Government assures no ARV shortages despite Trump’s permanent freeze of USAid funding

The Department of Health has assured parliament that antiretroviral (ARV) medication supplies remain secure, despite the freezing of USAid funding for health organisations across South Africa.

Inkatha Freedom Party (IFP) MP Nompumelelo Mhlongo recently raised questions in parliament about continuity of care and drug procurement for vulnerable communities following the withdrawal of funding from the US President’s Emergency Plan for Aids Relief (Pepfar).

In response, Health Minister Aaron Motsoaledi provided a reassurance about medication supplies.

“Fortunately, 90% of the supply of ARVs comes from the South African fiscus, while 10% is from the Global Fund which is not affected by Pepfar,” he said.

“The department also has contracts in place with ARV suppliers. Electronic systems are in place at clinics and hospitals to monitor stock levels.”

USAid funding permanently cancelled

The situation escalated on Thursday, when USAid sent letters to NGOs informing them of the permanent cancellation of funding in South Africa.

This development followed initial stop-work orders that had been temporarily mitigated by waivers issued by US Secretary of State Marco Rubio to allow life-saving therapy and prevention of vertical transmission to continue.

However, within 24 hours of the announcement, many USAid implementing partners received final termination notices, marking a definitive end to the funding relationship.

ALSO READ: Health experts warn of ‘huge disaster’ as USAid terminates Pepfar HIV funding in SA

Department of health efforts to address the funding gap

In a previous parliamentary briefing to the portfolio committee for health, Motsoaledi said that the US government had initiated a 90-day review period of Pepfar funding.

“The assessment by the US government, not us… they say they are going to assess whether the programme they are funding, not only in South Africa, all over the world, is in line with the values, beliefs and objectives of the American people and American government,” Motsoaledi said.

He said that initial discussions had occurred with US officials, but were complicated by the absence of an American ambassador in South Africa, with only a chargé d’affaires currently serving in that capacity.

In his recent response to Mhlongo, Motsoaledi outlined existing safeguards in the health system.

“Many provinces already have standard calculations for reordering and stock replenishment in place.

“The Centralised Chronic Medicines Dispensing and Distribution (CCMDD) programme is still operating and actions are being taken to avoid it being compromised,” he said.

Motsoaledi confirmed active efforts to address the funding gap.

He said he had engaged with donors, both local and international, to discuss the issues of Pepfar’s withdrawal.

“The national department is working with the nine provincial departments and the National Treasury to prepare for a range of possible scenarios to sustain the programmes,” the parliamentary response read.

ALSO READ: ‘No Sona has got us out of this’; health expert says promises won’t put a bandage on healthcare crisis

Health department response to USAid funding cancellation

Department of Health spokesperson Foster Mohale downplayed immediate concerns about HIV/Aids treatment access while acknowledging some impact would be felt.

“It will have an impact, but not that huge an impact, especially with regards to treatment,” Mohale said.

“I see that the most impact would be mainly on those who were on the payroll of USAid.”
Mohale said that patients should not panic about getting medication.

“Anyone who was receiving HIV treatment through or sponsored or funded by the US government, we say it’s not the end please just go to the nearest public hospital,” he advised.

When questioned about potential medicine shortages, Mohale was reassuring.

“No, we don’t foresee any shortage of ARVs provided by government. Don’t feel rejected. Don’t feel abandoned during difficult times so just go to the clinic public clinic and get your treatment. For now we don’t foresee shortage of treatment in terms of HIV,” he said.

According to Mohale, the department is still seeking official confirmation of the funding cancellation.

“The department has noted media reports about the cancellation. We haven’t received a formal correspondence on the cancellation,” Mohale told The Citizen on Thursday.

ALSO READ: US health funding has stopped permanently; here’s what we know so far

Health experts warn of long-term consequences

Despite government reassurances, health experts have expressed serious concerns about the long-term implications of the funding withdrawal.

During a Zoom conference held by organisation Change on Thursday, professor Linda-Gail Bekker, chief operating officer of the Desmond Tutu HIV Foundation, presented modeling studies suggesting dire consequences if the funding gap isn’t addressed promptly.

“Over a 10-year horizon, while there may be some cost saving in the short term, in the longer term we will lose money,” she warned.

“We stand to lose all the investment over the past 25 years if we do not work hard to fill the gaps that this funding freeze is causing. Secondly, we will see lives lost. So, more than half a million unnecessary deaths will occur because of the loss of funding and up to a half a million new infections.”

USAid funding freeze has major impact on jobs

Vice-chairperson of the Unity Forum for Family Practitioners Dr Angelique Coetzee provided additional perspective on the impact.

“The biggest impact so far is about the loss of jobs and the funding that’s been stopped, especially on research,” she said.

Coetzee expressed concern about medication distribution challenges.

“It will be the lack of medication going to people who need it, especially people who don’t have transport or any other means to get to a local clinic to get their medication,” she said.

While increased HIV rates aren’t expected in the short term, Coetzee echoed Bekker’s sentiments and cautioned about infections in the longer-term.

“We will not immediately see an increase in the rates of the HIV numbers, but it will come. It will take a few months and then we would most probably see an increase in HIV positive treatments,” she said.

Regarding government preparedness, Coetzee expressed her scepticism.

“I do not really have huge confidence. Even if there’s work done behind the scenes, it has not reached a lot of the research institutions or some of the NGOs that have now been cut off from funding,” she said.

Coetzee called for greater government responsibility.

“Maybe it’s time for national department of health and the government to take responsibility for helping the poor, the needed, putting your money where your mouth is,” she urged.

According to Mohale, more information about contingency plans will be forthcoming.

“The department will communicate the contingency plans at the right time,” he said.

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