Health Minister Aaron Motsoaledi has acknowledged that the South African government cannot entirely compensate for the funding gap left by the US President’s Emergency Plan for AIDS Relief (PEPFAR) following the termination of USAID-funded health programmes by President Donald Trump’s administration.
The sudden funding halt has impacted the supply of life-saving drugs for HIV, malaria, and TB, as well as medical supplies for newborns, affecting several USAID-supported organisations.
Government focuses on ARV access amid financial strain
Motsoaledi revealed that, of the 271,606 people employed in HIV/AIDS-related work, approximately 254,452 are funded by the South African government, while only 15,000 rely on US-backed programmes.
He said our immediate aim is that nobody must run out of antiretroviral treatment (ARVs) when they need and deserve them.
However, he recognised that South Africa cannot afford to assume responsibility for all USAID-funded services, including research and other specialised health initiatives.
Motsoaledi said it is not about filling the whole gap; it’s about prioritising, identifying what is more urgent, and determining what we can afford.
South Africa’s reliance on US health funding
Since the launch of PEPFAR in 2003, South Africa has received approximately $8 billion (R52 billion) in US funding. For the 2024–2025 US financial year, South Africa had been allocated over R7.4 billion before the funding was reduced.
Motsoaledi has previously assured patients in US-funded programmes that they will continue to receive ARV treatment through the government’s healthcare system.
Government seeks solutions with Treasury and provincial departments
Motsoaledi is currently in discussions with the National Treasury to evaluate the financial implications of the PEPFAR withdrawal and identify urgent funding priorities. Urgent needs include:
- Redirecting patients to public health facilities where USAID-supported clinics have closedÂ
- Reallocating extra healthcare staff from the Department of Health to affected areasÂ
The USAID funding cuts exert further pressure on South Africa’s already strained public healthcare system. While ensuring continued access to ARVs remains a top priority, the government faces challenging financial decisions as it navigates the loss of crucial US support.
The coming months will reveal how South Africa adapts to this substantial funding shortfall, as discussions with the Treasury and international donors persist.
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