South Africa says its budget can't cover for the deep US cuts in foreign aid
South Africa doesn't have the funds to cover the over $430 million shortfall caused by the Trump administration's cuts in foreign aid, the country's finance minister said Wednesday.
Finance Minister Enoch Godongwana spoke to Parliament while presenting an updated budget — one without the value-added tax increases that had sparked public outcry and fierce disagreement among parties in the ruling coalition.
Without that tax revenue, he said, South Africa doesn't have enough money to make up for the cuts that have threatened the vast network of support for one of the world's largest HIV-positive populations.
The country runs the largest treatment network in the world.
The finance minister spoke shortly before President Cyril Ramaphosa's much-anticipated meeting with U.S. President Donald Trump at the White House.
Earlier this year, the dismantling of USAID by the Trump administration saw around $436 million in annual funding for HIV treatment and prevention in South Africa evaporate, putting the program and thousands of health care jobs on the line.
Godongwana said the updated budget prioritizes financial resources to support what is currently feasible, and defers other programs until 'our resources allow.'
More pain might be coming, he warned.
'The spending pressures that may require funding later this year include, among others, the withdrawal of the presidential emergency plan for AIDS relief called PEPFAR funding, particularly which was through the USA,' he said.
'We've not made provision for the allocation for that now."
Globally, PEPFAR is credited with saving at least 26 million lives since it began in 2003, according to the U.N. AIDS agency.
South Africa's previous budget presentation allocated 28.9 billion rand ($1.6 billion) for health. The current one allocates a significantly lower 20.7 billion rand ($1.1 billion) instead. The money is earmarked to protect around 4,700 health positions, hire 800 doctors who have finished their community service and address shortages in medical supplies, services, and accruals.
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The Independent
17 minutes ago
- The Independent
Global aid cuts are a massive wake-up call. It's time to give Africa a bigger voice
In less than a month, Seville will host the Fourth International Conference on Financing for Development in a climate of uncertainty following the abrupt decision by the US to dismantle its aid programmes. But Washington is not alone in this posture. The European Union agreed to reallocate €2 billion (£1.7bn) reallocation from development budgets in February 2024 —and many individual European countries have made cuts to their aid budget. It is a clear signal that the landscape of Overseas Development Assistance (ODA) is shifting. For Africa, this isn't just a reshuffle, it is a wake-up call for deep reflection and action: will we adapt, or will aid simply become a relic of the past? The timing is bad, the rationale questionable, and the ripple effects threaten to impact the lives and health of millions depending on aid programmes. Let's be honest: aid has had a mixed impact. The spectrum of aid's legacy in Africa, including my country, Guinea, runs from positive to disastrous. On the positive side, aid has contributed to infrastructure development – I'm thinking for instance about a project in northwest Guinea to replace an old ferry with a new road and bridge. During a visit, a cunning minister of public works convinced a skeptical partner to go on a very 'special' field trip via the old route, one that left a senior official so sore and tired that all doubters saw the project's true necessity. Once it was completed, traffic soared, proof that aid can work when it's aligned with real needs. But aid can fall flat. When I was serving as minister of finance, I led efforts to curb directly awarded contracts and boost transparency following an audit of public procurement procedures. The goal was to improve the quality and cost-effectiveness of public spending. But some donors were not willing to support this effort. I deplored one particular partner's failure to listen and, above all, a stubborn insistence on taking us backwards by ignoring our analysis. I said no to the help on offer. It was hard but necessary. Aid must serve the real priorities, not satisfy bureaucratic checkboxes. In a recent discussion with the director of an incubator to help small and medium-sized businesses grow – funded by a government donor – I was struck by the emergence of shortcomings I thought belonged to the past. These included a laziness to question one's own model for delivering results, despite warnings about the risks of inefficiency. We also see a narrow focus on so-called "easily accessible" geographic areas, such as capitals, and on disbursements. Aid, in many cases, has helped sustain corrupt elites or fostered unhealthy alliances with public administrations – perpetuating dependency rather than solving problems. When I look back on my own experience in development – a journey close to an out-of-body experience for an African – I realise we are at a critical juncture. It's the moment to question the very foundations of aid institutions inherited from the post-colonial era. Despite some positive reforms, such as untying aid, the core premise remains unequal. It is predominantly driven by the donors, with African countries still being passive recipients rather than active partners. How can this be changed? Change starts with listening. The 