Latest news with #Pepfar
Telegraph
2 days ago
- Health
- Telegraph
Lesotho mothers fear passing HIV to their babies as US aid cuts halt testing
When the young mother-to-be arrived for the test to tell if she was HIV positive and therefore might infect her unborn child, she found the door to the clinic testing room locked. The tests had been halted Mareabetsoe Monyamane, 26, was told, and the counsellors who had once given peace of mind to expectant mothers had been laid off. 'My heart sank,' she told the Telegraph. 'I felt helpless. I sat there thinking about my baby – what if I had contracted HIV since the last test?' For nearly two decades in Lesotho, making sure that women do not pass on HIV to their children has been a cornerstone of the tiny Southern African kingdom's campaign against Aids. If women do test positive, the unborn child can still be protected by prescribing antiretroviral drugs, or anti-HIV protective medicine called pre-exposure prophylaxis, or PrEP. But the programme had been paid for with American aid, which until recently underwrote nearly every level of Lesotho's HIV response. The Prevention of Mother-to-Child Transmission (PMTCT) programme has now become a casualty of Donald Trump's decision to sharply cut back the US President's Emergency Fund for Aids Relief (Pepfar). In a country that has the world's second-highest HIV prevalence, according to the World Health Organization's August 2023 Disease Outlook report, this is devastating for pregnant women like Ms Monyamane. Over 800 of the 1,500 HIV counsellors and nurses who once guided women through testing and helped them protect themselves and their babies have been dismissed as casualties of the aid freeze. The moment she was told she would not be tested 'hit me like cold water,' Ms Monyamane recalled. 'I wanted to cry. Some of us even thought of buying self-test kits, but I am one of those who could not afford it. 'I worry even more – not just about the money to buy the test, but what the results might be and what that would mean for my unborn child. I fear for my baby's life.' Mamello Nchela, aged only 18, says she is terrified of not taking an HIV test. She said: 'The fear of not knowing leaves me with so many what ifs? I keep asking myself: 'What if I'm too late? What if I can't protect my baby?'' Some 19 per cent of people in Lesotho have HIV and their plight led Prince Harry, the Duke of Sussex, to found his charity Sentebale, to help. Unfortunately, Harry and other founders of the charity stepped down earlier this year following a clash with the charity's chief executive. At £54m ($72m) per year, Pepfar accounted for 67 percent of the £78m ($106m) HIV budget for 2024/25, according to Lesotho's ministry of health. The US has now agreed to continue only 28 percent of the Pepfar funding, which will be narrowly focused mainly around medicine distribution. The PMTCT programme has not been spared. In a health centre built with American money but now without American support, eight pregnant women, aged between 17 and 33, sit inside a yellow-walled room where the cold winter air battles the warmth of a small black-and-red paraffin heater. They have come for their monthly check-up and health talk with midwife Mphonyane Thetso, who helplessly watches as drama unfolds before her. 'We have records showing that some women delivered their babies in April and May 2025 with invalid (inconclusive) HIV status because they were not retested after we lost our HIV counsellor,' Ms Thetso said. She explained: 'Sometimes a pregnant woman tests HIV-negative at her first visit. Then, when she comes back at 36 weeks for a re-test, she tests HIV-positive. A woman can give birth HIV-positive without knowing it, if she wasn't retested. 'If she tests positive, we can still prevent mother-to-child transmission with antiretroviral therapy and PrEP 'But you can't give PrEP to someone if you don't know their HIV status.' The concern is shared at the highest levels of Lesotho's health system. The ministry of health's HIV/Aids manager, Dr Tapiwa Tarumbiswa, told parliament in May that 'HIV-unsuppressed mothers are more likely to infect their children during pregnancy, birth, and breastfeeding'. There is little hope in Lesotho that the American aid will be switched back on. Dr Tlohang Letsie, a senior lecturer at the National University of Lesotho said the country lacked minerals that the US can benefit directly from. He said: 'Another factor is that Lesotho seems to be hopeless in engaging the US. The country is simply not doing enough. It appears we are waiting for the divine intervention to blow some spirit of philanthropy into the Americans.' Maitumeleng Tsiame, aged 17, spent £1.70 ($2.30) on a ticket from Metolong, Thaba-Bosiu to Nazareth Health Centre to take her HIV test. When she arrived there, she was told instead to travel to St Joseph Hospital in Roma, requiring another £2.95 ($4) for transport. She said: 'I didn't go to Roma – not because I didn't care – but because I simply couldn't afford it. Deep inside, I am tormented by fear. I keep imagining my