Newly Released 2025 Scorecard Unveils Progress and Setbacks on Health and Gender Equality Across Southern Africa

The Southern African Development Community (SADC) has launched its biennial scorecard, a critical tool that tracks progress on sexual and reproductive health and rights (SRHR) across its 16 Member States. New data, including from demographic health surveys, shows great strides in improving the sexual and reproductive health of people across the region, while in other areas, concerted efforts are urgently needed.

The SADC scorecard offers a regional snapshot of progress towards the implementation of the SADC SRHR Strategy and SRHR targets of the 2030 Sustainable Development Goals (SDGs) on health and gender equality. First developed in 2019, the scorecard serves as a social accountability tool and uses a “traffic light” system to track 20 indicators.

The scorecard highlights improvements in reducing adolescent birth rates and the vertical transmission of HIV, while sounding the alarm on a rise in sexually transmitted infections and the need for investments to further reduce maternal mortality:

Lowered Adolescent Birth Rates: Twelve Member States recorded a decline in adolescent births, which can be attributed to the high roll-out of life-skills HIV and comprehensive sexuality education in primary schools.

Decline in HIV infection rates: The region has seen a decline in new HIV infections, however, the latest scorecard suggests that the rate of reduction in new HIV infections amongst adolescent girls and young women aged 15 – 24 years is slowing in seven countries. This could be partially linked to a rise in sexually transmitted infections (STIs) in half of the countries and a decline in condom use in a majority of countries.

Reduction in Maternal Mortality: Six countries recorded significant reductions in maternal mortality, based on their latest national health data. This can be attributed to the priority given by the region to reduce maternal mortality, which needs to be sustained in order to preserve the gains made.

Strong progress in the decrease in the vertical transmission of HIV: Twelve Member States are on track to meet the SDG target by 2030, five of whom already achieved the milestone in 2025. Despite this success, children and adolescent girls and young women are lagging behind in receiving HIV services.

In addition to the abovementioned gains, the scorecard also identified areas where concerted efforts are needed:

Family Planning: Eight Member States are not meeting the contraceptive needs of women. Investing in the contraceptive needs of women and adolescent girls can further reduce teen pregnancies and preventable maternal deaths, and ensure their contribution to their country’s economic growth and development.

Gender-Based Violence: Sexual and intimate partner violence remains persistently high across all Member States in the SADC region. Though all countries have made progress in putting in place relevant laws and policies, greater investments are required to ensure their implementation, including the integration of SRHR, HIV and GBV services, so that all survivors are able to ensure their health and well-being.

Domestic financing: No SADC country has met the ‘Abuja Declaration’ target of allocating 15% of their national budgets to health. Four countries have allocated more than 10% of their national budget to health. Countries need to accelerate domestic funding given declining donor investments if progress is to be made in achieving Universal Health Coverage, and to reduce out of pocket expenditures for citizens.

“The true power of this 3rd Milestone Scorecard lies not merely in what it measures, but in the action it demands from us. With only five years to 2030, we must move with urgency, we need to accelerate implementation, scaling what works, and we need to support our commitments with bold, measurable, and accountable actions,” said Dr Aaron Motsoaledi, Minister of Health, Republic of South Africa.

“Investing in sexual and reproductive health and rights (SRHR) is no longer just a public health issue; it is a fundamental economic imperative. Research has shown us that every dollar invested in family planning, particularly among the youthful population, can yield up to $100 in long-term economic benefits, yet our chronic underfunding and reliance on external aid actively sacrifices our demographic dividend. Political leadership must translate into urgent, domestic financial mobilization that meets the 15% Abuja target. Our greatest challenge is the paralysis between policy commitment and real-world execution. The SADC scorecard and mid-term review of the SADC SRHR strategy reinforces that Member States need to reform restrictive national laws, enforce gender-based violence and child marriage legislation, and fully integrate SRHR into climate adaptation plans to build truly resilient, rights-based health systems,” reaffirms H.E. Mr. Elias Mpedi Magosi, Executive Secretary of the Southern African Development Community (SADC).

Since 2018, the joint United Nations Regional Programme, 2gether 4 SRHR, composed of UNAIDS, UNFPA, UNICEF and WHO, has supported SADC to develop, implement and monitor the SADC SRHR strategy and its scorecard, with funding from the Government of Sweden.

“The leadership of the SADC Ministers of Health and the Secretariat, guided by the SADC SRHR Strategy, is demonstrating tangible results: reduced adolescent birth rates, fewer maternal deaths, and decreased rates of HIV. These must be celebrated and safeguarded. However, the 2025 scorecard is a stark reminder that these gains are fragile. Without continued commitment and increased domestic investments, these gains risk being undone. As a long standing partner to SADC, the 2gether 4 SRHR programme remains committed to using the scorecard findings and working with Governments in areas where the region and countries are lagging behind.

Collectively, we must do better to ensure that all people can exercise their sexual and reproductive health and rights and that young people can achieve their full potential, so that everyone can contribute to the economic and social development of the region,” highlights Lydia Zigomo, UNFPA Regional Director for East and Southern Africa, on behalf of the Regional Directors of the 2gether 4 SRHR programme.

“Despite our successes, we now risk a two-speed region where gaps in family planning, HIV prevention, and gender equality strand 94 million adolescents without the wellbeing they need to drive the economic and social development of SADC. To avoid this, all Member States must invest urgently and in sustained ways in adolescent SRHR as a foundation for all SRHR,” concludes Jonathan Gunthorp, Executive Director, SRHR Africa Trust.

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Africa Fact: Many southern Africans have indigenous and pre-colonial words for ‘gun’. Scholars have generally been reluctant to investigate or explain this fact.