'receiving hand' is not dumb and has ideas. It knows its needs. Recipient countries, especially in Africa, must be at the centre of the discussions. Conversations largely driven by donors are a recipe for failure. Furthermore, African organisations and think-tanks must be active players. Decolonising aid must be more than just a buzzword. We are making progress, but it must be accelerated. We continue to see consultancies denied opportunities due to insufficient financial strength – despite their thorough knowledge of the field. It also means better coordination between donors. You would think this is obvious, and yet despite witnessing many innovative and pragmatic approaches, I still see some partners continue to burden governments' limited capacities by each imposing their own distinct systems and reporting requirements. This ends up being a distraction. Recipient governments are key and are the only ones who should replace any donor. I believe the cuts could be an opportunity to make fiscal compromises that (finally) prioritise the necessary and the productive over the superfluous and the personal gain of some actors. Aid must be used strategically and selectively. It should foster technical cooperation for Africa's economic transformation, its integration higher in global value chains. Aid should be a catalyst to reform the global financial architecture by leveraging innovation and the capital needed to finance our massive infrastructure programmes. It must be an instrument for the Africa Union's theme of the year: "Justice for Africans and People of African Descent Through Reparations'. It's time to make sure those people are at the table, and their voices are listened to.
The Independent
18 minutes ago
- The Independent
Death, violence and endless delay: Inside Africa's most troubled energy project
Campaigners have demanded the UK government pull its funding for a natural gas mega project in Mozambique – alleging that it breaches Britain's human rights and environmental obligations. The project in question is a $20 billion (£15bn) liquified natural gas (LNG) development located in the Cabo Delgado region of Mozambique. The project, called Mozambique LNG, has been halted since 2021 after violence from an Isis-backed group led to 183 contractors being trapped in a hotel for two days, with 10 people killed when apparently trying to escape, including British national Philip Mawer. In all, the ongoing insurgency in the area has resulted in an estimated 6,000 deaths since the conflict began in 2017, with some 600,000 people displaced. In a letter seen by The Independent, campaign group Oil Change International (OCI) argues that the violence and other issues over the protection of the project makes a potential $1.15bn investment by UK Export Finance, a department of the UK government untenable. Continuing to finance the project is also not compatible with environmental commitments made in 2021 to no longer finance fossil fuels abroad, OCI argues. A tale of violence, delay and legal action was never meant to be the story of Mozambique's foray into natural gas, after some 180 trillion cubic feet of gas was discovered off the country's coast in 2010. In 2016, the International Monetary Fund (IMF) projected 34 per cent GDP growth for Mozambique by 2021. However, actual economic growth was around 2.5 per cent. TotalEnergies, the French energy firm, is currently in the process of trying to re-start the project by the middle of this year. 'The security situation has improved," CEO Patrick Pouyanne told Reuters on the sidelines of the World Gas conference earlier this month. Pouyanne's ambitions received a big boost in March when the US Export-Import Bank re-approved financial support worth $4.7bn for the project, boosting TotalEnergies' hopes of restarting the project. But the future of Mozambique LNG remains up in the air, with the British export credit agency still considering whether to recommit to its $1.15bn pledge – having joining with 33 countries, including the US, to sign a pledge to end public finance for fossil fuel projects abroad while hosting the COP26 climate summit in Glasgow in 2021. According to OCI campaigner Adam McGibbon, if the UK pulls out of the deal then the entire financial arrangement is expected to collapse. 'We know of at least one major bank involved in the deal that has said they will also pull out if the UK does,' he says. The legal letter sent by OCI argues that the funding of the LNG project in Mozambique goes against the UK's obligations under international law to promote human rights in business both domestically and abroad. The letter highlights the UN's Guiding Principles on Business and Human Rights, which state that companies and nations must ensure that human rights are respected in relation to business operations. A UK Export Finance spokesperson said: 'UK Export Finance is currently in talks with project sponsors and other lenders regarding the latest status of the LNG production project in Mozambique. 'We take reports of alleged human rights infringement extremely seriously and are looking further into the matters.' 