KZN's fight against HIV/Aids hinges on Ramaphosa-Trump meeting, budget

TimesLIVE

21-05-2025

KwaZulu-Natal premier Thami Ntuli said the provincial strategy to combat HIV, TB and sexually transmitted infections hinged on the outcome of President Cyril Ramaphosa's US visit and the adoption of the national budget.
Ntuli was speaking during a sitting of the Provincial Council on Aids (PCA) in Mayville, Durban, on Wednesday to discuss the status of KZN's HIV response and explore sustainable ways to maintain and enhance progress in combating the epidemic.
The PCA is a structure of the SA National Aids Council which serves as the primary co-ordinating body for each province's response to all STIs. It is chaired by the premier and includes different stakeholders including government, civil society and traditional leaders to develop and implement provincial strategic plans.
This year's PCA meeting came as the country's HIV/Aids fighting efforts were affected by fiscal constraints and heightened geopolitical tensions with the US, which saw President Donald Trump — in one of his first executive orders in office — cancelling the USAID programme and PEPFAR funding.
The PEPFAR funding, which amounted to R1.5bn had a significant impact on the fight against HIV and Aids in South Africa as it supported important roles in health, education and social development.
Ntuli said another implication of the withdrawal of the funding was the more than 5,000 job losses for people employed under the programme.
'I am certain many of us already know of human beings and livelihoods that this sudden withdrawal has negatively affected through job losses,' Ntuli said. 'This unfortunate development is frustrating our long-term plans which were based on the 'certainty' of this funding stream.'
He said the provincial government is pinning its hopes on the delegation led by Ramaphosa being able to persuade the US to restore the funding.
'Our position is that it is not our place to interfere with the policies of another country, but we would wish to see these funds being made available again, and the PEPFAR funding reinstated.
'We believe this will not be the last engagement with the US administration, but the beginning of new negotiations that will reopen room for continuing engagements including on the cancelled programmes.'
Ntuli emphasised the importance of quickly finalising the national budget, which has been delayed since March, as vital for the PCA, as it will provide clarity on funding for government programmes this financial year.
'Both these events — the president's US trip and the tabling of the national budget — have critical economic and financial implications as we sharpen our battle plan against HIV, TB and STIs in KwaZulu-Natal.'
He warned that the current fiscal landscape, in which they rely on allocated funds, means it is essential to adjust spending and programmes to match the available resources.
'We are in the age of leaner and smaller budgets, and unless there is a major change in economic growth projections, we will continue to struggle as a country and, by extension, KZN. Yet we must fight on.'
Ntuli said mother-to-child HIV transmission has been reduced from over 70,000 annual cases before 2004 to just 643 in 2024 while life expectancy has increased from 54.7 years in 2010 to 66.5 years in 2024.
'When I look at the numbers, I see the real impact being made by your intervention as men and women of the PCA in mobilising society and implementing our provincial plan. While we are still the highest in HIV infection in the country, we are collectively fighting back.'