‘Government must take control’: Trump closes SA health funding tap
'Staff that are currently employed through the US-funded grants, the activities of those staff will need to be shifted to government employees.”
US President Donald Trump. Picture: X/@MimiMefoInfo
The Dean of Wits University’s Faculty of Health Sciences has emphasised that the South African government must assume control of the country’s health programmes, which may be affected by newly elected President Donald Trump’s executive order.
‘America First’
On Monday, Trump ordered a pause on foreign assistance from the United States as his administration promoted its “America First” agenda.
“We get tired of giving massive amounts of money to countries that hate us, don’t we?” Trump said in a speech during the House Republicans’ annual retreat in Florida on Monday.
According to the USAID, in the Fiscal Year 2024, the United States provided nearly $6.6 billion in humanitarian assistance across sub-Saharan Africa.
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SA funding
South Africa receives with $448.5 million (R8.5 billion) from the US for the country’s health programmes, especially those supporting the fight against AIDS.
On Monday, the Wits Reproductive Health and HIV Institute (RHI) Trans Health Centre was one of the organisations affected by the USAID Stop Order.
“Due to the USAID Stop Order, the Wits RHI Key Populations Programme clinics will be closed until further notice. We sincerely apologise for the inconvenience this may cause and remain committed to your health and well-being,” it said in a post on X.
🚨 Important Notice: Clinic Closure 🚨
— Wits RHI Trans Health Centre (@WitsRHI_TransHC) January 27, 2025
Dear Clients,
Due to the USAID Stop Order, the Wits RHI Key Populations Programme clinics will be closed until further notice. We sincerely apologize for the inconvenience this may cause and remain committed to your health and well-being. pic.twitter.com/EJu6KIQbtG
‘Stop orders’
Speaking to The Citizen, Professor Shabir Madhi said that stop orders have not affected all US-funded programmes.
“Currently, there are very specific programmes where stop orders have been issued, and those stop orders have been issued largely at programmes that have got an element of diversity, equity and inclusion.
“So the rest of the programmes, there haven’t been stop work orders issued, but rather there’s been a postponement in terms of further activity until such time that the powers that be in the US have decided whether those programmes will continue to be prioritised, but it’s not all programmes that have been stopped,” Madhi said.
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Impact on SA’s health programs
Madhi said it is difficult to gauge the impact of the stop orders on South Africa’s health programs.
“Many of these programmes are actually integrated in government facilities, and what we hope for to happen is that if there is disruption, that government actually steps in to sort of address the disruption that might materialise because of the stock work orders that have been issued, which means that the staff that are currently employed through the US-funded grants, the activities of those staff will need to be shifted to government employees.”
Madhi said there is a concern surrounding the Wits RHI Trans Health Centre.
“I think concerning, and I think the Trans Health Centre is an example that forms part of diversity equity and inclusion, and that is something specific that the Trump administration seems to be targeting in terms of the stop-work orders.
“But it doesn’t affect all HIV programmes or all HIV testing. There is a potential for other programmes to be affected, but it’s unclear at this stage whether other programs will be affected. And again, I think it’s important to emphasise that it is eventually the responsibility of government to assume control of these programmes and to ensure that these programmes continue,” Madhi said.
Government responsibility
Madhi added that it’s the responsibility of government to provide healthcare to its citizens.
“Certainly, government has been assisted by the US, but at the same time, it can’t be a dependency on the US to ensure that the health of our citizens is protected.
“So, government has to come to the fore in terms of ensuring they put into place mitigation to actually minimise disruption to services,” Madhi said.
On Inauguration Day, Trump ordered a 90-day pause in almost all foreign aid to give the administration a chance to ensure that it fits with its priorities.
“The United States foreign aid industry and bureaucracy are not aligned with American interests and in many cases antithetical to American values,” the executive order reads.
USAID
Washington has long leveraged aid as a tool of its foreign policy, saying it cares about development and drawing a contrast with China, which is primarily concerned about seeking natural resources.
The United States has long been the world’s top donor in dollar terms, although several European nations, especially in Scandinavia, give significantly more as a percentage of their economies.
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