The freezing of US Agency for International Development (USAID) funds to South Africa and other African countries has resulted in a pending humanitarian disaster as millions of people in HIV care go without life-saving drugs.
The blocking of USAID funds follows an executive order by US President Donald Trump. The move, also aimed at Venezuela, Brazil, Mexico and Canada, has already seen the complete shutdown of clinics and the drying up of antiretroviral support for millions on HIV care.
It is also unclear what the aid block means for the South African programmes funded by the President’s Emergency Plan for AIDS Relief (PEPFAR). Currently, clinic workers are not working and fear commenting on the situation in case of reprisals.
MILLIONS WAITING FOR ANTIRETROVIRALS
Some 5.5 million people obtain antiretrovirals from the South African government. Health Minister Dr Aaron Motsoaledi says that the government funds roughly 74% of the HIV programme from internal sources and 2% is sourced from the private sector. The country is one of the major beneficiaries of PEPFAR, which supplies around 17% of South Africa’s HIV care programme.
HIV care patients rely solely on antiretrovirals to keep the disease at bay. These have to be taken daily to ensure their efficacy. Formerly, when such aid block bans were targeted at other countries, life-saving medicines were exempt. So far, with the current freeze, there has been no such waiver.
LIFE-SAVING DRUGS FOR HIV CARE HALTED
Professor Francois Venter, executive director of Ezintsha at the University of the Witwatersrand, told The South African: “We don’t get PEPFAR, USAID or CDC [Centers for Disease Control] funding, but organisations that we work with do, and this freeze has a dreadful effect on service delivery across the region for people living with HIV. PEPFAR is one of the most efficient health delivery platforms I have ever seen, and to have it stopped so abruptly is devastating.”
Ezintsha is a group of South African academics and healthcare professionals who work with partners around the globe. The consortium of people applies new technology to health-related issues and aims to extend access to effective drugs so that quality HIV care medication is readily available.
HOPING FOR USAID, HIV CARE RESTART
“We are simply supporting where we can and hoping communication from the US will urgently improve and USAID start up again. No one is clear on what is permitted and what will be funded in future. A massive delivery infrastructure is being dismantled and will take a long time to rebuild, at a cost of many, perhaps millions, of lives. We can only hope that whatever political processes are happening, there is a quick, successful outcome,” says Venter.
Thousands of employees at USAID in the US have been placed on leave, the agency says.
A USAID statement said the order would affect all “direct-hire personnel” except those on “mission-critical functions, core leadership and specially designated programmes”.
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