Pepfar restrictions ‘unfortunate’ and will affect many lives, says Nelson Mandela Children’s Fund

The Nelson Mandela Children’s Fund (NMCF) on Wednesday expressed deep concern over new restrictions to the US President’s Emergency Plan for AIDS Relief (Pepfar), warning that the limitations could have far-reaching consequences for healthcare services across South African communities.

The American administration’s decision to implement a limited waiver for Pepfar has created uncertainty among organisations that rely on the funding and those who use their services.

While the waiver maintains support for essential services such as HIV care, TB treatment, and prevention of mother-to-child transmission, it introduces significant restrictions that have raised alarm among healthcare providers, according to the NMCF.

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Pepfar ‘unfortunate development’ comes at critical time

The new limitations explicitly exclude coverage for family planning, abortions, conferences, administrative costs, transgender surgeries, and other non-life-saving assistance.

The reduction in scope has left many organisations questioning their ability to maintain comprehensive healthcare services.

“This development is unfortunate and arises at a time when such funding, particularly from Pepfar, is essential across our communities,” said Karl Muller, NMCF’s chief programs officer.

“We hope that once everything is reviewed, organisations working in this sector can fully resume their work and concentrate on the important tasks they undertake.”

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Pepfar funding restrictions raise unemployment concerns

The funding restrictions are expected to compound South Africa’s already high unemployment rate.

Several workers from Pepfar-dependent institutions have already been displaced, with more jobs potentially at risk.

This comes at a time when international funding has been declining due to budget cuts and various suspensions.

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‘Not business as usual’ warns NMCF

Addressing the broader implications, Muller emphasised the need for accountability while expressing concern about the increasingly stringent funding environment.

“All funding needs to be properly accounted for; however, what we are witnessing with this limited waiver from Pepfar is becoming increasingly stringent — a challenge we hope to overcome together,” he said.

“Thousands of South Africans have benefited from this funding over the years, which must not be taken for granted, yet we behave as though it’s business as usual.”

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