Dr. Alyalla Nandakumar Shares New Approaches to Global HIV Care in the Wake of Funding Cuts 

As the U.S. withdraws from its role as a key funder of the global HIV response, countries at the center of the HIV epidemic will bear most of the financial burden. Historically, donor funding (with the U.S. making up 73% of those funds) has been the core pillar of HIV control, but it has also fostered fragile health systems that are difficult to sustain if donor funds decline.   

In a recent op-ed for Devex, Dr. Allyala Nandakumar, Global Social Work and Public Health Lab director for the Center for Innovation in Social Work andin Health (CISWH) at BU School of Social Work (BUSSW) calls for a resilient HIV response that centers equity and has long-term sustainability.  

Excerpt from “Global health is at an inflection point. Can we save what PEPFAR built?” by Alyalla Nandakumar:  

The path forward lies in integrating HIV care into broader primary healthcare systems. Countries that have taken this approach are less exposed to political swings and more accountable to the citizens they serve. Integration makes systems both sturdier and fairer. 

We are at an inflection point. If funding continues to dwindle, the risk is not only losing ground against HIV but triggering a wider unraveling of public health systems in countries where these programs form the core of health infrastructure. Yet this moment can also serve as a catalyst, shifting the global health model toward long-term resilience rather than perpetual emergency aid. 
 
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