Scientists and healthcare activists have been unanimous in expressing frustration over government's slow response to the funding cuts, and in urging a rethink on the dependency created by SA's over-reliance on foreign funding, notes MedicalBrief.
In the SA Medical Journal, Ames Dhai writes that South Africans “need to see our government stepping in and showing leadership in addressing this calamity”, and that the state’s “lack of urgency in yet another crisis is appallingly woeful”.
“It is evident the Department remains far removed from the realities on the ground,” Dhai wrote.
“We stand to lose all the investment over the past 25 years if we do not work hard to fill the gaps. We will also see lives lost. More than half a million unnecessary deaths will occur because of the loss of the funding and up to a half a million new infections, (according to) modelling studies,” said Linda-Gail Bekker, CEO, Desmond Tutu Health Foundation.
“… I predict a huge disaster, a walk-back on the investment, unless other resources can be found, and found urgently.”
Bhekisisa’s Mia Malan reports that in gathering responses to the Pepfar-USAID funding crisis from around South Africa, this was a common theme – that the Health Department isn’t providing the required leadership during this time, with hardly any communication to partners and the media.
The Anova Health Institute, which receives the most Pepfar funding, lost all its funding, a senior official confirmed to Bhekisisa. Anova helped to test people for HIV and make treatment available in under-staffed government clinics.
Letters were also sent to partners of the Accelerating Programme Achievements to Control the Epidemic (Apace), which include large non-profits such as the Wits Reproductive Health Institute, Broadreach Healthcare and Right to Care.
The Apace projects conducted HIV testing, got people who tested positive on to treatment, got HIV-negative people who needed it on to preventive anti-HIV pills, increased children’s access to HIV treatment and also tested and treated people for TB.
Pepfar projects receiving their funds through the Centres for Disease Control and Prevention (CDC) are still operating. A federal judge ordered the Trump administration in February to allow CDC-funded projects to restart their original projects, but many say they’ve only received funds to operate until the end of March.
Yvette Raphael, co-founder and co-director, Advocacy for Prevention of HIV and Aids (APHA)
“The Trump administration has declared war on the right to health globally. The South African government must take this as an opportunity to expedite universal access to healthcare and meet its obligations to our people.”
Sibongile Tshabalala, chairperson, Treatment Action Campaign
“It is so painful that these (NGO) terminations mean death to poor people of the world. Key and vulnerable populations are the most affected, while the Trump administration is fighting for a land Bill that has nothing to do with them and making noise about human rights violations, they are inadvertently committing genocide that will be remembered for years to come. We need our government to step up … to come up with a plan to save lives.”
Linda-Gail Bekker, CEO, Desmond Tutu Health Foundation
“Saving dollars and spending lives – no words! We now really need to hear the plans from our country’s Health Department on how the chaos will be filled urgently.”
Fatima Hassan, founder, Health Justice Initiative
“One expects a greater sense of urgency and better communication from the Health Ministry and other departments, including the Presidency, in this time of crisis. They are downplaying the financial and human impact in South Africa, and that will not take us forward. We wrote in early February to the government, asking for its urgent plan. We got no response. We wrote again, and a month later we still await its urgent plan. Shockingly, we learnt from media reports that an assessment is being outsourced to Deloitte and will take a month or longer …while right now there is a crisis! Our government has no urgent plan to absorb staff, programmes, patients and communities. Frankly, one circular from the national Health Department, which is not even being fully implemented, will not mitigate the chaos. Government should answer – where is the money and where is the plan?”
Francois Venter, executive director, Ezintsha
“The programmes who received termination letters were among the most efficient, effective health delivery programmes in the country. This is a devastating blow for South Africa’s HIV response.”
Kholi Buthelezi, director, Sisonke
“Sex workers are at increased risk for a range of health issues, including sexually transmitted infections (STIs), TB, HIV, and violence-related injuries. Access to regular health screenings, education, and preventive care should be a basic right, not a privilege. When a major funding partner like USAID pulls its support, the ripple effects are felt throughout the entire ecosystem of services designed to support these individuals. The government must step up – now.”
HIV clinician, speaking anonymously, who has provided the Health Department with help in its clinics and hospitals via Pepfar for 17 years
“Government has to cease the inaction and seeming return to the behaviour we saw during the worst years of Aids denialism, where politicians let their own opinions impact hundreds of thousands of lives. This cannot be allowed to happen again. The SA Government must now also be held to account to step in, as we have seen with Nigeria and other African countries.”
Anon HIV prevention programme implementer in Gauteng
“Cutting USAID funding for health and education programmes in South Africa isn’t just about budgets – it’s about people. It’s about sex workers who no longer have a safe place to get HIV prevention services, LGBTI+ communities losing the support they fought so hard for and thousands now facing a future without the healthcare and education they rely on to survive. “These aren’t just numbers on a spreadsheet. They are lives, futures, and communities being abandoned. …people will suffer, people will die, and decades of progress will be undone. This is not just a funding cut – it’s a betrayal of the very people these programmes were meant to protect. And yet, from the national Health Department, there is silence. No communication, no co-ordination, no urgency – just a deafening void where leadership should be. The very institutions meant to protect the most vulnerable have offered no plan, no reassurance, no voice. This silence is complicity, and it is costing lives.”
Kate Rees, public health specialist
“Our programmes have been officially terminated. Thousands of dedicated healthcare workers have been retrenched. I am especially concerned for the community health workers and data capturers, who are financially vulnerable and won’t be easily absorbed into the health system. “Despite their years of commitment, they have been abandoned with almost no notice. For patients and communities, critical services have already been impacted – including following up on positive HIV tests for babies, following up on possible meningitis cases, and caring for the most vulnerable pregnant women whose babies are now at risk of contracting HIV.”
No budget
Activists have also expressed dismay that the draft budget flighted by Finance Minister Enoch Godongwana earlier this month contained no additional funding for HIV/Aids, and called on the Department of Health and the Treasury to implement an emergency plan to ensure patients were not abandoned.
See more from MedicalBrief archives:
US stands to lose from funding cuts for top-notch SA research
Ramaphosa urged to escalate action on US funding crisis
Top SA health experts rally to counter Trump’s funding block