'The Qatar of Africa' Observers at the time the gas was discovered off the coast of Mozambique suggested that the country – one of the world's poorest – could transform into the 'Qatar of Africa'. A number of massive projects aiming to ship the gas around the world in the form of LNG were soon proposed. TotalEnergies' Mozambique LNG project stands out for its sheer size, with the $20bn in financing a figure roughly the same size as Mozambique's entire GDP. The 65 trillion cubic feet of gas it was expected to deliver is the equivalent of six years of current EU gas demand. But in March 2021, the 'force majeure' declaration was made, which enables parties to renege on an agreement due to unforeseen external circumstances. It came after Islamist insurgents captured swathes of territory in the Cabo Delgado region, and at least 1,400 people were left killed or missing presumed dead. Earlier this year French authorities began investigating TotalEnergies over potential corporate manslaughter, after survivors and relatives of victims of the event accused the energy giant of failing to protect its workers. In a statement shared with The Independent, a spokesperson for TotalEnergies said that they will ' cooperate with this investigation', but that 'the company categorically rejects' the accusations. 'Mozambique LNG's teams provided emergency assistance and mobilised their resources to evacuate more than 2,500 people (civilians, employees, contractors, and subcontractors) from the site where the Mozambique LNG project is located at the time of the attacks,' the spokesperson said. But some say the need to resettle people so that the land can used for the project has aided recruitment for the insurgents. 'The local population is being deprived of jobs, in a scenario where pressure on land is increasing, where people are losing access to land, losing access to natural resources,' wrote local analyst Joao Feijo earlier this year. 'The discontent that is created here is very great and this kind of discontent is capitalised on by these violent groups. Many individuals joined this group because they had no other alternative,' he added. Signs of discontent can be found in villagers claiming that they have not been sufficiently compensated for giving up land that most rely on for subsistence farming, according to evidence collected by local NGO Justica Ambiental, after Mozambique LNG was given rights to 6,625 hectares of land to build its liquefaction terminal. 'We agreed that the company would take our areas, but when they took our areas – the forests and fields – and they didn't want to pay us, they denied it,' said Neto Agostino Paulo resident of Macala Village, in footage captured by Justica Ambiental in summer 2024. Fellow Macala villager Adija Momade Sumail Nkabwi said: 'The company came here to lie to us that they were going to compensate us for our property that they had occupied, leaving us with false expectations'. The spokesperson for TotalEnergies told The Independent that prior to the force majeure announcement, 89 per cent of compensation payments had been paid within six months of the signing of compensation agreements, and 66 per cent were paid within 90 days. 'The Force Majeure situation has prevented the full implementation of the relocation and compensation process and has slowed down the exercise,' they said. 'Drill baby, drill' For OCI's Adam McGibbon, the violence and displacement witnessed in Cabo Delgado is a 'classic example of the resource curse': The phenomenon where resource-rich countries with abundant natural resources ironically end up with a multitude of problems. Nigeria and Angola – both oil-rich countries plagued by corruption and inequality – are oft-cited examples of countries to have suffered this fate in Africa. At the same time, it has also been said that given the low living standards of countries like Mozambique, any opportunity to bring in billions of dollars of foreign investment is a good thing. Some, like former Irish President Mary Robinson, have argued that African nations should be allowed to extract natural gas to develop. But there are growing concerns that the economic benefits originally conceived in Mozambique LNG might not ever materialise, even if the project goes ahead as planned. For all the talk of ' Drill baby, drill ' coming from Donald Trump in the White House right now, the prospects of a major new LNG production terminal are much weaker than in 2020. Since Russia invaded Ukraine in 2022, and subsequently shut off pipeline gas flows to Europe, planned new LNG facilities in the US and Qatar have driven up projections of global LNG capacity. An increase of nearly 50 per cent is currently on the horizon, according to the International Energy Agency (IEA). This ' LNG glut ', as the IEA describes it, is exacerbated by renewables continually beating targets in Europe and Asia, as well as a global push for 'energy security' that did not exist in 2020, and which is making governments less inclined to rely on expensive liquefied gas imports for energy. 'If and when TotalEnergies' Mozambique LNG project gets off the ground, it will be adding further supply into a market characterised by oversupply and lacklustre demand,' says Simon Nicholas, from IEEFA, a think tank. 'This can hardly be a surprise: There is a long history in Sub-Saharan Africa of fossil fuel projects doing nothing to boost development in the host country.' If global gas markets are oversupplied, there is a risk that Mozambique LNG will become a 'stranded asset', which will plummet in value – or even become a liability for Mozambique. Even a 'moderate-paced transition' away from fossil fuels globally would lead to Mozambique seeing gas revenues of just 20 per cent of what they would be in a slow-paced transition, a report from the think tank Carbon Tracker has found. The authors described countries looking to exploit oil and gas assets for the first time as making a 'significant gamble'. 