A concerning new study has highlighted the potentially catastrophic consequences for South Africa's fight against HIV/AIDS. This could occur if the United States implements PEPFAR funding cuts. Additionally, the South African government does not significantly increase its investment. The research indicates that such a scenario by 2028 could lead to an alarming 65,000 additional AIDS-related deaths. There could also be an extra 300,000 new HIV infections.
Urgent Need for Financial Intervention
Commissioned by the National Health Department, the study underscores the critical role of sustained funding. This is essential in maintaining the progress achieved in combating the HIV epidemic. Experts warn that jeopardising the HIV response due to funding shortfalls could negate decades of hard-won gains. Programmes like the US President's Emergency Plan for AIDS Relief (PEPFAR) achieved these gains.
According to the latest Thembisa model estimates cited in the study, AIDS-related deaths and new HIV infections have been steadily declining. However, this positive trajectory is severely threatened. The projections indicate a grim reversal. Failing to maintain funding could cause a surge to 51,900 deaths and 173,000 new infections in 2024 alone.
PEPFAR Funding Cuts Causing Huge Health Gaps
The analysis suggests that to sustain current HIV/AIDS services through 2028, the South African government will need to bridge a substantial financial gap. This gap is estimated at $710 million (R13.4bn) to $1.5bn (R28.4bn) between 2025 and 2028. These figures are based on the 2024 average rand-dollar exchange rate of R18.84.
The study's findings follow the US President Donald Trump's administration's moves. These moves have already dealt blows to foreign assistance worldwide. They include a reduction in support for most PEPFAR-backed services in South Africa. The remaining aid also faces an uncertain future.
Expert Voices Raise Alarm
Gesine Meyer-Rath, the study's principal author and a researcher at the Wits Health Economics and Epidemiology Research Office and Boston University School of Public Health, emphasised the critical juncture. She said there was a dramatic decrease in incidence, and we were finally turning the curve on prevalence. Meyer-Rath described the situation as "a real blow, a punch to the stomach".
Broader Implications for the Health System
The scale of the potential deaths and additional infections resulting from PEPFAR funding cuts would severely strain South Africa's already burdened health system. This is particularly true in the aftermath of the COVID-19 pandemic. Meyer-Rath stressed the profound human cost, saying that we all know how that felt and how horrible it was. She added that it could be as bad as that if we do nothing.
PEPFAR Funding Cuts Cause Financial Strain on Resources
The study also points out that with South Africa already facing a high prevalence of HIV, the nation's public sector health programs are significantly reliant on funding from PEPFAR. The sheer scale of the epidemic means that unless substantial alternative funding is secured, the lives of at least 7.8 million people currently living with HIV are at risk. This includes those dependent on programs for tuberculosis and malaria.