US President Donald Trump’s aid cuts will not derail SA’s goal of providing treatment to an additional 1.1-million HIV patients by December, health minister Aaron Motsoaledi assured parliament on Tuesday.
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.
“We are confident we can still do it,” the minister said in response to questions from MPs in the National Council of Provinces.
Trump’s administration has thrown organisations supported by US foreign aid into disarray worldwide, first with a shock announcement all funding was paused pending a 90-day review and then with the abrupt termination of grants issued by the US Agency for International Development (USAID).
The future of US funding via other agencies, such as the Centres for Disease Control and the National Institutes of Health is also in doubt.
On Monday the World Health Organisation warned that eight countries, including Lesotho, were at risk of running out of HIV medication due to the 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 the world’s biggest HIV/Aids burden, with an estimated 7.8-million people living with the disease and 5.7-million on treatment.
In recognition of the scale of its epidemic, SA has been one of the biggest recipients of US support for HIV/Aids programmes, via the US President’s Programme for Aids Relief (Pepfar), which channels grants through several agencies including USAID.
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 assured 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 peer-reviewed 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.
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