A coalition of South African health organisations has issued a dire warning about the potential collapse of life-saving HIV and TB services due to cuts in US aid funding. If the US government halts its financial support through the President’s Emergency Plan for AIDS Relief (PEPFAR), the South African healthcare system could face a “severe crisis,” affecting millions of patients and putting over 15,000 health workers’ jobs at risk.
Impact of the PEPFAR Funding Cuts
PEPFAR has long been a crucial pillar in South Africa’s fight against HIV and TB, funding essential programs that provide testing, treatment, and prevention services. While a temporary waiver is allowing some HIV-related services to continue, it has failed to protect many organisations—especially those serving vulnerable groups such as the LGBTI community and people who inject drugs.
As a result, two PEPFAR-funded harm reduction centres have already shut down, and multiple organisations that focus on LGBTI healthcare have been forced to close.
According to a statement issued by 17 major health organisations—including Anova Health, Health Systems Trust, TB HIV Care, The Aurum Institute, and Wits RHI—the consequences of these funding cuts could be catastrophic.
“If PEPFAR funding is terminated, patients—including children—will lose access to life-saving antiretroviral treatment. The consequences will be immediate: rising infections, increased mortality, and a surge in TB cases,” the statement read.
Healthcare Services Under Threat
The waiver currently allows funding for certain HIV treatment programs, including antiretroviral therapy (ARVs) and HIV prevention for pregnant and breastfeeding women. However, it does not cover:
- HIV prevention services for the general population, including access to PrEP and condoms.
- Research initiatives, such as national HIV surveys that track infection rates.
- Harm reduction programs, including methadone treatment for people who use heroin.
Dr. Gloria Maimela, speaking on behalf of the coalition, highlighted the devastating impact of these exclusions. “The staff providing [HIV] testing and treatment are still at work, but those supporting other critical services—especially for high-risk groups—have been stopped.”
A Call for Private Sector Support
With uncertainty surrounding the future of US funding, health organisations are now turning to private sector donors and philanthropists to help fill the gap.
“We urge corporations, donors, and high-net-worth individuals to assist in sustaining these life-saving services,” said Maimela. “Even as we engage with the government, we need urgent intervention from all stakeholders.”
The suspension of PEPFAR funding marks one of the most significant challenges to South Africa’s public health system in recent years. Unless alternative funding sources emerge soon, the country could see a sharp rise in HIV and TB infections, reversing years of progress in combating these diseases.
