Cape Town — US President Donald Trump’s decision to halt the President’s Emergency Plan for Aids Relief (PEPFAR) has raised serious concerns about the future of HIV/Aids treatment in South Africa.
Trump issued an executive order to cut foreign funding for clinics and hospitals in low-income countries. South Africa, which has received more than R8 billion through PEPFAR to combat HIV/Aids, now faces significant challenges, The Citizen reported.
The Treatment Action Campaign’s Anele Yawa warned that the move could lead to a surge in new HIV infections and worsen the global Aids crisis, as clinics already face a critical shortage of healthcare workers.
“It means our clinics will be congested as people previously relying on external pickup points, like pharmacies in malls, return to clinics. This will strain an already overburdened health care system,” he said.
South Africa currently has 5.8 million people living with HIV, with 1.1 million disengaged from treatment. The country relies on PEPFAR for 20% of its HIV budget, while other low-income nations depend on it almost entirely.
According to Daily Maverick, a Gauteng-based health worker was informed this week not to report for duty, as she and her colleagues were no longer permitted to perform their roles. “I never thought I’d be told not to come to work,” she said.
When @RediTlhabi made a case for the continued funding of PEPFAR. She was vilified!!!
Today, Trump has ordered a funding stoppage. South Africa is high on the list of countries affected.
Where are all those fools now? It is time they donate from their pockets! pic.twitter.com/nvY3Di1nLM
— Victor Nwaneri🇿🇦🇺🇸🇳🇬🇧🇯 (@vnwaneri) January 28, 2025
Several health programmes have been suspended due to the stop-work orders, including the Wits Reproductive Health and HIV Institute’s (RHI) Key Populations Programme and Engage Men’s Health in Johannesburg.
South Africa has the largest PEPFAR portfolio in the world. For the US financial year spanning October 2024 to September 2025, the country received approximately $440 million from the programme.
During a media briefing, South African Minister of Health Dr Aaron Motsoaledi highlighted the country’s long-standing fight against malaria and HIV, noting that South Africa runs the world’s largest HIV counselling and testing campaigns.
Although PEPFAR funds only 17% of South Africa’s R44.4 billion HIV/Aids budget, Motsoaledi acknowledged that the funding cuts would still have a significant impact.
“The rest comes mostly from our own fiscus and other donors like the Global Fund. But where will we be affected? PEPFAR supports 27 of our 52 districts—these are the hardest-hit areas in the country,” he said.
The minister outlined the provinces most affected by the cuts, including:
- Eastern Cape (five districts)
- Free State (two districts)
- Gauteng (four districts)
- KwaZulu-Natal (seven districts, the most affected province)
- Limpopo (two districts)
- Mpumalanga (three districts)
- North West (three districts)
- Western Cape (one district)
Motsoaledi said that the health department was still assessing the full extent of the challenges it now faces.
[WATCH] ANC NEC Member and Minister of Health, Dr Aaron Motsoaledi, responds to Trump’s stop order on USAID funding.
HIV counselling and testing campaign in South Africa has a total investment of R44.4 billion. Of this, 17% is funded by PEPFAR, a program supported by the USA.… pic.twitter.com/I72DANlW5i
— African National Congress (@MYANC) January 28, 2025
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Compiled by Matthew Petersen
