Trump permanently cuts USAID to South Africa

The US has permanently stopped funding thousands of healthcare programs in Africa, with notifications to affected organizations arriving without warning and causing a cascade of chaos.

Letters from The United States Agency for International Development arrived overnight local time for many and were also sent to groups funded by the President’s Emergency Plan for AIDS Relief, or PEPFAR.

“The termination orders are coming through in droves,” Desmond Tutu Health Foundation Chief Executive Officer Linda-Gail Bekker said in an interview. 

PEPFAR was initiated in 2003 by then-President George W. Bush. It has saved an estimated 25 million lives and allowed 5.5 million children to be born free of the HIV virus that causes AIDS. 

At least nine African countries have AIDS programs. While many of these have transitioned to the respective countries assuming more responsibility for their national responses, each is still sorely affected by the funding cuts.

“It is not hyperbole to say that I predict a huge disaster, a walk back on investment unless other resources can be found — and found urgently,” Bekker said in a briefing Thursday. 

South Africa stands to lose 25 years worth of investment if the government fails to fill the gaps left by USAID, with more than 500,000 deaths expected to occur because of the terminations, she said.

Crucial support staff will also be lost, putting further pressure on the country’s already stressed public health service. 

A US-funded HIV vaccine trial, where the South African Medical Research Council had teamed up with scientists from eight countries on the continent, has also stopped because of the USAID moves.

“I never thought we’d be in a situation like this,” Mitchell Warren, Executive Director of US advocacy group AVAC, said in a briefing Thursday.

“We knew things were going to be different under the second term of this new president, but I don’t think any of us recognized the speed and scale and inequity and inhumanity with which this would happen.”

The US earlier this month issued a waiver to allow some PEPFAR activities to resume, focusing on “life-saving” tasks such as HIV care, testing, counselling, and medicine procurement.

While the waiver was set for 90 days, the confusion about how the stop-work orders were implemented resulted in many clinics remaining closed. The orders received Thursday have halted what remained.

One USAID-partner in South Africa said tomorrow they will terminate the jobs of 2,800 workers including counselors, data capturers and healthcare workers.

“The Trump administration, according to our organization, has declared war on the right to health globally,” said Yvette Raphae,l who heads a South African advocacy group for the prevention of HIV and AIDS. 

Still, local government needs to step up, she said. “In South Africa, healthcare is a human right, and our government has an obligation to ensure that our health right is reached.”