District councils across Malawi are facing serious funding gaps that are weakening the fight against HIV, with much of the national response still heavily dependent on donor support.
While Malawi has made policy commitments to strengthen domestic financing for HIV and AIDS, implementation at district level remains limited. Government policy recommends that at least 2 percent of the Other Recurrent Transactions (ORT) budget should be allocated to HIV and AIDS response. However, many councils are allocating far less, leaving prevention and community outreach activities underfunded.
Speaking during a District AIDS Coordinating Committee (DACC) meeting held Thursday in Mzuzu, Alex Kaomba, Programmes Manager for Community Health Rights Advocacy (CHeRA), said the financing gap is undermining progress, particularly in prevention.
“District councils are receiving limited resources, and in many cases HIV programming is not prioritized within their ORT allocations,” said Kaomba. “Yet we have a clear policy recommendation that 2 percent of ORT should go towards HIV and AIDS response. The challenge is implementation and accountability.”
Malawi’s HIV response has for years been largely sustained by international partners such as the Global Fund and PEPFAR. While donor support has been critical, stakeholders warn that overreliance on external funding makes the response vulnerable to global funding shifts and policy changes.
“Our national HIV and AIDS response has largely been left to donors,” Kaomba said. “As a country, we need to begin strengthening domestic financing mechanisms, especially at district level where services are delivered.”
CHeRA is currently implementing the Bridging the Gap: Community Power for Equitable Access to Long-Acting HIV Prevention in Malawi project, which focuses on strengthening community-led advocacy and accountability in HIV prevention. The initiative aims to ensure equitable, stigma-free, and sustainable access to new prevention tools such as long-acting PrEP.
As part of the project, CHeRA is building the capacity of community structures and civil society organizations to monitor service delivery and hold duty bearers accountable for budget commitments and policy implementation.
“We believe communities must have the knowledge and tools to engage their councils and demand transparency,” Kaomba explained. “Accountability is not about confrontation; it is about ensuring that policies are translated into real services on the ground.”
More than 40 civil society organizations in Mzimba have welcomed the initiative, describing it as timely given persistent prevention gaps and funding constraints. CHeRA is also an active member of the District AIDS Coordinating Committee, where it engages local authorities and partners on strengthening coordination and oversight.
Through community monitoring mechanisms and advocacy platforms, the project seeks to amplify community voices in district and national HIV planning processes. It also promotes the integration of HIV prevention with sexual and reproductive health and mental health services.
Kaomba emphasized that sustainable progress in HIV prevention will require stronger collaboration between councils, civil society, and national institutions.
“If we are serious about ending new HIV infections, district councils must play their part,” he said. “Domestic resources, even if modest, signal ownership and sustainability. Communities are ready to engage, and we are working to ensure their voices are heard.”
As Malawi continues rolling out long-acting HIV prevention options, stakeholders say bridging the gap between policy commitments and district-level implementation will be critical to achieving lasting impact.
