Finance Minister Enoch Godongwana has allocated an additional R590.4 million to support health services affected by the withdrawal of the US President’s Emergency Plan for AIDS Relief (PEPFAR) funding.

PEPFAR-funded HIV organisations receiving grants from the United States Agency for International Development, USAID, had received letters in February alerting them that their grants had been terminated.

Since Pepfar’s inception in 2003, the US government invested over $100 billion in the global HIV/AIDS response, saving over 25 million lives, preventing millions of HIV infections, and supporting several countries to achieve HIV epidemic control, all while significantly strengthening global health and economic security.

In May, the Health Minister, Dr Aaron Motsoaledi, said that the country has 5.9 million people on ART (Antiretroviral Therapy), and that mother-to-child transmission has reduced dramatically.

“We have reduced death from HIV and concomitantly reduced the deaths from TB. When we started this programme, we needed R3.5 billion; today we spent R46.8 billion, of which R7.9 billion was from PEPFAR. It is inconceivable that out of R46.8 billion spent by the country on the HIV programme, the withdrawal of R7.9 billion by President Trump will collapse the entire programme,” he said.

In July, he announced that the National Treasury released R753 million, which was divided as follows:

• R590,407,000 for service delivery in provinces to be allocated via the comprehensive HIV/AIDS Component of the District Health Programme Grant.
• R32,121,000 to the National Department of Health to support the Central Chronic Medicine Dispensing and Distribution Programme and pharmaceutical supply chain management.
• R132,000,000 to be transferred to the South African Medical Research Council to support Health Research around the country.

The Bill and Melinda Gates Foundation and the Wellcome Trust also pledged R100 million each, but put a condition that each R100 million they contribute be matched by R200 million from South Africa’s Treasury, and that that money be given to researchers.

The announcement for additional funding came during Godongwana’s 2025 Medium Term Budget Policy Statement (MTBS) on Wednesday.

“In response to the withdrawal of PEPFAR funding, R590.4 million is added in 2025/26 to support provincial health services and sustain priority HIV/TB interventions.

“Over the MTEF period, provinces are required to demonstrate credible plans to transition from PEPFAR funding,” Godongwana said.

Over the medium term, the health function will maintain its focus on delivering effective services by strengthening operational efficiency.

He explained that provisional allocations announced in the 2025 Budget for the 2025 medium-term expenditure framework (MTEF) period total R20.8 billion in health.

“This consists of R2.7 billion to employ doctors, R9.9 billion to cover accruals for medical services and R8.2 billion to retain health professionals.”

After the announcement, Desmond Tutu Health Foundation’s CEO, Dr Linda-Gail Bekker, said that they are very grateful for interim funding to lessen the blow of the loss of USAID and PEPFAR funding.

“The money we received from PEPFAR was not the bulk of our HIV response, but provided an important component of funding community-based work, data collection, tracking and tracing of patients and clients and many other critical components that are going to help us bring the SA HIV epidemic under control.

“This money is hugely appreciated – it doesn’t completely fill the deficit, but it will certainly help,” Bekker said.

“Hopefully, provincial health departments will really put it to excellent use to get the maximum benefit. We hope our own fiscus can increase its investment in HIV and TB, including in community-based programs and services, to sustainably bring an end to HIV as a public health threat sooner rather than later.”

theolin.tembo@inl.co.za

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