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Through the President’s Emergency Plan for AIDS Relief (PEPFAR) Country Operational Plan 2023 (COP23), the United States (US) government will support the Government of South Africa (GoSA) toward the shared goal of ending HIV as a public health threat by 2030. PEPFAR South Africa (PEPFARSA) is centering COP23 on the GoSA’s vision and strategy for achieving this goal. While PEFPAR SA has long strived to align with the GoSA’s policies, guidelines, and goals, the COP23 commitment to follow the GoSA’s lead on the epidemic response is a major paradigm shift and will ensure a clear, aligned, country-led HIV response.