Urgent need to address US funding gaps for HIV and TB services

IF THE funding gap created by US President Donald Trump's withdrawal of aid is not urgently addressed, critical support in the provision of HIV and TB services in South Africa will be crippled. 

This is according to the TB Accountability Consortium as activists expressed disappointment that Finance Minister Enoch Godongwana failed to account for the additional finances required to cover activities that were sponsored by US funding, particularly for HIV and TB treatment programmes.

In his budget speech on Wednesday, Godongwana announced that R941,5 billion has been allocated over the medium-term expenditure framework (MTEF) period to support the equitable provision of public health services, including free primary healthcare.

The minister said that mainly to keep 9,300 healthcare workers in hospitals and clinics, they have added R28,9 billion to the health budget.

But in regard to the withdrawal of the US President’s Emergency Plan for AIDS Relief (PEPFAR)  Godongwana only said that Pepfar "is too heavy on the administration to take on", and they have instructed an audit firm to do an evaluation and assessment on what is needed and what isn't. 

He said that the audit firm will submit their evaluation at the end of the month.

The TB Accountability Consortium, a collective of organisations working in the TB space to strengthen advocacy and improve South Africa’s TB response, and an initiative of the Rural Health Advocacy Project, said there were about 280 000 people estimated to have TB each year and it remained the biggest infectious disease killer. Just under 60% of people with TB are co-infected with HIV.  

“The aid that was halted from PEPFAR funds 17% of HIV and TB services in South Africa, and amounts to about R7billion. 

“It covers the salaries for 15 000 health workers, of which 8000 are community health workers, 2000 are nurses and 300 are doctors,” the TB Accountability Consortium said.

They noted that in his State of the Nation address in February, President Cyril Ramaphosa noted with concern the funding gap and announced that the government was looking at “various interventions to address the immediate needs and ensure the continuity of essential services”. 

“The health sector has anticipated details of a programme to transition the services. However, in delivering his speech (the minister) remained mum on the US aid gaps.” 

TBAC Coordinator Sihle Mahonga-Ndawonde said it was concerning that the PEPFAR funding gap had not been addressed. 

“It is critical that the government provide guidance on how these services will be covered. Millions of people rely on this lifesaving treatment,”  she said.

South African Medical Research Council (SAMRC) spokesperson Tendani Tsedu said they were in discussions with the Department of Health and Treasury about the need to fill the critical gaps that have been left by the abrupt termination of funding from the US administration. 

“We welcome the appointment of the audit firm to conduct an assessment and hopefully their evaluation will enhance the government's understanding of the negative impact of the cutting of Pepfar and the need for solutions,” Tsedu said.

Cape Times