US funding cuts for HIV relief could be devastating. South Africa may see a resurgence of the epidemic. A new study predicts many additional HIV infections. This could be between 150,000 and 295,000 by 2028. The study shows the impact of HIV funding cuts in South Africa.
The National Department of Health commissioned the study. Researchers from UCT and Wits conducted it. The study highlights the critical role of Pepfar. Pepfar is the US President’s Emergency Plan for AIDS Relief. Severe consequences loom if the government fails to assist.
The Scale of HIV Funding Cuts in South Africa
Pepfar has been a cornerstone of the HIV response. It provided around R7.5 billion in 2024. This funding supported non-profit organisations. They hired health workers for government clinics. They also ran their own health facilities.
Funding streams have now become unstable. This followed US policy changes. Some funding channels through the CDC have resumed. But they face uncertainty beyond September. USAID cancelled about 89% of its funding. This has forced many non-profits to close.
Modelling the Consequences of HIV Funding Cuts in South Africa
The study models a stark scenario. It assumes all Pepfar funding is eliminated. The government would not intervene in this model. Currently, 78% of HIV-positive people are on ARV treatment. The complete loss of funding would reverse this trend. ARV coverage could drop to as low as 59% by 2026.
This is due to the closure of funded centres. The country would lose nearly 2,000 lay counsellors. Fewer diagnoses result in fewer people receiving treatment. Prevention services are also severely impacted. These cuts could result in 56,000 to 65,000 additional deaths by 2028.
Government Intervention and Uncertainty
These dire predictions could be avoided. This depends on the South African government. It must compensate for the lost funds. An extra R13 billion to R30 billion is needed. This would be between 2025 and 2028.
The Health Department is identifying critical services. This offers a glimmer of hope. Some PEPFAR funding is still reaching the country. However, the study shows a profound vulnerability. The HIV response is vulnerable to HIV funding cuts in South Africa. This shows an urgent need for local solutions.