Budget 3.0: Some political parties worried about non-allocation of funds for SA's HIV programme
JOHANNESBURG - Concerns have been raised by some political parties over the government not allocating money to cover the shortfall of using USAID.
Earlier this year, US President Donald Trump suspended the president's emergency plan for AIDS relief, also known as PEPFAR (President's Emergency Plan for AIDS Relief).
As one of the many countries that receive aid through PEPFAR, the suspension left South Africa's HIV fight efforts with a budgetary gap of more than R8 billion.
ALSO READ: PEPFAR withdrawal a 'train smash' for thousands of workers, Motsoaledi tells NCOP
During his budget speech on Wednesday, Finance Minister Enoch Godongwana said allocations to cover PEPFAR have not been made yet.
United Democratic Movement (UDM) deputy president Nqabayomzi Kwankwa says Godongwana is treating the budget as a statement of hope instead of making concrete plans.
'It means we are treating this budget like manna from heaven, we are going to pray and expect him to fall from heaven, that only happened during biblical times. That is why some of the expenditure items, which are very sticky, like providing funding for PEPFAR, have been deferred to a future point in time. He says once resources allow.'
Democratic Alliance (DA) national spokesperson Karabo Khakhau says the party is hopeful President Cyril Ramaphosa's bilateral meeting with Trump today will result in the reinstatement of PEPFAR.
'We are obviously very worried because HIV is a very serious illness in this country, and we want to make sure the country is safe, and we want to have a healthy population. We also know today, the president of the country is engaging the US, and we will see what comes out of those engagements.'
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Without that help, their condition worsened, and some died.' This forms part of an issue that extends far beyond the district of Buzi. In the Sofala capital of Beira, I sat down with some of the province's senior health officials. The HIV supervisor for the province, Manuel Seco, provided data on the HIV response in Sofala, before and after the cuts. Between May and December of 2024, the total number of people on ARVs in the province had risen by more than 20,000 people, the data shows. This increase occurred steadily, rising by 500 to 5,000 people each month. But as soon as the cuts were made, this progress was halted and the trend reversed. Since January, the number of people on ARV treatment has been falling by hundreds of people each month. The reason, according to Seco, is that many people who were on ARVs have stopped their treatment, while new ARV initiations have dropped sharply. And the impact extends far beyond just the HIV response. TB left untreated Buried within a compound owned by Tongaat Hulett is a government hospital that services the rural population of Mafambisse, in Dondo district. Joaquim Mupanguiua, who deals with TB at the hospital, says that after the activists were laid off, the hospital saw a steep decline in the number of TB patients coming to the facility. 'Only when they are already very ill do they come to the health unit,' he says. 'But with the activists they would easily go to the communities and find the sick.' The number of patients coming to the hospital is roughly a third of what it once was: 'We used to get around 28 to 30 [TB] patients per month, but now we're down to fewer than 10,' Mupanguiua notes. Because patients come to the hospital when they're already severely ill, there's significantly less that health facilities can do for them. It's thus no surprise that Mupanguiua believes that there has been an uptick in needless TB deaths. Finding other ways Back in the Buzi district office, Gemo says that efforts have been made to assist terminal patients who had previously been supported by activists, but there are so many people in need that they aren't able to help everyone. Activists often said something similar — they continue to visit their beneficiaries when they can, they say, but without ComuSanas sponsoring their transport costs, many struggle to visit children in remote areas. And the loss of their income with the programme means that they now need to spend their days finding other ways to survive — subsistence farming and street markets are the usual routes. But this work rarely offers the kind of regular income that ComuSanas was providing. 'Honestly, buying notebooks, pens and clothes for my children has become very difficult,' says Dondo-based activist Brito Balao. Meanwhile, in Tica, activists asked how they could provide food to their former beneficiaries when they are themselves going hungry. Despite this, the activists still live within the same villages as their beneficiaries. And so unlike those in Washington, they cannot withdraw their support without facing the resentment or desperation of their communities. 'We work with love, and we get really sad not being able to be there for those kids,' says one Mutua-based activist. 'There's even another family that cried today [when they saw me]. 'You've been away for a while,' they said. Gosh, we feel bad.' Among former beneficiaries of the programme the sense of abandonment was palpable, and their anger was often directed at the former activists. This was often compounded by the fact that no one had explained to them why the programme had stopped. In the village of Nharuchonga, Joana explains that in the past her activist, Fatima, would always come and ensure that her daughter took her ARVs. Now that Fatima has stopped coming, her daughter doesn't always take the medication, she says. (Fatima is present during this conversation.) 'We've been abandoned by Fatima,' she states, looking directly away from the former activist. 'Until now we have been too shy to ask why she has abandoned us.' In many other cases, the tone was simply one of sadness. Back in Tica, inside an outdoor kitchen made of corrugated iron sheets, Maria holds her five-year-old granddaughter Teresa. Despite facing hunger at various points over recent years, she cooks sweet potatoes above a small fire, and insists that everyone eats. Both of Teresa's parents died of Aids, says Maria. It has been left to her to raise the child, while trying to grow rice and maize for subsistence — an effort hampered by frequent drought. For a long time Maria has had help with this parental role, she says. Activist Marta Jofulande had been assisting her family and acting like a mother to the child. But since the programme was terminated, they don't see much of Jofulande anymore. Instead, five-year-old Teresa has been forced to deal with the exit of yet another parental figure. DM A note on quotes: Most of our interviews were in Portuguese and were mediated by a local translator. We subsequently transcribed and translated the recordings of these interviews using AI-based software, including Descript and ChatGPT. Where there was a significant mismatch between the interpretations of the translator and the software, we contacted the interviewee or got third parties to help translate the recordings. The cost of travel, accommodation and the journalist's remuneration was shared between GroundUp and Spotlight. Part two will be published next week.
