OPINION PIECE
By the Chairperson of the GPL TB Caucus:
Dr Bandile Masuku7 August 2026
ENDING HIV AND TB BY 2030: THE TIME FOR INTEGRATION, INNOVATION AND LEADERSHIP IS NOW
The 26th International AIDS Conference in Rio de Janeiro brought together more than 7,000 delegates from across the world at a defining moment in the global response to HIV and AIDS. Against the backdrop of declining international funding and growing uncertainty about future support, one question dominated discussions: can the world still achieve the goal of ending AIDS as a public health threat by 2030?
The answer emerging from Rio was clear. Ending AIDS as a public health threat by 2030 remains achievable, but only if countries act decisively, invest strategically and place prevention, integration and equity at the centre of their responses.
For the Gauteng Provincial Legislature’s TB Caucus, which participated in the conference from 26 to 31 July 2026, the message was equally clear: the fight against HIV cannot be separated from the fight against tuberculosis. If we are serious about ending AIDS as public health threat by 2030, we must be equally serious about ending TB.
One of the strongest themes throughout the conference was that prevention must become the cornerstone of the HIV response. Scientific innovation has provided highly effective prevention tools, including Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), condoms and groundbreaking long-acting options such as Lenacapavir. These innovations have the potential to dramatically reduce new HIV infections, but only if they are made accessible, affordable and integrated into routine health services.
Delegates also emphasised that scientific advances alone will not end the epidemic. Policy remains one of the most powerful levers for achieving equity and improving health outcomes. Discussions on health, justice and human rights highlighted the need for legal and policy frameworks that protect human dignity, equality, privacy and access to evidence-based healthcare. The conference warned against punitive approaches, including HIV criminalisation, which continue to undermine public health goals by increasing stigma and discouraging testing and treatment.
Migration emerged as another critical issue. Large-scale population movements, including the displacement of millions of Venezuelans and people affected by global conflicts, are reshaping the HIV landscape. Presenters stressed that migration itself does not cause HIV transmission; rather, poverty, instability, interrupted healthcare, legal insecurity and discrimination increase vulnerability and disrupt continuity of care. The lesson was clear: policy determines whether migration becomes a pathway to exclusion or to inclusion. Health systems must be designed to follow people, rather than expecting people to navigate fragmented systems.
The conference also highlighted the growing importance of caring for an ageing population living with HIV. Thanks to successful antiretroviral therapy, people are living longer, healthier lives. However, HIV is increasingly associated with conditions such as diabetes, hypertension, cardiovascular disease, kidney disease and frailty. The concept that resonated throughout the conference was simple but powerful: “One Person, One Coordinated Clinical Plan.” Healthcare systems must move away from treating diseases in isolation and instead provide integrated, person-centred care.
“One Person, One Coordinated Clinical Plan.”
This message has profound implications for South Africa. Despite significant progress against HIV, tuberculosis remains the leading cause of death among people living with HIV. The conference repeatedly emphasised that the era of disease-specific silos must come to an end. People should not have to navigate separate systems for HIV, TB, diabetes, hypertension and mental health services. Integrated care is not only more efficient; it leads to better health outcomes.
Every person living with HIV should be routinely screened for TB, while every person receiving TB services should have access to HIV testing, prevention and treatment. Clinics must become centres of comprehensive care where multiple health needs are addressed during a single patient encounter. This approach is especially important as South Africa faces a dual burden of infectious diseases and growing rates of non-communicable diseases.
Rio reinforced the importance of strengthening TB prevention alongside HIV prevention. Greater investment is therefore needed in TB preventive therapy, early case finding, contact tracing, community-based screening and adherence support. Every missed opportunity to prevent TB among people living with HIV represents a missed opportunity to save lives.
Technology and artificial intelligence also featured prominently in discussions. AI is already being used to support treatment adherence, identify patients at risk of interrupting care, improve communication with patients, forecast medicine stock levels and strengthen disease surveillance. However, delegates stressed that technology must support healthcare workers rather than replace them and must be guided by principles of equity, privacy, trust and community participation.
For Gauteng, these lessons are particularly relevant. Effective oversight must ensure that limited health resources are directed towards interventions with the greatest impact. We must accelerate the integration of HIV and TB services, embrace innovation, strengthen prevention programmes and ensure that no one is left behind because of poverty, migration status or geography.
The overarching message from AIDS 2026 was one of cautious optimism. The world possesses the scientific knowledge, tools and experience required to end both HIV and TB as public health threats. What is required now is political leadership, smart policy and sustained commitment.
As Chairperson of the Gauteng Provincial Legislature’s TB Caucus, I return from Rio convinced that ending HIV and TB by 2030 is still within reach. Achieving this goal, however, will require us to break down silos, strengthen integrated care, invest in prevention, embrace innovation and place people at the centre of our health system.
The future will not be determined by shrinking budgets alone, as the world Rethinks, Rebuilds, and Rises. It will be determined by the choices we make today. If we choose integration over fragmentation, prevention over complacency, and leadership over hesitation, then ending HIV and TB by 2030 can become a reality.
GAUTENG PROVINCIAL LEGISLATURE
