Recent cuts in funding have led to significant adjustments in health services across low- and middle-income countries. In this series of articles called “Voices from the Frontline” launched on World Health Day, we talk to those on the ground about the implications in country and sharing our partners perceptions. Our first article features Maureen Luba from Malawi, a dedicated public health specialist and MPP board member representing civil society.

A Story of dedication and advocacy

Maureen Luba’s journey in global health spans 15 years, during which she has worked tirelessly to ensure that health programs and policies are grounded in the needs of the most affected communities. As a Senior Advisor for Global Policy at AVAC, Maureen focuses on strengthening meaningful engagement  between civil society, communities, and global health stakeholders (researchers, regulatory bodies, funders, policymakers) to inform policy, program and funding decisions.

“I am a Malawian public health specialist, a wife, and a mother. My work involves advocating for policy and program improvements with government, funders, and implementing partners,” Maureen shares. Her commitment to public health is evident in her efforts to improve HIV prevention and treatment services in Malawi and beyond.

Maureen emphasises the importance of community involvement in health initiatives. “Dr. Mark Hyman once said: the power of community to create health is far greater than any physician, clinic, or hospital,” she says. As a CSO representative on the MPP Board, Maureen is proud to contribute to shaping the organisation’s strategy and priorities, ensuring that the voices of affected communities are represented and valued.

Achievements and challenges

In December 2024, Malawi was on track to achieving epidemic control, having met all the UNAIDS 95:95:95 targets . However, the funding gap has introduced significant challenges. “The cessation of international funding has had a devastating impact across many countries supported by the US; in Malawi the cessation of funding significantly reduced human resource capacity, disrupting service delivery across public health facilities. In response the government swiftly implemented HRH redeployment to ensure the continuation of HIV services. However, despite these efforts, challenges still remain. We are also hearing reports indicating that people living with HIV are facing difficulties accessing essential HIV services,” Maureen explains.

Almost immediately across the African continent clinics have closed, and healthcare workers have been laid off, resulting in severe staffing shortages. Outreach services for key, vulnerable, and hard-to-reach populations have been halted, leading to overcrowded ART clinics and reduced time for patient care. “People are anxious and are scared that they may not have continued access to their medication in the coming months,” Maureen notes.

A Call to action

Maureen calls on governments, international organisations, the private sector, philanthropists and donor countries to step up and fill the funding gap. “We definitely need more funding to fill in the gap. We need more funding for human resources, and continued supply of medication and commodities so that all HIV services including HIV prevention can resume and continue,” she urges.

Without renewed funding and support, Maureen warns of dire consequences. “We will witness a catastrophe. With the disruption in the provision of HIV prevention and treatment services in some countries, we should expect an increase in new HIV infections. Ensuring that ART services continue will be key as people with an undetectable viral load due to continued access to treatment, not only live health productive lives, but they also cannot pass on the infection. This should be complemented by continued access to primary HIV prevention services to ensure a balanced response” she stresses.

Maureen believes that raising awareness about the importance of continued funding for HIV programs is crucial. “We need more voices from the global community to weigh in on why continued funding for HIV is important. Diseases and infections know no borders,” she reminds us.

The Role of local communities and the Government

Local communities and grassroots organisations play a vital role in addressing the challenges posed by the funding changes. “They have the local perspective of the situation on the ground. Since the end of January, they have continued their outreach, gathering hard facts and sharing it with relevant stakeholders,” Maureen highlights.

According to a report from UNAIDS dated 10 February 2025, the Government of Malawi has ensured continuity of treatment in Malawi. The report mentions that there has been minimal disruption to HIV services in Malawi. People living with HIV are currently receiving the necessary services, and those who visit facilities that have recently closed are being referred to open government services. In response to advocacy from UNAIDS, the government issued a press release assuring the public that HIV services will continue uninterrupted. UNAIDS is collaborating with international partners to seek support for these essential services.

“With many non-governmental organisations releasing staff, surrendering the maintenance of equipment, and closing in country programs across Africa, we urgently need to work with governments, international partners and donors so we do not see the 95-95-95 targets that Malawi has achieved lost.”

MPP was founded by Unitaid in 2010 to ensure affordable access to quality affordable HIV treatments. At the end of 2024, over 24 million people had access to high quality affordable versions of the WHO recommended treatments for HIV through MPP’s licences. This article serves as a powerful reminder that access to treatments relies on services and continued support and funding for global health initiatives. Stay tuned for more voices from MPP stakeholders in our upcoming articles from our Voices from the Frontline series.