By Maleruo Leponesa
It’s been over a month now since US President Donald Trump signed an executive order freezing crucial PEPFAR funding internationally. According to the Institute for Security Studies Africa, in 2024 the US provided US$453 million (R8.5 billion) in direct funding to South Africa under PEPFAR and a projected US$439 million (R8.2 billion) was to arrive in 2025. Maleruo Leponesa reports on how these cuts will affect those with TB, HIV and with chronic conditions.
Dr Natasha Davies, HIV specialist of Clinical Care at Anova Health Institute which is one of the biggest NGOs affected by the executive order said that while the cut in funding has not affected the supply of medication (which is provided for by the South African government), it has had drastic effects on staffing. She said that out of 3 000 health care employees working for the institute around the country, 2 800 have been retrenched, and among these are 1 300 counsellors.
“ARVS are available as the South African government has been buying its own medication,” she said, but “what has been negatively affected is the human resource. ” By having to cut highly-skilled staff, Davies said, several major threats are likely to result from this predicament.
She highlighted that her colleagues foresee a potential disengagement of chronical illnesses patients because the counsellors who used to work with vulnerable groups of people such as youth, pregnant women etc — and were central to the process of dispensing medication and treating people are no longer there. Patients who came for family planning, ARVs and other chronical illnesses were all treated in their department, and this made all the logistics less complicated.
There was easy follow up on each patient as all the files were within one sector. If one had to further see the doctor, was not obliged to go and queue at another department as this department was a one-stop shop, she said. Patients would even find their medication pre-packaged, and accessing information about their treatment was effortless.
Now all these patients have to go through the general queue and all the work that used to be done by the 2 800 who’ve lost their jobs has to be shared among the already-burdened remaining staff. This is likely to be overwhelming for both staff and patients, she said.
The remaining staff has to take over tasks they’ve never done before, such as supply chain logistics, placing orders of medication, etc.
Locally, Rhodes University Health Centre’s Sister Heather Ferreira also affirmed that the impacts of the cuts are not on the supplies of medication. A good relationship with the Department of Health ensures that there is no crisis in this centre at the moment. She said the centre has a supply of ARVs which will last for the year.
But added she has no idea as to how this predicament is likely to affect them going forward as the department has not mentioned any challenge to them.
In response to the question of how the Department has been affected by this situation, Siyanda Manana, Director of Communications for the Eastern Cape, explained that Centres for Diseases and Control and Prevention (CDC) which is the body responsible for TB, HIV care, took Trump’s decision to court and Trump’s order was revoked by the court. As a result, the CDC is still operational.
He did say they are worried about losing skilled health workers from the sector. He also said HIV/AIDS sexually-transmitted infections and TB (HAST) programme indicators’ performance will be negatively affected.
Where possible, he said the department will try to find the resources to employ or absorb the staff affected by the funding cuts. This would assist with health department vacancy gaps in the districts, sub-districts and other facilities.
