As the world marks World AIDS Day 2025, a leading healthcare executive has issued a stark warning for Africa: the continent must urgently strengthen its health systems, particularly diagnostics, or risk losing hard-won gains in the fight against HIV.
A Critical Inflection Point for Africa's HIV Fight
Dr. Allan Pamba, the Executive Vice-President for Diagnostics, Africa at Roche Diagnostics, has stated that Africa is at a new and critical juncture. He made this call in a policy paper linked to the International AIDS Society's 2026 "Road to Rio" campaign, themed #RethinkRebuildRise. Pamba, who started his career treating HIV patients in Kenya two decades ago, stressed that bold action and fresh thinking are now required to safeguard the progress made over the last twenty years.
He acknowledged that millions of Africans are alive today thanks to faster diagnosis, more accessible treatment, and greater community involvement in care. Laboratory networks and local expertise have grown at an unprecedented rate. However, this progress is under threat.
The Looming Threat of Shifting Global Funding
The primary challenge, according to Pamba, is the significant pressure on global HIV funding. For years, Africa's response has relied on a mix of domestic budgets and substantial donor support. "Major programmes are under strain, budgets are tightening and donors are shifting to a broader array of global health threats," he cautioned. He urged African nations to proactively reinforce the systems that sustain essential health services, with diagnostics at the forefront.
Pamba pointed to a recent World Health Organisation (WHO) report that champions locally manufactured, quality-assured diagnostics and medicines to build more resilient supply chains. He noted that WHO, alongside African governments, the Global Fund, and Unitaid, is already supporting high-volume labs and point-of-care testing to boost regional self-reliance.
The Path Forward: Integration and Domestic Investment
Pamba outlined a clear strategy for the continent's next major step: a decisive move towards integrated testing models. This approach would maximize existing laboratory infrastructure by combining tests for HIV, Tuberculosis (TB), Hepatitis, and Human Papillomavirus (HPV) on shared platforms.
He cited South Africa's national laboratory network as a successful case study, where integrated systems allowed for a rapid scale-up of viral load testing through coordinated sample transport and shared high-volume equipment.
The benefits of this model are clear:
- It lowers operational costs.
- It reduces turnaround times for test results.
- It extends reach into primary health centres.
- It improves pandemic preparedness.
- It strengthens the continuity of national care.
This integrated model becomes especially vital as global funding becomes less predictable. "To protect essential services during periods of uncertainty, countries must align infrastructure, workforce and financing," Pamba advised. He highlighted that training and retaining laboratory professionals, alongside embedding diagnostics in national budgets, are key to building long-term resilience.
He called on African governments to adopt domestic financing reforms, including:
- Direct procurement of key diagnostics.
- Strategic reallocation of funds to protect high-impact services.
- Public-private partnerships designed around national health priorities.
These approaches are not meant to replace donor support, Pamba clarified, but to ensure that external contributions "are leveraged rather than depended upon." The future, he emphasized, depends on long-term collaboration between governments, civil society, donors, health workers, and industry.
As African countries prepare for the 2026 International AIDS Conference in Rio, Pamba's message is one of cautious optimism. "Progress is possible even in the most challenging circumstances. We now have an opportunity to safeguard the gains we've made and build systems that will carry Africa into the next generation of health challenges," he concluded.
