The Southern African Development Community has released its 2025 sexual and reproductive health scorecard, showing both progress and ongoing challenges across the region.
The report, launched in Johannesburg on Tuesday, tracks how 16 member states are performing on key health and gender equality targets linked to the Sustainable Development Goals. It uses a traffic light system to measure progress on 20 indicators, including HIV infections, maternal health and access to family planning.
The scorecard shows that several countries have made gains in improving health outcomes, particularly among young people. Twelve countries recorded a drop in adolescent birth rates, which has been linked to increased access to life skills programmes, HIV education and comprehensive sexuality education in schools.
There has also been a decline in new HIV infections across the region. However, the pace of improvement is slowing among adolescent girls and young women aged between 15 and 24 in at least seven countries. The report links this to a rise in sexually transmitted infections and a decline in condom use in many parts of the region.
Progress has also been recorded in reducing maternal deaths. Six countries reported significant improvements based on recent national data. At the same time, the region has made strong gains in preventing the transmission of HIV from mothers to their children. Twelve countries are on track to meet global targets by 2030, with five already reaching that milestone in 2025.
Despite these improvements, the report highlights serious gaps that still need urgent attention.
Access to family planning remains uneven, with eight countries failing to meet the contraceptive needs of women and girls. The report warns that this could lead to higher rates of teenage pregnancy and preventable maternal deaths if not addressed.
Gender based violence remains widespread across all member states. While most countries have introduced laws and policies to address the issue, implementation remains weak. The report calls for stronger investment in services that support survivors, including better integration of health, HIV and gender based violence programmes.
Another major concern is funding. No country in the region has met the Abuja Declaration target of allocating 15 percent of national budgets to health. Only four countries have exceeded 10 percent. The report warns that declining donor funding makes it more urgent for governments to increase domestic spending to sustain progress and reduce the financial burden on citizens.
South Africa’s Health Minister, Aaron Motsoaledi, said the findings should push countries to act faster.
“The true power of this scorecard lies not only in what it measures, but in the action it demands. With only five years to 2030, we must accelerate implementation and support our commitments with measurable actions,” he said.
SADC Executive Secretary Elias Mpedi Magosi said investing in sexual and reproductive health is critical for economic growth. He warned that continued underfunding and reliance on external aid could undermine the region’s future.
United Nations partners, including UNFPA, said while progress should be recognised, it remains fragile. They warned that without sustained investment, gains in reducing HIV infections, maternal deaths and teenage pregnancies could be reversed.
Experts also raised concerns about the risk of growing inequality across the region. With millions of young people still lacking access to essential health services, there are fears of a widening gap between countries that are improving and those falling behind.
The report concludes that urgent and coordinated action is needed to strengthen health systems, expand access to services and ensure that all people, especially young women and girls, can access the care they need.
