Non-Governmental Organisations (NGOs) have warned that the decision by the US government to cut foreign funding could undermine and set back the fight against HIV/AIDS by 20 years.
They stated that this decision could lead to patients not receiving their medication, developing drug resistance, which may result in the resurgence of “untreatable” diseases.
NGOs that have been conducting a variety of programmes on HIV, TB, and scientific research are scrambling after US President Donald Trump announced that his administration was halting funding for a period of 90 days.
Besides the health implications, there have also been media reports indicating that this could trigger a jobs bloodbath, with close to 20 000 jobs at risk.
Positively Alive, a support network for men living with HIV, stated that this decision could set back the work done to combat HIV spread by 20 years.
Alan Brand, the founder of Positively Alive, told a news channel that this has created widespread panic. He called on the Department of Health to step in and provide clear guidelines to patients to ensure that they do not default on treatment.
He emphasised that many men who are part of Positively Alive receive their medication through NGOs that rely on this funding.
“We all know that if you think about HIV, it is not the case that if you don't find medication, you can wait until it’s available. There is a very high risk of drug resistance, and an incredible risk of people going from being undetectable to having a viral load, which means they are transmitting again,” he said.
“The impact is a resurgence of HIV, and we could return to a situation where we have untreatable HIV,” he added.
Brand acknowledged that the US has every right to reassess funding but suggested that this could have been handled better by providing notice to those benefiting.
“Going cold turkey and just cutting it is ruining all the work the organisations have been doing. The long-term effect could take us back 10-20 years,” he noted.
Dr Munya Saruchera of The Africa Centre for Inclusive Health Management stated that while the new US administration has the right to make decisions that serve their interests and sovereignty, their decision will take the fight against HIV/AIDS, TB, and related health and socio-economic issues backwards.
“The interconnectedness of nations and humanity today is such that the indirect costs of this decision will be felt over time, particularly by poorer countries that have been receiving tremendous USAID-PEPFAR support, and indirectly by Americans who visit those countries. As we saw with Covid-19, health security does not insulate some nations more than others for long, given the increased contact and inter-relationships between nations through sport, cultural activities, education, and training.”
“This situation may serve as a wake-up call for poorer nations to look internally, renegotiate new agreements in more inclusive, fairer, and equitable ways, and mobilise resources domestically and in partnerships with other nations or parties using their resource base,” said Saruchera.
He added that there is hope that other financiers and partners will emerge; otherwise, the situation will worsen, with increases in infections, re-infections, and those accessing effective medication struggling to stay on it, as poorer countries are unlikely to suddenly increase their health budgets to cover the resultant gap.
“The moment has come for active citizenry to push for change, end corruption, and redirect national resources towards health and other key sectors,” said Saruchera.
Meanwhile Health Minister Dr Aaron Motsoaledi has said the world is baffled by the decision to halt USAID funding.
"We have been fighting the scourge of HIV and malaria together for more than 20 years as a global community and depending a lot on global funding," Motsoaledi said. "But on the South African side, as you know, we are running the world's biggest HIV counselling and testing campaigns."
He explained that 5.5 million people are on ARVs, with no other country coming close to this. The minister added that the total amount spent on this campaign is R44.4 billion. Motsoaledi emphasised that Pepfar contributes 17% of this.
"The rest is mostly our own fiscus and some other funders ... the (United States) President's Emergency Plan for AIDS Relief (Pepfar) is helping us in 27 districts out of the 52. The 27 are the most affected in the country."
Some of the districts that will be most hard hit, according to the minister, are five in the Eastern Cape, two in the Free State, four in Gauteng, seven in KwaZulu-Natal (province most affected), two in Limpopo, three in Mpumalanga, three in North West and the Western Cape.