access to pre-exposure prophylaxis (PrEP), strengthening retention and viral suppression through the postnatal period, and ensuring early HIV diagnosis and prophylaxis testing for infants of women living with HIV. 

“There have been a lot of lessons,” said Stella Kasone, technical director for the National Council of People Living with HIV in Tanzania. “We’ve learned from the innovations other countries are implementing. We’re going back more focused—ready to engage our communities and prioritize quality, even while mobilizing new resources.” 

Two Meetings, One Momentum 

Though held on separate days, the two meetings offered a unified call: to protect and reimagine HIV systems and services for long-term resilience. 

“Our goal was to showcase country-led innovations and strategies that stabilize prevention, linkage, treatment, retention, and ultimately improve outcomes for recipients of care—especially pregnant and breastfeeding women and their infants,” said Dr. Syowai. 

A panel of speakers sits at a long table onstage at a conference, with an audience seated at round tables. A woman stands at a podium while screens and banners display event information in the background.

Maureen Syowai, CQUIN and HIVE interim project director giving a recap of the week’s meeting

Both meetings underscored the importance of government-led leadership, inclusion of community voices, and the need for sustained political commitment to drive meaningful follow-through. 

“The urgency now is to streamline systems, focus on key services and indicators, and protect the core principles that have guided our work,” said Dr. El-Sadr. “CQUIN and HIVE are uniquely positioned to support countries in navigating this moment and emerging stronger.” 

Next Steps: From Plans to Progress 

In the months ahead, CQUIN and HIVE will continue to offer technical support as countries refine their national plans. The networks will encourage ongoing sharing of knowledge and best practices through the communities of practice meetings, webinars, and learning exchange visits. During the CQUIN and HIVE annual meetings coming up in November of this year, teams from member countries will reunite to review their progress and lessons learned. 

About CQUIN

CQUIN is a multi-country learning network dedicated to improving differentiated service delivery (DSD) for people living with HIV. Launched in 2017 with support from the Bill & Melinda Gates Foundation, the network convenes health system leaders from countries in sub-Saharan Africa to participate in joint learning and information exchange, with the goal of fostering scale-up and spread of high-quality differentiated services.

About HIVE

The HIV Impact Network for Vertical Transmission Elimination (HIVE) project is a partnership with ministries of health and other key stakeholders, including the Global Alliance to End AIDS in Children by 2030, to decrease the vertical transmission of HIV in children in Kenya, Mozambique, Nigeria, South Africa, Tanzania, and Zambia. ICAP is working with the six countries to establish a multi-country impact platform, leveraging the systems, partnerships, and achievements of the Coverage Quality and Impact Network (CQUIN) to share innovations and best practices and identify common gaps and challenges in addressing HIV vertical transmission.

About ICAP

A major global health organization that has been improving public health in countries around the world for two decades, ICAP works to transform the health of populations through innovation, science, and global collaboration. Based at Columbia Mailman School of Public Health, ICAP has projects in more than 40 countries, working side-by-side with ministries of health and local governmental, non-governmental, academic, and community partners to confront some of the world’s greatest health challenges. Through evidence-informed programs, meaningful research, tailored technical assistance, effective training and education programs, and rigorous surveillance to measure and evaluate the impact of public health interventions, ICAP aims to realize a global vision of healthy people, empowered communities, and thriving societies. Online at icap.columbia.edu

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