Political leaders’ comprehension and responsiveness to HIV/Aids are pivotal for local, national and global initiative success. This qualitative study scrutinised the responses to the epidemic of members of the Northern Cape Provincial Council on Aids. A response sample from 12 council representatives was analysed, revealing gaps in responses stemming from the absence of district and local Aids councils after the November 2021 local government elections.

The study aimed to address challenges hindering progress towards the UNAIDS 2030 targets. The data analysis revealed participants’ awareness of HIV/Aids prevention and of their roles in the Provincial Council on Aids. Municipal integrated development plans (IDPs) however lacked HIV/Aids programmes, indicating systemic issues. Non-operational district and local Aids councils exacerbated the problem, reflecting varied municipal responses and understanding of their roles in combatting HIV/Aids, tuberculosis and sexually transmitted infections.

The Northern Cape faced significant challenges, including low testing rates and prevalent factors like substance abuse, TB, stigma, urbanisation and poverty. Effective responses required political will, civil society involvement, multisectoral collaboration and alignment of policies with actions.