The Future of the U.S.–South Africa HIV/AIDS Partnership
Trip Report of the CSIS Delegation to South Africa, January 2013
South Africa has the highest burden of HIV/AIDS in the world, with 5.6 million people living with the virus and over 400,000 newly infected annually. Since 2004, the U.S. government has committed more than $4 billion to combating HIV/AIDS in South Africa—the largest U.S. investment in HIV/AIDS worldwide. Continued progress in controlling HIV/AIDS in South Africa, the epicenter of the pandemic, is pivotal to sustained progress against the disease worldwide.
Over the past three years, a joint U.S.–South Africa effort has been underway to transition responsibility for HIV/AIDS programming and policies to the South African government. The South African and U.S. governments negotiated a Partnership Framework outlining the broad terms of this transition; the agreement was signed in October 2010 by then-Secretary of State Clinton and her South African counterpart Maite Nkoana-Mashabane. Through this process, the United States has begun to move from a lead role in the provision of lifesaving services to an approach focused increasingly on technical support. The fast-evolving partnership is among the most important dimensions of the United States’ bilateral relationship with South Africa. A successful U.S.–South Africa transition will bolster confidence in the U.S. Congress in U.S. funding for HIV/AIDS, as well as inform U.S. approaches during similar transitions with other partner governments in the future.