The abrupt decision by the US government to halt funding for HIV programs has sent shockwaves through South Africa, with Health Minister Dr. Aaron Motsoaledi calling it a “wake-up call” for the country.
Thank you for reading this post, don't forget to subscribe!Speaking to the BBC, Dr. Motsoaledi acknowledged that the cuts could lead to loss of life but assured that state-funded clinics had been instructed to continue providing life-saving antiretroviral drugs (ARVs). The funding termination, which took effect immediately, has left organizations scrambling to secure alternative support for nearly 900,000 HIV patients.
Kate Rees, from the Anova Health Institute—one of the largest beneficiaries of US funding—described the situation as being “pushed off a cliff” rather than undergoing a planned transition.
The cuts are part of broader cost-saving measures targeting the US President’s Emergency Plan for AIDS Relief (PEPFAR), a program launched in 2003 under President George W. Bush. PEPFAR has been instrumental in providing ARVs to millions globally and is credited with saving over 25 million lives.
Dr. Jean Kaseya, head of the Africa Centres for Disease Control and Prevention (Africa CDC), warned that halting critical health funding could have dire global consequences. “The world is playing with fire,” he cautioned, urging Western nations to reconsider their decisions before a new pandemic emerges.
South Africa, home to the world’s largest ARV program, has been among PEPFAR’s biggest beneficiaries, with the initiative contributing 17% of the country’s HIV/AIDS funding. Organizations reliant on these funds were notified late Wednesday of the immediate termination, forcing them to lay off staff and suspend services overnight.
Dr. Rees lamented the abrupt nature of the decision, noting that there had been plans to gradually reduce donor dependency over the next five years, allowing for a smoother transition to government-run programs.
The Desmond Tutu Health Foundation has projected that the loss of US funding could result in up to 500,000 deaths. Experts also warn that the cuts could set back vital HIV research, including efforts to develop a cure.
The Treatment Action Campaign (TAC), South Africa’s leading HIV/AIDS advocacy group, expressed deep concern that the country could revert to a time when patients struggled to access treatment. TAC Chair Sibongile Tshabalala, who has been living with HIV since 2000, broke down in a press conference, questioning how patients would survive without continued support.
With the immediate loss of PEPFAR funding, TAC has already laid off 101 of its 189 staff members. Programs for HIV testing, tracing, and prevention, including those protecting unborn children from mother-to-child transmission, are among the hardest hit.
South Africa’s history with HIV has been fraught with challenges. In the late 1990s, the epidemic surged, but it was only in 2004—after the government was legally challenged over its “AIDS denialism”—that widespread ARV distribution began.
Dr. Motsoaledi acknowledged the country’s past reliance on donor funding but stressed the need for self-sufficiency. “When PEPFAR started, we accepted the support. But looking back, I believe it was something we should not have allowed to flourish,” he said.
The crisis has reignited fears that progress in the fight against HIV/AIDS could be reversed unless urgent measures are taken to replace lost funding.
