South Africa has not been able to raise any additional funds to plug the gap in the country’s HIV programme following the withdrawal of PEPFAR funding in January.
Speaking at a media briefing in Pretoria on Thursday, Health Minister Dr Aaron Motsaoledi says the department has met with various donors, including the Bill and Melinda Gates Foundation and the Clinton Health Access Initiative, to cover the R7.9 billion rand shortfall.
“None of the donors we’ve been speaking to have made any commitments, apart from the Global Fund that has committed R1bn for ARVs,” says Motsoaledi.
South Africa was a major beneficiary of PEPFAR (the U.S. President’s Emergency Plan for AIDS Relief) which funded 17% of the R46.8 bn HIV programme.
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Researchers have estimated that if the funding gap isn’t filled, South Africa could see an additional half a million unnecessary deaths, and up to half a million new HIV infections over the next 10 years. Motsoaledi, however, slammed media reports about the fallout of the funding loss.
“ The narrative by some prominent people in the HIV and AIDS circles is that since the announcement on the 20th of January, 2025 by President Donald Trump to withdraw funding, the HIV and AIDS programme has collapsed. It is inconceivable that the withdrawal of the PEPFAR would collapse the programme,” he says, emphasising that it would take a significant blow to collapse the world’s largest ARV programme which provides treatment to 5.9 million people.
Three months in, it’s been reported that viral load testing has gone down by 21%.
“We do accept that there would be an upset initially, we never said that wouldn’t happen. But just because viral load testing has gone down by 20% doesn’t mean the programme has collapsed. If they told me that 21% of people who were on ARV are no longer taking ARVs, I would really not sleep.”
‘Afriforum approach’
The minister goes on to say that South Africa must accept that Trump has taken away what belongs to his country. The stress caused by this situation, he says, may cause people to act in ways that may “create enemies”.
”But this is not the time to fight each other, denigrating each other, pointing fingers, reporting and spreading disinformation about the status of the campaign.
I also want to state clearly that propagating wrongful information about the status of the HIV/AIDS campaign in the country in the manner that is being done is no different than the approach adopted by Afriforum and its ilk which led Trump to thrash the whole country.
Afriforum is a lobby group that has been calling on the U.S government to protect the Afrikaners from what they call the “genocide” propagated by the South African government.
“If people believe the approach they must take to mobilise funding is to adopt the Afriforum approach, it’s actually going to achieve the opposite.”
“The minister’s statements are very disappointing. Saying Donald Trump is taking back what is his is like saying the programme was never ours. A critical mass of the successes in the HIV response was because of PEPFAR,” Johnson tells Health-e News.
Tian Johnson, founder of the African Alliance, accuses Mostoaledi of “politicising a human crisis”.
Johnson says, instead of providing a clear way forward, the minister is attacking activists.
“It’s a setback in the relationship with civil society – these are people who took trains to marches, who watched their families die, who went without treatment until everyone got treatment.”
Motsoaledi’s key facts about PEPFAR in South Africa
“When the PEPFAR- funded clinics were closed, we removed the files of these people from those clinics to the nearest public health facilities. We can confirm today that all 63,322 files belonging to these key populations were moved to public health facilities,” Motsoaledi says.
Jonson calls this claim into question stating that government doesn’t collect data on key populations. But thousands of transgender individuals are still unable to access hormone therapy, due to limited facilities offering the service.
Motsoaledi says in addition to PEPFAR, the Global Fund has also been supporting the country with health services for key populations.There are 34 facilities funded by the Global Fund which serve 74,140 people.
To ensure uninterrupted care, Motsoaledi says the department has embarked on a sensitisation training programme, targeting healthcare workers on the barriers affecting access to healthcare by key populations. According to Motsoaledi, 1012 clinicians and 2377 non-clinicians have been trained thus far.
Across 27 health districts, 271 606 people worked on the HIV programme. Of these, 15 539 were funded by PEPFAR. “Unfortunately, 8061 [people] are out of jobs. And these are people of interest when we talk to funders,” Motsoaledi says.“The remaining 7478 people are still employed because they’re funded through the Centers for Disease Control.” –Health-e News
