Diplomatic Inside
Minister of Health Dr. Aaron Motsoaledi on Thursday confirmed that the South African government has not received any emergency funds to mitigate the impact of the United States’ withdrawal of financial support from the country’s HIV/AIDS and TB response programme. He addressed the media at a briefing held in Pretoria to update the public on mitigation efforts.
Motsoaledi said that despite extensive engagement with Treasury and other stakeholders, no funding—beyond R1 billion from the Global Fund for antiretrovirals—has been secured to replace the R7.9 billion previously contributed by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
“We have not raised a cent from anybody except the Global Fund,” Motsoaledi stated. “We’ve met funders, even governments. Everyone promises, but none have come to the fore with actual financial support.”
PEPFAR had previously funded the programme via U.S. government agencies like USAID and the Centers for Disease Control and Prevention (CDC). The CDC also employed around 7,000 staff under this initiative, whose contracts will remain in place until December 2025.
Emergency Funding Still Unclear
The Minister expressed confusion and concern around the notion of “emergency funding,” which has been frequently cited in public discourse. “I’ve been in government for more than 15 years, and I’ve never heard of this type of emergency funding,” he said. “I know of disaster funding, but not this.”
Motsoaledi said he had personally approached both Finance Minister Enoch Godongwana and Director-General of the National Treasury Dr. Duncan Pieterse to clarify whether such emergency allocations exist under the Public Finance Management Act (PFMA). “If it existed, believe me, it would have been empty by now—we would have applied.”
According to Motsoaledi, the Department of Health submitted requests in February, and Treasury had asked them to submit ten provincial plans and one national plan to assess how they could assist. “They never said, ‘Submit a plan and we’ll give you emergency funding.’ We’re still waiting,” he said.
Clinics Closed, Services Disrupted
Motsoaledi confirmed that all 12 specialized clinics previously run through PEPFAR funding have closed, affecting over 62,000 patients. Notably, he responded to reports of the Ivan Toms Clinic and a satellite clinic in Cape Town shutting down, saying patient files had been transferred to public health facilities and that staff are contacting affected individuals.
However, disruptions are evident. The Minister acknowledged that viral load testing has dropped by 21% since the funding withdrawal. “We expected some setbacks initially. But saying the programme has collapsed based on that is wrong. The real concern would be if 21% of the 5.9 million people on ARVs stopped taking them,” he said.
Civil Society Involvement and LGBTQ+ Inclusion
Responding to questions about support for LGBTQ+-led health organizations, Motsoaledi reiterated that the South African National AIDS Council (SANAC) is inclusive. “SANAC has 18 sectors representing all walks of life, including LGBTQ+ communities. Some hold senior positions in the council.”
Still, no specific funding or programme guarantees were offered to LGBTQ+-led health service providers.
National Lottery Engagement Ongoing
In response to inquiries about potential support from the National Lottery, Motsoaledi confirmed that SANAC had formally approached the entity and that he personally attended meetings to follow up. “We told them about the R70 million they gave in 2010, and asked them to come to the table again. The CEO was asked to provide documentation. We’re still waiting for a response.”
Funding Gap Remains Unresolved
According to internal reports, the Department of Health requires an additional R2.82 billion for the current financial year to plug the gap left by PEPFAR. For now, Motsoaledi said, that amount remains unfunded.
Despite these setbacks, the Minister expressed confidence in the resilience of the healthcare system. Over 1,000 clinicians and 2,300 non-clinical staff have been trained to ensure continuity of HIV/AIDS services. The Department has also pledged to accommodate patients’ preferences in the relocation of their treatment to alternative clinics.
Still, as of 15 May, the government has not secured sufficient financial resources to fully replace PEPFAR’s contribution—leaving South Africa’s flagship HIV/AIDS and TB programmes in a precarious position.