'Huge economic costs' TotalEnergies has also structured its LNG deals in a way that activists have warned is disadvantageous to Mozambique, with revenues Mozambique set to come in the mid-2030s and 2040s, think tank IISD has said. This means that if the project does not see out its lifespan, TotalEnergies and other partners will have seen an outsize share of profits so far, with Mozambique losing out. Mozambique also faces 'substantial economic risks' related to investor-state dispute settlements (ISDS), a separate report from Columbia University found last year. ISDS are lawsuits where foreign investors sue countries where they have invested if they believe the government has violated the terms of the agreement. Mozambique's international investment agreements allow foreign investors to bypass the national judicial system in such disputes, the report found, while 'stabilisation clauses' protect investments from unexpected regulatory changes or new fiscal rules, potentially preventing Mozambique enacting new legislation to transition away from fossil fuels. 'What they have basically done is said Mozambique cannot invest in climate action without paying huge economic costs,' says Daniel Ribeiro, a Mozambican activist with Justica Ambiental. Such an arrangement is likely to 'only amplify social tensions in Cabo Delgado,' if little money is seen to reach local people while a Western company makes large profits, warns Ribeiro. Given the insurgency, delays, and economic concerns, it might seem the simplest thing for Mozambique to do would be to try and pull out of the deal. However, the country has racked up government debts since gas was discovered, using expected future gas revenues as collateral for borrowing. But expectations have not matched reality. The year 2016 also saw a corruption scandal rock the country after it was found that members of the Mozambican Government had secretly taken out loans for themselves from London-based banks, using assurances of future LNG gas revenues to do so. A 2023 report from Debt Justice found that the Mozambican government has been paying back some of those loans. Mozambique's external national debt more than doubled between 2010 and 2018, according to CEICC data, while Friends of the Earth has warned that potential corruption arising from the 'mere promises of LNG development' may have already cost the country more than any actual profit the project could generate for the country over its lifetime. For Ribeiro, who lives in the Mozambican capital of Maputo, the priority for the country should be investing in renewables and climate change adaptation. 'My main message is that the cost of climate change is going to be far greater than any profits from Mozambique LNG, and that should be the priority,' he says. The country is considered one of the most climate-vulnerable on the continent, exposed to extreme weather concerns including cyclones, droughts and floods. Cyclone Kenneth, which hit Cabo Delgado in 2019, caused damage estimated at $300m. But the Trump administration has a different idea about what is good for the country. Weeks before confirming its $4.7bn loan for Mozambique LNG, the US government shut down the USAID-backed Power Africa programme's operations in the country – with an emphasis on renewable energy – which has been leading efforts to boost energy access, in a country where only 40 per cent of the country's population has access to electricity. 'Cycle of death' The push to resume the Mozambique LNG project also comes despite the fact that the Islamist insurgency very much remains a threat. While insurgents no longer control full towns and villages, they have become more agile, and have stepped up the number of road blocks in recent weeks, according to local media. 'There are still believed to be several insurgency units of hundred or so people, and they still have the ability to make attacks and destabilise the area,' says Ribeiro. 'And every time they suffer losses, they continue to be able to recruit. Why? Because we are still not dealing with the economic and social drivers of the problem,' he adds. The EU is currently funding Rwandan troops to help protect the region - but this arrangement is also under threat due to accusations Rwanda has been supporting rebels in the Democratic Republic of Congo, as well as allegations that the Mozambican government is using units trained by the EU for protest suppression. For Marisa Lourenço, an independent risk analyst in Southern Africa, the threat of violence is 'definitely still there' in Cabo Delgado. She believes that while TotalEnergies will be able to securely lock down its site on the coast, it remains unclear if doing so is worth the money. 'TotalEnergies can secure the site. But is the infrastructure cost worth it? Will it recoup its sunken costs? Probably not. TotalEnergies rushed into taking on this project, and I think it regrets it,' she believe. For Mozambique, meanwhile, it remains clear for Ribeiro that the best option is for the country to pull out of the project. 'Pulling out will cause a whole host of problems in the short term, but it will help us emerge from this cycle of death,' he says. So long as the project continues, the Western world can turn a blind eye to what is happening in Mozambique, by imagining that it is financially supporting the country, believes Ribeiro. But if the project fails, then the country can focus on other development pathways that actually benefit the people. 'It's like a chronic condition that keeps flaring up, for which there is no cure' he says. 'Sometimes you just need to take the bullet.'
