A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it also showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.

A historic funding crisis is threatening to unravel decades of progress unless countries can make radical shifts to HIV programming and funding. The report highlights the impact that the sudden, large-scale funding cuts from international donors are having on countries most affected by HIV. Yet it also showcases some inspiring examples of resilience, with countries and communities stepping up in the face of adversity to protect the gains made and drive the HIV response forward.

UNAIDS uses ‘cost of inaction’ as an indicator of the negative impact on the lives of people and communities of not investing resources to end AIDS. This issue is particularly significant with regard to the provision of sexual and reproductive health and rights (SRHR) and HIV services for young people in eastern and southern Africa.

The cost of inaction for young people is especially significant as the impact extends through most of their life. This report explores the costs of inaction in not realising the SRHR needs of young people in South Africa and Zimbabwe, focusing on costs related to: 1) adolescent pregnancies, 2) HIV acquisition and 3) gender-based violation.

Using a cost of inaction approach, this report calculates the current cost of the inadequate provision of SRHR and HIV services to young people aged 15–24 years old in the two countries. This provides a foundation for alternative policies to be costed to address these gaps and a true cost–benefit analysis to be conducted.