Abstract

West Africa has made considerable progress in national HIV/AIDS policy and program implementation over the 
past decade, including alignment with global 95-95-95 targets, expanded antiretroviral therapy (ART) access, and 
enhanced prevention services for pregnant women and children. Despite these achievements, progress remains 
uneven, with persistent gaps in sustainable domestic financing, donor dependency, legal and human-rights barriers 
affecting key populations, weak data and surveillance systems, under-resourced primary care and community 
platforms, and insufficient youth-centered interventions. This review synthesizes national strategic plans, UNAIDS 
reports, donor assessments, and recent literature to evaluate policy progress, identify recurring gaps, and provide 
actionable recommendations. Key strategies include reducing donor dependence through sustainable financing, legal 
reform to remove punitive barriers, scaling services for adolescents and key populations, strengthening public-health 
data systems, and integrating HIV services into broader health systems. Institutionalized community engagement 
is emphasized to ensure accountability and equitable service delivery, ultimately supporting resilient and inclusive 
HIV responses across West Africa.