USAID funding cuts to South Africa: 'the damage is irreversible' - NGO
“It’s like walking into a hospital and turning off the power while patients are on ventilators and in surgery,” an NGO programme leader said of the United States Agency for International Development (USAID) funding cuts.
The leader, who spoke on anonymity, said the cuts have already had devastating consequences. "This abrupt funding pause has essentially stopped our work dead in its tracks. The damage is irreversible."
The recent 90-day pause in funding by USAID, under the directive of the new US administration, has sent shockwaves through South Africa’s healthcare sector, particularly in the fight against HIV and TB.
South Africa’s HIV epidemic is one of the largest in the world, with more than 8 million people living with the virus.
For more than two decades, USAID and its flagship initiative, the President's Emergency Plan for AIDS Relief (PEPFAR), have been pivotal in supporting South Africa’s battle against HIV/AIDS and TB.
One NGO leader, who spoke off the record, highlighted the scale of this impact. These programmes have been responsible for providing treatment to over 4 million people in South Africa alone, making substantial contributions to the country’s health system.
The programmes have supported about 200 000 to 300 000 people annually in recent years.
This analogy starkly illustrates the gravity of the situation. These programmes have been the backbone of HIV and TB treatment in South Africa, not only saving lives but preventing the spread of drug-resistant strains of these diseases.
HIV and TB
While great strides have been made in providing antiretroviral therapy (ART), the fight is far from over. TB, often referred to as the "silent killer", is closely tied to HIV, as it remains the leading cause of death among people living with the virus.
The halted funding has disrupted programmes that were addressing these intertwined health crises.
The NGO leader explained: “By dealing with the HIV epidemic, we were also helping to stop the TB epidemic. Now, with this funding pause, we risk seeing a resurgence of both diseases.
“Drug-resistant TB is 10 to 100 times harder to treat than HIV, and we don’t have the resources to deal with it effectively.
“Without the dedicated resources provided by USAID, government healthcare workers, who are already overstretched, will have to pick up the slack.
“This is a daunting task in a country where public healthcare facilities are often under-resourced and overburdened.”
The global ripple effect
The implications of this funding pause extend beyond South Africa’s borders. PEPFAR, a programme that supports nearly half of the world’s HIV patients, has been instrumental in preventing the global spread of diseases like HIV, TB and even emerging threats like Ebola and Marburg.
Stopping these programmes will have a blowback effect, even in the US. Diseases like Marburg, which has an 80% fatality rate, could easily reach American shores.
Covid-19 showed us how poorly the world handles pandemics. Imagine something far deadlier making its way across borders, the NGO leader warned.
This funding halt also affects critical research initiatives aimed at preventing future pandemics. The disruption of these programmes jeopardises progress in global health security, leaving the world vulnerable to emerging health threats.
One of the most frustrating aspects of this crisis is the lack of clear communication from US agencies.
According to the NGO leader, staff at partner organisations have been left in the dark, with no official directives or timeline for when or if funding will resume.
“Staff need to know if they’ll be paid next month. Patients need to know if they’ll get their medication. Without clear communication, we’re stuck in limbo, unable to act.”
In South Africa, the government funds most of the HIV medication. But in many other African countries, up to 100% of medications and supplies are funded by international aid.
Patients there are being told they can’t even receive the drugs sitting on shelves. It’s utter chaos, the NGO leader explained.
South Africa’s role in the global fight against HIV
South Africa plays a critical role in achieving global HIV targets. The country alone contributes to 50% of PEPFAR’s global HIV treatment goals. Despite its significant contributions, the country is now left to navigate this funding gap on its own.
“Donor funding may only make up 20% of South Africa’s HIV budget, but that 20% does 50% of the work. Without it, we’ll see a massive gap in service delivery,” the NGO leader explained.
The potential fallout is staggering; job losses, halted research, and, most importantly, interruptions in life-saving treatment for hundreds of thousands of people.