The SKPA-1 Program was an eight-country initiative to scale up and promote HIV prevention services for communities most affected by HIV, with an aim to stop HIV transmission and AIDS-related deaths by 2030.

• Funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria, the SKPA Program was a three-year project that works with gay and bisexual men, transgender people, people living with HIV, sex workers and people who inject drugs in Bhutan, Lao PDR, Malaysia, Mongolia, Papua New Guinea, the Philippines, Sri Lanka and Timor-Leste. While different social and political contexts exist across these countries, rapid economic growth in recent years is shifting these countries towards middle-income status, reducing their eligibility for international development funding. Middle-income countries are expected to fully fund health and HIV programs domestically. However, funding key populations who bear the greatest burden of HIV is a contentious issue, as gay and bisexual men, transgender people, sex workers and people who inject drugs are still highly stigmatised in these countries.

• As a result of political sensitivities, domestic government spending on these communities are minimal, with international donors funding most of the programs for these populations. As HIV is becoming increasingly reliant on domestic investment, the question becomes: will investment in key populations and their programs, which have been shown to be most effective and value for money, be reversed?

  The SKPA Program aimed to sustain the investment gains in these countries, by working with governments and key population communities to increase the financial sustainability of community focused programs, to strengthen the use of up-to-date information to inform programmatic design, bridge HIV service delivery gaps, and work on strengthening systems that support community ownership and action.