The South African government and health experts are sounding the alarm over the devastating impact of US funding cuts on the country's HIV/AIDS program.

The US President's Emergency Plan for AIDS Relief (PEPFAR) has been a crucial lifeline for South Africa's HIV response, but the recent funding freeze has left thousands of jobs at risk and the lives of millions of people living with HIV, in jeopardy.

Professor Linda-Gail Bekker, director of the Desmond Tutu HIV Centre and chief executive officer of the Desmond Tutu Health Foundation, warned that the funding cuts would have catastrophic effects.

"Prolonged treatment interruptions, new and missed HIV acquisitions, and lost opportunities to intervene will result in more hospitalisations, lives lost, infections acquired, and overall increased cost to the healthcare budget over time," she said.

A recent study co-authored by Bekker and published in the Annals of Medicine estimated that the withdrawal of PEPFAR support without a transition plan would lead to an estimated 601,000 HIV-related deaths and 501,000 new infections in the next 10 years.

The funding cuts have already resulted in the loss of jobs of around 15,000 trained healthcare providers, data capturers and technical support staff.

This has led to reduced services, clinic closures, and diminished data collection.

Health Minister Aaron Motsoaledi described the situation as a "train smash" for the thousands of workers affected.

"That's a train smash for them – we accept that; we're not hiding that," he said.

A group of health and human rights organisations has written a letter to the government, calling for a coordinated emergency plan and increased budget for healthcare services to mitigate the crisis.

The organisations expressed concern over the lack of transparency in the government's handling of the matter and the potential disruption of critical health services.

"We are concerned that the current discourse and planning is focused on critical ARV programs, but ignoring the continuation of several specialised counseling, support, prevention, and treatment services for at-risk or key populations – that already face high levels of stigma and discrimination," the letter stated.

The organisations urged the government to prioritise the needs of people living with HIV and to ensure that the funding shortfall is addressed urgently.

Bekker emphasised that the crisis presents an opportunity for the South African government to reassess its healthcare system and identify strategies to enhance healthcare delivery for long-term sustainability.

"Home to the world's largest HIV epidemic, the South African government, in partnership with civil society, has the potential to turn this crisis into an opportunity," she said.