In the ongoing battle against HIV/AIDS, Africa is poised to take charge of its destiny, and the world must step up to support this bold initiative. The continent has already made remarkable strides in combating the epidemic, with a 59% reduction in AIDS-related deaths and a 68% decrease in new infections since 2010. This is a testament to Africa's resilience and determination, as it has managed to turn the tide of the epidemic with its own efforts. However, the recent decline in external health aid to Africa, estimated to have fallen by 70% between 2021 and 2025, poses a significant challenge. The current model, where Africa delivers while others finance and direct, is at risk of collapse, leaving the continent to either lead the transition or absorb the shock. This is where the Common Africa Position comes in, as a bold statement of Africa's commitment to ending AIDS on its own terms. The position is built on three main demands: financing the transition, securing access to science, and defending rights. Africa needs to shift the focus of HIV financing within national budgets, primary healthcare, and social protection, ensuring that it can sustain the progress made so far. International solidarity is still crucial, but the terms have changed. Every dollar should support a national plan, budget, and monitoring framework, with a concrete target of at least 20 countries financing half or more of their health spending by 2030. Access to essential medicines and diagnostics is another critical issue. Africa must ensure a reliable supply of antiretrovirals, diagnostics, and innovative prevention tools, such as long-acting pre-exposure antiretroviral prophylaxis. The African Pooled Procurement Mechanism (APPM) and the African Medicines Agency are key to achieving this, turning scattered demand into bargaining power and supporting local manufacturing. The systems that hold the response together are also essential. HIV care must be integrated into primary healthcare, with testing, treatment, and maternal health services accessible through a single door. Communities living with HIV have led the response from the start and need funding and formal standing to continue doing so. Rights, including those of migrants and refugees, must be at the center of the response, with a focus on stigma, gender-based violence, and punitive laws. The direction is already set, and the 2026 political declaration should reflect this. Africa has earned the right to set the terms of the fight against AIDS, and the world must back it to finish the job on African terms. The question is whether the world will support Africa in this endeavor or continue to manage the continent's dependence. The choice is clear, and the declaration should make the same one: to empower Africa to take charge of its health destiny and end AIDS once and for all.
