COVID-19 shone a harsh light on global health inequities. Africa was last in the queue for all the lifesaving tools needed to defeat the new virus, including vaccines, tests, oxygen and personal protective equipment. Yet this is not a new phenomenon. It was several years after antiretroviral drugs (ARVs) for HIV became widely available in high-income countries that the Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) were created to ensure broader access to these lifesaving medicines in Africa.