child being born with HIV because I couldn't get tested. It hurts. I cry in silence.' Nineteen-year-old Itumeleng Thamae was also turned away from the health centre, saying it was one of the scariest days of her life. She said: 'I felt like my baby's life was at risk, and I couldn't do anything about it. I was overwhelmed by fear – every day I worry if I am unknowingly putting my child in danger.' Matebello Khoahli's children are proof that Lesotho's PMTCT programme used to be effective. The 40-year-old tested HIV-positive in 2009, but two of her three children, aged 12 and five, have been medically declared HIV-negative. But she is now worried about her 23-month-old baby, who missed her final HIV test aged 18 months, in April. She said: 'I was told the office was closed because Trump cut foreign aid to Lesotho, and the people who worked there are no longer around. 'My mind was troubled when I was told my daughter couldn't be tested. Even today, I am still troubled, wondering where I can go for help so my daughter can get her last HIV test,' she said, adding: 'when I asked at the Nazareth Health Centre, they told me to go to St Joseph's Hospital in Roma.' But Khoahli never made the trip. She did not have the £1.90 ($2.60) needed for transport. 'We are in darkness,' she said.
News24
6 days ago
- Health
- News24
Small win for activists, but SA's HIV projects won't be reopened
The $400 million that the United States Congress removed from a list of programmes from which the Trump administration wants to cut funds, doesn't cancel the cuts to global HIV and TB programmes made in February. HIV projects that have closed in South Africa, which were formerly funded by the US government, won't restart as a result of this decision. The 'limited Pepfar waiver' that President Donald Trump announced in February remains in place. The $400 million that the United States (US) Congress removed from a list of programmes from which the Trump administration will now take back previously approved but unspent funds doesn't mean that the cuts to global HIV and TB programmes in February, including those in South Africa, are now reversed. HIV projects that have closed in South Africa, which were formerly funded by the US government, won't restart as a result of this decision. In fact, quite the opposite. The 'limited Pepfar (President's Emergency Plan for Aids Relief) waiver' that US President Donald Trump announced in February remains in place. That means no HIV-prevention activities, unless they intend to stop pregnant and breastfeeding women from infecting their babies, can be paid for with US government money, and projects that make it easier for teen girls and young women in Africa, trans people, sex workers, injecting drug users and gay and bisexual men - groups of people that have a higher chance of getting HIV than the general population - cannot be funded. READ | 'Systemic shock': SA's HIV viral load testing fell 21% in wake of Pepfar cuts - UNAIDS Without a proper explanation for it, the $400 million seems to be a random amount that Trump's administration picked to take back from Pepfar, a US government programme which funds Aids projects in poorer countries with high HIV infection rates, such as South Africa. The amount is about 8.5% of Pepfar's $4.725-billion budget for this financial year and was part of a larger $9.4-billion 'rescissions package' - that has now been reduced to $9 billion and passed as the HR4 Rescissions Act of 2025. Rescissions happen when the presidential administration wants to cancel funding that was approved by Congress and use it for something else. What the decision to remove the $400 million from the package does, however, mean is that activism could finally be starting to pay off. Activists have had hundreds of meetings with US senators and Congress committee chairs. There have been 'Save Pepfar' social media campaigns, and plenty of media coverage about the devastating consequences of the funding cuts. READ | Motsoaledi urges unity, assures HIV/Aids programme stability amid US Pepfar funding pullout Tens of modelling studies have also projected what could happen if the lost funds are not replaced. Opposition from within Trump's Republican Party against nonevidence-based cuts to a programme that has, for two decades, been supported by both the Democrats and Republicans and has saved over 25 million lives, is now at last emerging. 'It's a small win within the bigger context, but nonetheless, a huge win for advocacy, and a reminder that activism is powerful and alive, and making an impact,' Jirair Ratevosian, a former head of staff at Pepfar and fellow at Duke University's Global Health Institute, told Bhekisisa at last week's Conference on HIV Science in Kigali. Around $8 billion of the money was for foreign aid and development programmes, including global health, and just over $1 billion for public broadcast stations that the Trump administration has accused of being biased because they're too liberal. Marko Milivojevic/Pixnio via Bhekisisa But the Rescissions Act is, in itself, bad news. 