Malawi is a low-income country making significant strides in preventing new HIV infections and HIV-related deaths. Despite these efforts, it is estimated that there were 1 million people living with HIV in Malawi in 2019, with HIV remaining the leading cause of death in the country. However, sustainability of funding for the HIV response is under threat, with donor contributions declining worldwide. Since more than 97% of the HIV program in Malawi is funded by donor financing, it is essential that funds be allocated most efficiently, where they can make the greatest impact.

This report outlines findings from an HIV modeling analysis conducted for Malawi by the country team, the Global Fund to Fight AIDS, Tuberculosis and Malaria, the Clinton Health Access Initiative (CHAI), and the Optima Consortium for Decision Science. For this analysis, the Optima HIV model was applied to estimate the optimized resource allocation to improve the response to the HIV epidemic in Malawi. The aim of this analysis is to inform the 2020-2025 National Strategic Program (NSP) and the 2020 Global Fund funding request. The primary focus of Malawi’s 2020-2025 NSP is to end the HIV epidemic in the country by 2030. Recommendations from a previous Optima HIV modeling analysis conducted for Malawi in 2017 included scale-up of treatment and HIV testing for the general population, including a district-level analysis recommending allocation of funding to ‘hotspots’ to increase impact.