U.S. foreign aid pause a blow to South Africa’s HIV/Aids efforts | The Witness

Some of South Africa’s major health programmes were brought to a sudden halt after the newly-elected President of the United States, Donald Trump, ordered a pause on foreign assistance as his administration promoted its “America First” agenda.

According to USAID, which is responsible for administering civilian foreign aid and development assistance, in the fiscal year 2024, the U.S. provided nearly $6,6 billion (R123,4 billion) in humanitarian assistance across sub-Saharan Africa.

HIV/Aids programmes would be most affected, as these programmes were the focal point of funding through the U.S. President’s Emergency Plan for Aids Relief (Pepfar).

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Speaking to The Witness on Tuesday, the National Health Department confirmed awareness of the U.S. government’s announcement to pause funding for health programmes in South Africa. However, it said it had yet to receive formal communication.

Department spokesperson Foster Mohale said that, even without any formal suspension of funding, services in some areas had already been disrupted.

“We are aware that several organisations directly and indirectly funded by Pepfar and USAID have been urged to suspend the implementation of their activities across the country,” Mohale said.

The department will assess the impact of the pause [in funding] and communicate the implications and mitigation plans at the right time.

“Unfortunately, it is difficult at the moment to say how many organisations and individuals countrywide will be affected, because some of the organisations are implementing agents for the main funding recipients, subcontractors in simple terms, and it is not clear how long this pause will last,” Mohale added.

Speaking during an ANC press briefing on Tuesday, Health Minister Aaron Motsoaledi said they were not surprised by Trump’s decision and provided a brief overview of the areas that would be impacted by the directive.

“We have been fighting the scourge of HIV and tuberculosis as a group for more than 20 years. We have 5,5 million people on ARVs, and no other country has these figures.

“We have Pepfar operating in 52 districts around the country, and most of those that are funded through the relief fund are those that informed us of their receipt of the letters,” Motsoaledi said.

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He added that they had yet to compile the necessary information and write to the National Treasury based on their needs, as outlined in the report on the scale of the setback caused by the pause in funds.

The relief fund is currently active in seven districts in KwaZulu-Natal, five in the Eastern Cape, four in Gauteng, and several districts in other provinces across the country.

Since 2004, Pepfar has collaborated with over 1 200 community organisations to deliver HIV and TB services.

An employee at the Health Systems Trust (HST), which supports healthcare by managing and implementing health programmes, conducting research, and providing data for planning and decision-making, said some of its NGOs had already been instructed to “devise means to dispense services”.

The employee, who asked not to be named, said their top management was in conversation with the funder and the national Health Department.

The situation is very unclear at this stage, but we have heard that some NGOs have already been instructed to devise their means to dispense some services.

“We will wait to hear from our top management,” she said.

HST communications manager Antoinette Stafford declined to comment, but referred The Witness to Pepfar. The trust has offices in various parts of the province, including Pietermaritzburg, Ladysmith, Durban, and Ulundi.

The Dean of Wits University’s Faculty of Health Sciences, Professor Shabir Madhi, said the South African government must assume control of the country’s health programmes if Trump’s order paralyses the functionality of NGOs.

“There are very specific programmes where stop orders have been issued, and those stop orders have been issued largely to programmes that include elements of diversity, equity, and inclusion. For the rest of the programmes, stop-work orders have not been issued; instead, there’s been a postponement of further activity until such time as the powers that be in the U.S. decide whether those programmes will continue to be prioritised. But it’s not all programmes that have been stopped,” said Madhi.

He said it was difficult to gauge the impact of the stop orders on South Africa’s health programmes.

“Many of these programmes are integrated into government facilities, and what we hope happens is that if there is disruption, the government steps in to address the disruption that may materialise due to the stop-work orders. This means that the staff currently employed through U.S.-funded grants will need to be shifted to government employees,” he said.

Madhi said he was concerned about the Wits RHI Trans Health Centre. “I think the Trans Health Centre is an example of a programme that forms part of diversity, equity, and inclusion, and that is something specific that the Trump administration seems to be targeting in terms of the stop-work orders.

“But it doesn’t affect all HIV programmes or all HIV testing. There is a potential for other programmes to be affected, but it’s unclear at this stage whether other programmes will be impacted,” Madhi said.

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On inauguration day, Trump ordered a 90-day pause on nearly all foreign aid to allow his administration time to align programmes with his administration’s priorities.

“The United States foreign aid industry and bureaucracy are not aligned with American interests and, in many cases, are antithetical to American values,” his order read.