'It opens the floodgates for the Trump administration to say: 'We don't want this or that in the budget that Congress approved,' says Mitchell Warren, the head of international advocacy organisation, Avac. 'It's trying to take the congressional power of the purse and put it in the executive branch to usurp the role of Congress in deciding how much money - and on what to spend it.' So how did this all happen, and does it hold any good in the long term for South Africa? We break it down. 1. How did we get here? In the US, Congress - which consists of the Senate and the House of Representatives - decides how much government money goes to who, just like Parliament does in South Africa. Both the Senate and the House have to pass budgets. But, as analysts at the Centre for Budget and Policy Priorities in Washington, DC point out, Trump wants more control over how his administration's money is spent. In March, he signed the 2025 budget that Congress approved into law. Three months later, in June, he decided he wanted to change some of that and submitted a $9.4-billion rescission request, which the House of Representatives (it has five more Republican than Democrat members) passed on 12 June. When it was the Senate's turn to vote on this, some Republican senators weren't happy with the $400-million Pepfar cut, signalling they wouldn't sign off on the deal unless the Pepfar part was removed. Because there was a danger of them swinging the vote, the Republicans removed the $400 million from the Rescissions Bill and got the House to pass that too. All that's left is for Trump to now sign the Act. 2. What was the $400 million that was removed from the Rescissions Act for? In short, no one really knows, because the Trump administration hasn't said what it was for - or what it plans to do with it. But what we do know is that the US law that governs rescissions, the Impoundment Control Act, says that the president can only request that Congress takes back funding that it previously approved, if the money has not yet been obligated - that means funds hadn't yet been given to a particular recipient, for instance, an HIV project in South Africa. We also know that the $400-million was part of the financial budget for 2025, says Warren, but because the law gives Pepfar permission to spend money over five years, that money doesn't have to be legally spent until 2029. 3. What will the $400 million now be used for? Again, no one knows. We don't even know if it will be used, because over the past few months, the Trump administration's main strategy has 'simply been to illegally impound funds - by announcing a 'funding freeze' or 'programmatic review' with no public notice at all - and force those harmed by the impoundments to pursue relief in court', the Centre on Budget and Policy Priorities explains in an analysis. But we do know what the money can't be used for. Unless the rules of Trump's 'limited waiver' are changed, Pepfar funds can mostly not be spent on any of the evidence-based strategies it paid for before Trump was elected in January. Pepfar used to focus on groups of people and areas where people have the highest chance of getting infected with HIV - that way, the programme got the biggest bang for its buck. In South Africa, for instance, Pepfar worked in the 27 districts with the highest infection rates and groups known as 'key populations' - sex workers, gay and bisexual men, trans people, injecting drug users and African women between the ages of 15 and 24 - that are much more likely to get newly infected with HIV than other South Africans. Now those projects, which studies show stopped many new infections, have been closed down and the Trump administration says it's not prepared to buy HIV prevention medicine for any group other than pregnant and breastfeeding women. 'It used to be all about evidence,' Warren says. 'Now it's all about ideology.' 4. What do scientists and activists want the $400 million to be used for? Ratevosian says this moment should be used to gain Republican support to change the waiver rules, so that Pepfar money can cover more of the populations and services needed for HIV prevention. Lenacapavir, a pricey twice-a-year anti-HIV jab, which scientists believe could help to stop HIV in its tracks if it's rolled out properly, could be used to convince Republican Congress members, says Ratevosian. 'Pepfar has long wanted to get countries to transition to taking more ownership [read: Pay more] for their HIV responses. So now activists are arguing: 'Preventing more new infections with the jab, will make it easier for countries to take ownership because the pandemic will be easier to manage.'' In December, Pepfar said it would join another organisation, the Global Fund for HIV, TB and Malaria to buy enough lenacapavir for two million people over three years. But in July, the Global Fund had to go ahead with the deal by itself, because Pepfar seemed to no longer be on board. Warren says: 'If I were in charge, I would take the $400 million and double the two million people the Global Fund is planning to cover, because that's how you build a market, prevent new infections more quickly and drive the price down.' 5. What will Pepfar look like in future? Trump's funding cuts didn't kill Pepfar - at least not in theory, but it's a shell of its former self. What it will look like, will depend on the size of its next budget (the Trump administration wants to cut it by 40% but, so far, the House hasn't agreed to that, (the Senate still needs to sit on it) and how much support Republicans who believe in Pepfar can gain to have waiver rules changed. But, Warren points out, 'we're not going to get pre-January projects back; we have to build something different. 