Political Will Needed to Save Lives Amid USAID Funding Cuts, Say Activists

• Activists from several organisations including Movement for Change and Social Justice, #UniteBehind, Triangle Project, and the People’s Legal Centre, met on Wednesday to discuss the looming health crisis as a result of the stoppage of USAID funding.
• The decision by US President Donald Trump to terminate all USAID to South Africa has had life-threatening impacts on HIV programmes across the country.
• Now activists want government to step up and commit to bolster funding to cover the shortfalls left by these programmes.

Activists, many of whom were instrumental in the fight for free antiretrovirals for those living with HIV two decades ago, are once again picking up the baton. This comes amid rising concerns over the life-threatening impact PEPFAR-funding cuts are having on HIV programmes across the country.

This follows the decision by US President Donald Trump to terminate all USAID to South Africa. The US President’s Emergency Plan for AIDS Relief (PEPFAR) funded nearly 20% of the state’s HIV response.

“We will not let our people die,” said veteran HIV activist Zackie Achmat at a meeting with several civil organisations at Bertha House in Mowbray, Cape Town on Wednesday night to discuss the looming health crisis as a result of the USAID funding cuts.

Discussing various strategies to deal with the funding shortfall, Achmat said it was critical to assist the City of Cape Town and provincial government to get mobile clinics, which have been suspended, out to communities.

He called on Aspen Pharmacare, the leading manufacturer of ARVs in the country and the rest of Africa, to lower its prices, which will allow the government to spend more money to bolster other services.

Achmat also raised concern that the government has not allocated funds specifically to mitigate shortfalls to PEPFAR-related programmes.

Organisations in attendance at the meeting included Movement for Change and Social Justice, #UniteBehind, Triangle Project, People’s Legal Centre, and several others. Also in attendance was MP Karl le Roux (DA), who is on Parliament’s health portfolio committee. He addressed the crowd and said they are worried about the impact funding cuts will have. He said he was at the meeting “not … to make promises but to listen”.

Critical services targeting high-burden areas have collapsed, including services for vulnerable groups, such as sex workers, the LGBTQ community, and people who inject drugs, GroundUp reported earlier this month.

The cuts have led to many HIV programmes shutting their doors. Professor Linda-Gail Bekker, an infectious disease scientist at the Desmond Tutu HIV Centre at UCT, said that about 39 organisations and about 150 of their implementing partners have been affected by the cuts. These included programmes for treatment, care, and the prevention of HIV, orphan care, and support for gender-based violence.

Kasiefa Charles was retrenched from the Ivan Toms Centre for Health last month after having worked there for ten years.

“When we started in 2000, when we first started to get treatment coming into the country, we had to hustle, everywhere for treatment,” said Bekker. She said that when PEPFAR came along in 2003, it had funded 100% of HIV support in the country.

She said the recent funding cut was critical for counselling with the aim of finding the remaining estimated 2 million people living with HIV who are still not on lifesaving antiretroviral (ARV) treatment.

“We can get to the end of AIDS… We can do it in our lifetime. But we can’t do it without money, without resources, and without the will and political support of our government,” said Bekker.

Bekker also lauded South Africa’s HIV treatment programmes as being the biggest in the world, along with having the highest number of PrEP (pre-exposure prophylaxis) initiations in the world. “There is real concern that taking this money away as quickly as it has, and if we don’t get that money back, is taking us backwards,” she said.

There are also concerns about the effect the funding cuts are having on other African countries such as Lesotho, Zimbabwe, Mozambique, Malawi, and Uganda, who rely much more on PEPFAR funding for their HIV response.

Kasiefa Charles, a former employee at Ivan Toms Centre for Health, described how the clinic had to close its free services, including the provision of HIV testing and counseling, PrEP, ARV medication, and other sexual health services.

Charles, who worked at Ivan Toms for over ten years before she was retrenched last month, said they also ran a crucial outreach programme with teams regularly travelling to Delft, Mfuleni, Dunoon, and Atlantis to test and treat HIV patients.

She said that many of their regular clients preferred to come to Ivan Toms because they felt stigmatised and unsafe in public clinics.

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