In early 2025, the global HIV response entered crisis mode when abrupt funding cuts from international donors sent shockwaves through countries heavily affected by HIV. Clinics closed their doors. Health workers were sent home. Community programmes that had been lifelines for millions were forced to shut down. The funding that had sustained the HIV response for decades vanished almost overnight. For people living with HIV, this was not an abstract policy shift, it was personal. It meant missed appointments, medications running out, and the fear of falling through the cracks of health systems already stretched thin.
Countries began integrating HIV services into primary healthcare as a path to sustainability. But what does integration mean when the money disappears? When the community organizations that knew how to reach marginalized populations got defunded? When health workers trained in HIV care were let go?
In November 2025, GNP+ conducted in-depth interviews with national people living with HIV network leaders in Nigeria, Kenya, Indonesia, Ghana, Zimbabwe, and Eswatini—countries at different stages of integration, each navigating the funding shifts in their own context.
These case studies show what integration actually looks like on the ground: the innovations, the struggles, and the gaps between policy and practice. In some places, integration is opening doors; in others, it’s closing them. This document curates what the community is seeing, what it needs, and what must change if integration is to work.