Daily Mail
23 minutes ago
- Daily Mail
Subtle warning signs of 'silent disease' 16m Americans are living with and don't know
Nearly 16 million people have the most deadly type of liver disease, yet 80 percent of them have no idea. About five percent of adults worldwide have metabolic dysfunction-associated steatohepatitis (MASH) a serious liver condition caused by fat buildup, inflammation, and scarring. It's the most dangerous type of fatty liver disease MASH triggers liver scarring, which can progress to cirrhosis, and significantly increases the risk of heart disease, chronic kidney disease, and liver cancer. Just one in five Americans with the condition are actually diagnosed. Most patients do not experience symptoms until the damage is irreversible, making it a 'silent disease'. However, as the condition progresses, individuals may experience fatigue, pain or discomfort in the upper right belly, unexplained weight loss, weakness, and in some cases, jaundice (yellowing of the skin and eyes). A coalition of researchers from the US, Europe, and South Africa said that MASH-related liver failure and other complications, including deaths, are becoming more severe and common. The scientists behind the report, published in The Lancet Regional Health Europe, are calling for a doubling in MASH diagnosis rates from the 2022 level, about 13 percent (the current rate is just under 20 percent). They estimated that about 2.6 million people in the US, UK, Germany, and France have been diagnosed with MASH. But if testing were adequately improved and scaled up to become more accessible and commonplace, that figure could balloon to 6.1 million. People with type 2 diabetes, obesity, and heart disease should be prioritized for blood work and other screening tests, which will need to skyrocket from about two million to 36 million. Follow-up testing also needs to jump by nearly 1,300 percent to meet patient needs, and in more settings than liver clinics, such as family doctors' offices, and with diabetes and heart doctors. People with diabetes are especially prone to liver damage leading to MASH. Around 30 to 60 percent of diabetics also have MASH. Obesity is another leading risk factor, with estimates suggesting that 75 percent of overweight people and 90 percent with obesity will develop the condition. People with MASH also have a tripled risk of also developing heart disease, including coronary artery disease, stroke, and heart failure, compared to people without the condition. MASH diagnosis is poised for a major shift, mirroring past breakthroughs in chronic disease management. With new treatments approved and others on the horizon, the focus now turns to fixing systemic roadblocks. Currently, limited access to non-invasive tests and reliance on specialists leave most cases undetected until late stages. MASH arises from a cascade of liver damage typically linked to a buildup of fat in the liver, which triggers inflammation that damages liver cells and activates scar-forming cells. What was once healthy liver tissue becomes stiff, progressively crippling the liver's ability to detoxify blood. Though this is often painless until the damage becomes too severe to be reversed. If caught early, people can live normal lifespans with MASH. Lifestyle changes - eating a healthier diet, exercising regularly, and losing between five and 10 percent of one's body weight - can slow down the progression of MASH and repair some of the damage. Doctors may prescribe resmetirom, the first FDA-approved medication for MASH, to work hand-in-hand with those lifestyle changes. But severe damage can cause deadly conditions that cut a person's life drastically short. 'Each late-stage MASH diagnosis represents a missed opportunity for earlier intervention to prevent disease progression, threatening worse [liver] and [non-liver] outcomes for people living with the condition and greater costs for individuals, health systems, and societies,' researchers told a Barcelona medical conference this week. The solution requires concrete changes from moving diagnostics to implementing automated tools in electronic records. The researchers said that success in improving diagnostics goes beyond devising better tests. A fundamental reworking of methods of care is needed that catches at-risk patients before irreversible damage occurs. 'Paradigm shifts do not occur in a vacuum, but arise when leaps in science, technology, and innovation are coupled with changes in perception and understanding within a community,' they said. 'A confluence of factors in 2024 and expected drug approvals in many European countries in 2025 point to a near term tipping point for MASH diagnoses; nonetheless, focused and sustained efforts are needed to turn such opportunities into reality.'