'This has been the most seismic shift in democracy. We didn't think we lived in an earthquake zone, but January 20 (when Trump retook office) taught us: You need to be prepared for that earthquake and you therefore need a different infrastructure. 'In an earthquake you don't build back the same thing. You build better, something that is more resilient.' Show Comments ()
TimesLIVE
6 days ago
- Health
- TimesLIVE
Small win for activists, but SA's HIV projects won't get reopened
The $400m that US Congress hasn't cut with the rest of its funding programme doesn't undo the blow to global HIV and TB programmes By The $400m that the US Congress took off a list of programmes from which the Trump administration will now take back previously approved but unspent funds, doesn't mean the cuts to global HIV and TB programmes in February, including those in South Africa, are now reversed. HIV projects that have closed in South Africa, which were formerly funded by the US government, won't restart as a result of this decision. In fact, quite the opposite. The 'limited Pepfar waiver' that President Donald Trump announced in February remains in place. That means no HIV prevention activities, unless they intend to stop pregnant and breastfeeding women from infecting their babies, can be paid for with US government money, and projects that make it easier for teen girls and young women in Africa, trans people, sex workers, injecting drug users and gay and bisexual men — groups of people that have a higher chance to get HIV than the general population — cannot be funded. Without a proper explanation for it, the $400m seems to be a random amount that Trump's administration picked to take back from Pepfar, a US government programme that funds Aids projects in poorer countries with high HIV infection rates, such as South Africa. The amount is about 8.5% of Pepfar's $4.725bn budget for this financial year and was part of a larger $9.4bn 'rescissions package' — that has now been reduced to $9bn and passed as the H.R.4 Rescissions Act of 2025. Rescissions happen when the presidential administration wants to cancel funding that was approved by Congress and then use it for something else. What the decision to remove the $400m from the package does, however, mean is that activism could finally be starting to pay off. Activists have had hundreds of meetings with US senators and Congress committee chairs. There have been 'Save Pepfar' social media campaigns, and plenty of media coverage about the devastating consequences of the funding cuts. Tens of modelling studies have also projected what could happen if the lost funds are not replaced. Opposition from within Trump's Republican Party against nonevidence-based cuts to a programme that has, for two decades, been supported by both the Democrats and Republicans and has saved over 25-million lives, is now at last emerging. 'It's a small win within the bigger context, but nonetheless, a huge win for advocacy, and a reminder that activism is powerful and alive, and making an impact,' Jirair Ratevosian, a former head of staff at Pepfar and fellow at Duke University's Global Health Institute, told Bhekisisa at last week's Conference on HIV Science in Kigali. Around $8bn of the money was for foreign aid and development programmes, including global health, and just over $1bn for public broadcast stations that the Trump administration has accused of being biased because they're too liberal. But the Rescissions Act is, in itself, bad news. 'It opens the floodgates for the Trump administration to say 'we don't want this or that in the budget that Congress approved',' says Mitchell Warren, the head of international advocacy organisation Avac. 