What comes next for SA organisations after Pepfar funding cut

It is difficult to know the scope of the gaps caused by the cancellation of funding to Pepfar-funded HIV organisations, but going forward, it will mean the involvement of the Department of Health.

This is according to Desmond Tutu Health Foundation's CEO, Linda-Gail Bekker, who provided insights into what comes next for organisations affected by the Pepfar funding cut.

Pepfar-funded HIV organisations receiving grants from the United States Agency for International Development, USAID, received letters on Thursday alerting them that their grants have been terminated.

Pepfar, the US President’s Emergency Plan for Aids Relief, saves lives, prevents millions of HIV infections, and supports several countries to achieve HIV epidemic control—all while significantly strengthening global security.

Since Pepfar’s inception in 2003, the US government has invested over $100 billion in the global HIV/AIDS response, saving over 25 million lives, preventing millions of HIV infections, and supporting several countries to achieve HIV epidemic control, all while significantly strengthening global health and economic security.

Bekker said the termination order delivered a major blow to the country’s HIV response. She explained that some of the work done by Pepfar includes supporting health systems, looking for individuals who haven’t yet been tested, and been linked to ARV care.

She added that some of the support has also gone to data-collection, data management, and “other ways that the health system has been strengthened to cope with having the largest HIV treatment programme in the world, and the biggest HIV epidemic of any country in the world”.

“The situation is that the USAID funded work, Pepfar, has been terminated across the region, and this definitely does have potential impact on delivery of treatment, care and prevention for HIV in South Africa.

“The Pepfar funding makes up about 18% of the HIV response in South Africa, and the global fund of course contributes to that,” Bekker said.

“We don’t yet have a full understanding of what the gaps would be, but this is an important time for rapid assessment in collaboration with the department of health, really to understand what those gaps would be, and how we can in the short-term can fill them, and then in the long term, make sure that our response remains on track, as we have been doing, to reach some UNAIDS goal by 2030.”

Department of Health spokesperson, Foster Mohale, said: “The Department of Health will this week conduct stakeholder engagement or consultation with the affected NGOs to discuss how to mitigate the impact of funding cuts as part of the process to find a long lasting solution.”

At Cape Town Pride Mardi Gras and Parade on Saturday, Minister of Forestry, Fisheries and the Environment, Dr Dion George said: “The first casualty of the new US government was Pepfar. Our (LGBTQIA+) community has survived two pandemics in my lifetime – AIDS and COVID.

“AIDS took a lot longer to grip the attention of the world and for medication to be developed, because it was associated with people like us and nobody cared enough until it was not just us.

“The DA-run Western Cape Government Department of Health and Wellness has ensured that the purchase of antiretroviral treatment and clinical staff are mainly funded through the Province’s own budget,” George said.

“Anyone who accessed this care in the Western Cape from non-profit organisations that are now closed, can access medication and care from the nearest primary health care facility, and specific clinical needs can be referred within the Western Cape health care system.”

The South African Federation of Trade Unions (SAFTU) spokesperson Newton Masuku said that they strongly condemn the Donald Trump regime’s decision, and said that this is a blatant act of political retaliation against the SA government's unwavering support for Palestine.

“The Pepfar funding cut is part of a wider pattern of economic coercion. The U.S. and its allies have long used financial pressure to punish governments that refuse to be complicit in their imperialist agenda.

“Just as the U.S. imposes sanctions on countries that stand against its wars, it is now withdrawing life-saving health funding from South Africa because our government refuses to turn a blind eye to genocide,” Masuku said.

Founding director of the Centre for Epidemic Response and Innovation (CERI) and professor at Stellenbosch University, Tulio de Oliveira, said that the biggest problem is not the loss of funding but the manner in which it is done.

Masuku said that the Pepfar cuts are deep and wide, and regardless of foreign policy are also affecting Malawi, Zambia, Tanzania, Lesotho, Eswatini-Swaziland and Zimbabwe, as well as UNAIDS.

theolin.tembo@inl.co.za