For over 20 years, Rwanda has relied on foreign donors to provide free Antiretroviral (ARV) treatment to its population living with HIV, but now, experts believe the reliance should gradually reduce to avoid challenges that may arise in case donors fail.

There are more than 210,000 Rwandan adults living with HIV, and almost all of them are receiving ARV treatment. Key funders of the support include the US President's Emergency Plan for AIDS Relief (PEPFAR), the Global Fund, and the American CDC.

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"Can you imagine (what would happen) if they stopped the funding tomorrow?” asked Francois Xavier Karangwa, Executive Director of the Umbrella of Organisations of Persons with Disabilities in the Fight Against HIV and AIDS (UPHLS).

He pointed out that though the recent USAID funding halt by President Donald Trump’s administration did not affect ARV treatment programs, it should serve as a wake-up call for African nations like Rwanda to prepare for self-sufficiency.

Karangwa said that there is a need for the government, organisations, individuals, and the private sector to engage in work aimed at creating sustainable health funding strategies.

Stopping antiretroviral therapy (ART) for patients can lead to serious consequences, including illness, drug resistance, increased viral load, and death.

Deo Mutambuka, Executive Secretary of Rwanda Networks of People Living with HIV/AIDS (RRP+), said in an interview with The New Times, that if ARVs supply is inconsistent for patients, the country faces threats like drug-resistant strains of HIV, as well as increased viral loads among patients, which may translate into higher HIV transmission.

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"Over-reliance on external donors can be risky. Governments should integrate ARV procurement into national budgets, explore local manufacturing, and strengthen supply chain systems to ensure sustainability,” he noted.

According to the Rwanda Population-Based HIV Impact Assessment (RPHIA), a national survey conducted from October 2018 to March 2019, the prevalence of HIV among adults in Rwanda is 3.0 per cent.

Hind Hassan, the UNAIDS Representative to Rwanda, previously told The New Times that Rwanda should consider manufacturing ARVs since they are a lifelong treatment for patients, yet there is no guarantee that foreign partners will continue providing them to the country forever.

Rwanda is one of the countries that have achieved the UNAIDs’ 95-95-95 targets which aim to ensure that by 2030, 95 per cent of all people living with HIV know their HIV status, 95 per cent of all people diagnosed with HIV receive sustained antiretroviral therapy, and 95 per cent of all people receiving antiretroviral therapy have viral suppression.