Trump’s return ‘bad news for South Africa’ if funding stops

United States’ donor funding has been central in keeping South African health services and medical research vibrant for generations, but the return of Donald Trump to the White House could see some funds restricted or cut off.

Medical and academic fraternities fear that the US funding of certain health care programmes under the US National Institutes of Health (NIH) and other health care programmes that do not appeal to the Republicans’ conservative views, such as reproductive health and abortion might face funding restrictions.

Progressive Health Forum national co-ordinator Dr Aslam Dasoo said the Trump administration could mean bad news for donor funding to South African health care and research programmes.

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Some avenues of funding may stop

Dasoo and other health workers and academics did not envisage a complete stopping of the funding, but believe the programmes could be affected by restrictions imposed by Trump.

However, they were optimistic that the United States President’s Emergency Plan for Aids Relief (Pepfar) would remain untouched in any policy shift.

Dasoo and the University of the Witwatersrand’s dean of health faculty, Prof Shabir Madhi, said in the previous Trump presidency, there was no interference with long-running Pepfar, which is a global health initiative that provides funding to address the HIV/Aids epidemic in more than 50 countries, mainly in Africa.

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Madhi said the US funded the implementation of activities around Pepfar and USaid.

This included providing countries with financial support for health systems for antiretroviral treatment for people living with HIV.

“Trump did not pull back on such support in his previous term, so I’m unsure whether he would deprioritise or defund such programmes,” Madhi said.

Dasoo said: “The benchmark is the previous Trump administration, which was clearly more conservative in funding programmes, but Pepfar was left alone because it is so successful there is no reason to change it.”

According to Dasoo, though Trump adopted a conservative approach to health care, he quickly authorised Covid vaccines during his previous administration.

Trump on reproductive health and LGBTQI

The administration could go further to restrict funding to non-governmental organisations that dealt with reproductive health and LGBTQI issues.

Trump is widely regarded as a homophobe who also speaks in derogatory terms on abortion. But South African health practitioners and research academics are worried about the possible appointment of Robert F Kennedy Jnr, a vaccine denialist as Trump’s secretary of health.

Dasoo said under Kennedy, there was likely to be massive shift towards conservatism. He is known for being an antivaccine theorist.

“One of the things is that funding for reproductive health and abortion will be under pressure and this may affect health care funding to African countries,” Dasoo said.

“Congress could review donor funding and that review may affect South Africa when it comes to these services.”

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But Madhi and Dasoo said grant funding for research was unlikely to be affected.

The funding is crucial for medical research in South Africa. But Dasoo envisaged that the criteria for grant funding on reproductive health and abortion could be changed or restricted.

Rubani Trimiew, spokesperson for US embassy in South Africa, said: “I cannot speculate on the future policies of the next administration.

“What I do know is that for 21 years, Pepfar has been one of our nation’s most profound, transformational investments and has enjoyed bipartisan support.”