Innovating for HIV Impact: The South African HIV Innovations Accelerator

South Africa has the largest HIV burden globally, with an estimated 7.2 million people living with HIV (PLHIV), and a projected increase to 7.5 million PLHIV by 2020. Approximately 82% of this HIV burden is in 27 of the country’s 52 districts, and about 31% is in the four biggest metropolitan areas. While South Africa has the largest HIV treatment program in the world, with more than 4 million on antiretroviral therapy (ART), in February 2018 the President of South Africa announced a bold plan to put an additional 2 million people on ART by 2020. This major investment to accelerate epidemic control sits in the context of continued high rates of HIV infection, especially among adolescent girls and young women, and substantial challenges to HIV-related health service delivery. In addition, demand for HIV services is weak, with reluctance among PLHIV to get and stay on ART, despite the fact that ART prevents HIV-related illness and HIV transmission. The legacy of apartheid and significant income inequality pose additional challenges to the HIV response, compounded by gaps in service delivery and strategic information in the public sector. Moreover, the national HIV response is complicated by complacency and a need for new approaches to generate sustained individual and organizational engagement throughout the country. Through the South African HIV Innovations Accelerator, USAID, together with its partners PEPFAR-South Africa and the South Africa National Department of Health (NDoH), seeks to catalyze the development of innovative approaches and technologies that will enable South Africa to mitigate the spread and impact of HIV and ultimately reach HIV epidemic control. Promising solution concepts will leapfrog current approaches in an effort to fill critical gaps in the response and make rapid progress towards epidemic control. Through this Addendum, USAID and its partners will support the further development/refinement, adaptation, testing, introduction, and/or scale-up of innovative solutions that will improve our ability to reach HIV epidemic control in South Africa. Solutions should address a clearly articulated gap related to initiating and maintaining an additional 2 million people on ART in South Africa.