Pepfar contributed just 17% to the overall funding for South Africa’s HIV/Aids response.
Health Minister Aaron Motsoaledi at Good Hope Chambers in Cape Town on 11 July 2024. Picture: Gallo Images/Misha Jordaan
The National Treasury has allocated just over R750 million to the Department of Health to help close the gap left by the withdrawal of the President’s Emergency Plan for Aids Relief (Pepfar).
Earlier this year, United States (US) President Donald Trump signed an executive order to freeze foreign aid administered by the United States Agency for International Development (USAID), impacting global health programs including Pepfar.
The decision has had significant repercussions for South Africa’s HIV/Aids and tuberculosis (TB) programmes.
According to the government, Pepfar funding accounted for only 17% of the country’s HIV response funding.
Government reaffirms HIV/Aids commitment after Pepfar withdrawal
Speaking in Parliament during a budget vote debate on Wednesday, Health Minister Aaron Motsoaledi reiterated the government’s commitment to eliminating HIV/Aids as a public health threat by 2030.
To reach the target of having 95% of HIV-positive people on antiretroviral therapy (ARVs), Motsoaledi said the department needs to reach 1.1 million people.
Despite the funding cut, he stressed that the programme continues to make progress.
“I know that the withdrawal of Pepfar funding made some people believe that our massive – actually the world’s biggest – HIV counselling, testing and treatment campaign has collapsed or is on the verge of collapsing,” Motsoaledi said in his speech.
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“I have noticed with regret that in South Africa we seem to like the word ’collapse’. Every time something meets headwinds, it is said to have collapsed.”
“The public health system suffers this tag quite a lot. It is said to have collapsed so many times that I do not know how many lives it has.”
“Anyway, there is no way we are going to allow the world’s biggest HIV/Aids Programme to collapse – never,” he continued.
The minister told MPs that in addition to requesting help from the National Treasury, the Department of Health also approached other local and international funders.
“Treasury has come to the party,” he remarked.
Watch the budget vote debate below:
Treasury allocates funds
Motsoaledi revealed that Treasury has provided R753 million (R753 528 000) to bolster the department’s HIV/Aids initiatives.
From this total, R590 million (R590 407 000) will be allocated to provinces through the comprehensive HIV/Aids section of the district health programme grant.
Another R32 million (R32 121 000) is earmarked for strengthening the central chronic medicine dispensing and distribution (CCMDD) programme, as well as managing the pharmaceutical supply chain.
In addition, R132 million will be allocated to the South African Medical Research Council (SAMRC) to fund health research efforts.
READ MORE: Health experts warn of ‘huge disaster’ as USAID terminates Pepfar HIV funding in SA
Motsoaledi also noted that both the Bill and Melinda Gates Foundation and the Wellcome Trust have pledged R100 million each for research, on the condition that Treasury matches the combined contribution with R200 million.
“This has been accepted. Treasury is going to add R400 million,” he said.
The R400 million will be released over a period of three years, with the first tranche of R132 million allocated in the current financial year.
Pepfar contributed close to R8 billion
Despite the new allocation, experts say it is not sufficient to fill the gap left by Pepfar’s withdrawal.
Bhekisisa Centre for Health Journalism founder and editor-in-chief Mia Malan expressed concern about the shortfall.
“Is the R753 million awarded by Treasury enough to plug the gap of Pepfar funds? Not even close.
“Pepfar awarded $439 537 828 (around R7.9 billion) to SA for [financial year] 2024/2025. [The health department] needed R2.82 billion to plug essential gaps,” Malan said in a social media post on Wednesday.
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