Leveraging public–private partnerships to safeguard HIV service delivery in sub-saharan Africa’s evolving funding landscape

Sub-Saharan Africa (SSA) continues to rely heavily on external donor support to sustain HIV prevention, testing, and treatment services, with the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) historically serving as a central pillar of regional HIV programs. However, recent funding contractions, shifting geopolitical priorities, and implementation uncertainties have intensified concerns about the long-term resilience of HIV service delivery across the region. This policy commentary synthesises current evidence and programmatic experience to examine how public–private partnerships (PPPs) can support governments in sustaining essential HIV services amid an evolving global funding landscape. We identify four priority areas in which PPPs can contribute meaningfully: mobilising diversified financing to reduce dependence on fluctuating donor resources; strengthening service delivery through private health facilities, pharmacies, and technology-enabled platforms; reinforcing governance and regulatory structures to ensure accountability and equity; and building public-sector capacity to design, contract, and manage PPPs effectively. By aligning PPP approaches with universal health coverage (UHC) aspirations and ongoing efforts to integrate HIV care within primary health care systems, SSA governments can enhance sustainability while maintaining progress toward epidemic control.