AMID donor funding cuts by US President Donald Trump, Finance Minister Enoch Godongwana has been urged by the Western Cape government to provide a clear and credible path for provinces to navigate South Africa’s fiscal pressures when tabling his budget speech.

Western Cape finance MEC, Deidré Baartman said provinces were facing growing service delivery demands in the face of cuts to donor funding, a national revenue shortfall and rising government debt.

“We can, and must, maintain fiscal consolidation while supporting the increasing demand for social services. Now is not the time to desert our core services of education, health, and social development,” Baartman said.

Western Cape Premier Alan Winde said while the Western Cape Government recognised that there was very little room for Godongwana to manoeuvre, he still needed to assure the residents of the province and country that repeated commitments to fast-tracking economic reforms are being implemented.

“A key priority remains further enabling infrastructure development and structural reforms to the country’s logistics sector, desperately needed to fuel economic growth and job creation.”

Winde also said the USAID/PEPFAR funding freeze will place added pressure on programmes in health, social development, education and economic development.

“Failure to address the vacuum left by the funding freeze will hit countless vulnerable South Africans hard. While the WCG (Western Cape Government) welcomes the measures announced by the National Department of Health to mitigate the impact of the funding freeze, clarity is still needed around the uncertainties regarding the long-term financial sustainability of these initiatives,” he said.

But economist Azar Jammine said donor funding was not a huge problem as it amounted to about R7 billion.

“It sounds lot bigger in the scheme of things. It is not huge.”

He speculated that the government may want to make up for the shortfall in donor funding from the US by reallocating funding from other programmes.

Godongwana will table his budget speech as the Department of Health director-general Sandile Buthelezi recently issued guidelines to the provincial heads of departments’ directors of health services, CEOs of public health facilities and stakeholders on the provision of uninterrupted HIV services across all health facilities.

The guidelines tackle reducing visits to clinics and alleviating the burden on health facilities.

Buthelezi said in his memorandum, trained staff should be redeployed to fill the gap left by PEPFAR-funded personnel to ensure critical services were not disrupted.

He said there should be leveraging of enrolled nurses, nursing assistants, clinical associates, allied health professionals and community health workers to assume responsibilities previously managed by PEPFAR-supported staff.

Buthelezi stated that there should be prioritisation of three-month anti-retroviral treatment dispensing for all ART clients and HIV self-testing and three months PreP dispensation for all PreP clients.

“This includes children older than six months, re-engaging clients with elevated viral loads and post-natal women.”

Buthelezi said the department was in ongoing communication with PEPFAR-funded South African implementing partners to ensure the immediate continuation of the life-saving services.

“While redeployment of Department of Health staff is necessary at this time, this may change in the very near future should the implementing partners resume services covered by the waiver.

“However, the priorities emphasised in this circular remain critical for both the Department of Health and implementing partner operations to prepare and shield the HIV programme from potential risks should the US foreign assistance review process result in further cuts to PEPFAR funding.”

DA deputy spokesperson on health Karl le Roux said his party was pleased to see that Buthelezi has released clear guidance on how health facilities should continue to provide uninterrupted HIV services.

“Many of these measures will ensure that patients need to visit facilities less often, will help decongest clinics and hospitals, and should be kept in place even if PEPFAR-funded healthcare workers are re-instated in the future,” Le Roux said.

He said the suspension of more than 15,000 jobs in the health care space was a grave concern in a country that is already struggling with significant unemployment of healthcare workers, including doctors.

“Despite ideological and policy differences within the GNU, the DA, alongside our coalition partners, is dedicated to upholding a robust and mutually beneficial partnership with the Trump administration.

“We remain willing and eager to engage with American policymakers to provide clarity on South Africa’s current political context and to advocate for the continuation of vital aid and trade agreements.”

Le Roux urged the department to continue engaging with the American government to ensure that the services were reinstated.

mayibongwe.maqhina@inl.co.za