US President Donald Trump’s aid cuts will not derail SA’s goal of providing treatment to an additional 1.1m HIV patients by December, Health Minister Aaron Motsoaledi assured Parliament on Tuesday, saying “it won’t be difficult to absorb the extra patients”.
The target is the estimated number needed to close SA’s “treatment gap” and attain all of the UN’s 95-95-95 targets. These goals aim to ensure 95% of people living with HIV know their status, that 95% of people who have been diagnosed are on treatment, and that 95% of those on treatment are virally suppressed. SA now stands at 96-79-94, reports BusinessLIVE.
“We are confident we can still do it,” the Minister said in response to questions from MPs in the National Council of Provinces.
On Monday, the World Health Organisation warned that eight countries, including Lesotho, were at risk of running out of HIV medication due to the USAID cuts, which threaten to reverse hard-won gains in the fight against HIV, tuberculosis (TB) and malaria.
Motsoaledi said the cuts posed no risk to HIV treatment in SA, as the fiscus paid for 90% of the antiretroviral medicines provided to patients, with the remainder covered by the Global Fund to Fight HIV/Aids, TB and Malaria.
SA has an estimated 7.8m people with HIV, and 5.7m on treatment.
Motsoaledi previously told Parliament that Pepfar and USAID had been expected to provide R6.27bn in the 2025/2026 fiscal year, about 13% of the total R48bn HIV/Aids funding anticipated for the period.
A circular had been issued to provinces to dispense six-month supplies of medication to HIV patients, and people who had used Pepfar-funded clinics could use state clinics instead, he said.
“It won’t be difficult to absorb patients,” he told MPs.
His optimistic outlook stands in contrast to the warning issued by HIV scientists earlier this month about the risks of withdrawing funding to organisations supported by Pepfar in SA.
According to a modelling study published in the Annals of Medicine, if the services these organisations have provided are not effectively transitioned, it could lead to 601 000 HIV-related deaths and 501 000 new infections in the next 10 years.
“Prolonged treatment interruptions, new and missed HIV acquisitions and lost opportunities to intervene will result in more hospitalisations, lives lost, infections acquired and overall increased cost to the healthcare budget over time,” said study co-author Linda-Gail Bekker, CEO of the Desmond Tutu HIV Foundation.
Earlier this week the WHO said that America’s pause on US foreign aid had “substantially disrupted” supply of HIV treatments in eight countries, which apart from Lesotho also included Haiti, Kenya, South Sudan, Burkina Faso, Mali, Nigeria and Ukraine.
WHO Director-General Tedros Adhanom Ghebreyesus said the decision could undo 20 years of progress with the HIV programmes.
The WHO-co-ordinated Global Measles and Rubella Laboratory Network, with more than 700 sites worldwide, also faces imminent shutdown, the agency added, coinciding with the surge of measles cases in the US.
Ghebreyesus said the US had a “responsibility to ensure that if it withdraws direct funding for countries, it’s done in an orderly and humane way that allows them to find alternative sources of funding”, reports Reuters.
Efforts to tackle HIV, polio, malaria and TB have all been affected by the foreign aid pause implemented by President Donald Trump, while funding shortages could also force 80% of WHO-supported essential healthcare services in Afghanistan to close.
As of 4 March, 167 health facilities had shut down due to funding shortages, and without urgent intervention, at least 220 more facilities could close by June.
The WHO said it would slash its funding target for emergency operations to $872m from $1.2bn in the 2026-2027 budget period.
Meanwhile, Reuters reports that Bill Gates is personally lobbying Trump administration officials to keep funding health programmes worldwide, from childhood vaccination to HIV treatment, and warning that his foundation cannot step in to fill gaps, two sources said.
Gates, the billionaire Microsoft co-founder turned global health philanthropist, has held meetings with the National Security Council as well as lawmakers in recent weeks to press that case as officials, led by the State Department, review what kinds of foreign aid will remain under its “America First” policy, with a list of around 30 global health projects for consideration.
In the meetings, Gates said his foundation cannot replace the role of the US Government, while its directors have also said publicly that no foundation has that capability.
At the same time, many Gates Foundation top priorities – like eradicating polio and fighting malaria – will be hit by the US pullback. In such cases, the Foundation would need to decide if and how it can keep those programmes on track, one source said.
Gates’ discussions focused on organisations like Gavi, the Vaccine Alliance, as well as the Global Fund to Fight Aids, TB and Malaria, among others. They are on the shortlist for review by Secretary of State Marco Rubio and Trump. The US gives around $300m annually to Gavi, and more than $1bn to the Global Fund.
Several projects under the President’s Emergency Plan for Aids Relief (Pepfar) are also on the review shortlist, the source said.
USAID terminated more than 5 200 grants and contracts, a State Department spokesperson said, adding that critical programme awards remain active.
“USAID continues to support the its coordinated, interagency response to the Ebola outbreak in Uganda; to provide lifesaving HIV care and treatment services; to provide emergency assistance in conflict zones; and to support key American strategic partners,” the spokesperson said.
At the National Security Council, Gates also pushed for the US to continue to support the World Health Organisation, which Trump moved to exit on day one of his administration, as well as efforts to eradicate polio.
Established in 2000, the Gates Foundation has an annual budget of more than $8bn. Gates has met regularly with security officials in previous administrations on key areas like malaria or Covid-19. He had a meeting with Trump at a dinner in December, and the White House in early February after the USAID cuts were first announced.
BusinessLIVE article – Motsoaledi confident SA will reach HIV treatment goal despite US aid cuts
Reuters – Exclusive: Gates warns White House he can't fill shortfalls in US global health funding
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