'It's trying to take the congressional power of the purse and put it in the executive branch to usurp the role of Congress in deciding how much money — and on what to spend it.' So how did this all happen, and does it hold any good in the long term for South Africa? We break it down. 1. How did we get here? In the US, Congress — it consists of the Senate and the House of Representatives — decides how much government money goes to who, just like parliament does in South Africa. Both the Senate and the House have to pass budgets. But, as analysts at the Centre for Budget and Policy Priorities in Washington, DC point out, President Trump wants more control over how his administration's money is spent. In March, he signed the 2025 budget that Congress approved into law. Three months later, in June, he decided he wanted to change some of that and submitted a $9.4bn rescission request, which the House of Representatives (it has five more Republican than Democrat members) passed on June 12. When it was the Senate's turn to vote on this, some Republican senators weren't happy with the $400m Pepfar cut, signalling they wouldn't sign off on the deal unless the Pepfar part was removed. Because there was a danger of them swinging the vote, the Republicans removed the $400m from the Rescissions Bill and got the House to pass that too. All that's left is for Trump to now sign the Act. 2. What was the $400m that was removed from the Rescissions Act for? In short, no one really knows, because the Trump administration hasn't said what it was for — or what it plans to do with it. But what we do know is that the US law that governs rescissions, the Impoundment Control Act, says that the president can only request that Congress takes back funding that it previously approved, if the money has not yet been obligated — that means funds hadn't yet been given to a particular recipient, for instance, an HIV project in South Africa. We also know that the $400m was part of the financial budget for 2025, says Warren, but because the law gives Pepfar permission to spend money over five years, that money doesn't have to be legally spent until 2029. 3. What will the $400m now be used for? Again, no one knows. We don't even know if it will be used, because over the past few months, the Trump administration's main strategy has 'simply been to illegally impound funds — by announcing a 'funding freeze' or 'programmatic review' with no public notice at all — and force those harmed by the impoundments to pursue relief in court', the Centre on Budget and Policy Priorities explains in an analysis. But we do know what the money can't be used for. Unless the rules of Trump's 'limited waiver' are changed, Pepfar funds can mostly not be spent on any of the evidence-based strategies it paid for before Trump was elected in January. Pepfar used to focus on groups of people and areas where people have the highest chance of getting infected with HIV — that way, the programme got the biggest bang for its buck. In South Africa, for instance, Pepfar worked in the 27 districts with the highest infection rates and groups known as 'key populations' — sex workers, gay and bisexual men, trans people, injecting drug users and African women between the ages of 15 and 24 — that are much more likely to get newly infected with HIV than other South Africans. Now those projects, which studies show stopped many new infections, have been closed down and the Trump administration says it's not prepared to buy HIV prevention medicine for any group other than pregnant and breastfeeding women. 'It used to be all about evidence,' Warren says. 'Now it's all about ideology.' 4. What do scientists and activists want the $400m to be used for? Ratevosian says this moment should be used to gain Republican support to change the waiver rules, so that Pepfar money can cover more of the populations and services needed for HIV prevention. Lenacapavir, a pricey twice-a-year anti-HIV jab, which scientists believe could help to stop HIV in its tracks if it's rolled out properly, could be used to convince Republican Congress members, says Ratevosian. 'Pepfar has long wanted to get countries to transition to taking more ownership [read: pay more] for their HIV responses. So now activists are arguing: 'Preventing more new infections with the jab, will make it easier for countries to take ownership because the pandemic will be easier to manage.'' In December, Pepfar said it would join another organisation, the Global Fund for HIV, TB and Malaria to buy enough lenacapavir for two-million people over three years. But in July, the Global Fund had to go ahead with the deal by itself, because Pepfar seemed to no longer be on board. Warren says: 'If I were in charge, I would take the $400m and double the two million people the Global Fund is planning to cover, because that's how you build a market, prevent new infections more quickly and drive the price down.' 5. What will Pepfar look like in future? Trump's funding cuts didn't kill Pepfar — at least not in theory, but it's a shell of its former self. What it will look like, will depend on the size of its next budget (the Trump administration wants to cut it by 40% but, so far, the House hasn't agreed to that, (the Senate still needs to sit on it) and how much support Republicans who believe in Pepfar can gain to have waiver rules changed. But, Warren points out, 'we're not going to get pre-January projects back; we have to build something different. 'This has been the most seismic shift in democracy. We didn't think we lived in an earthquake zone, but January 20 [when Trump retook office] taught us: you need to be prepared for that earthquake and you therefore need a different infrastructure. 'In an earthquake you don't build back the same thing. You build better, something that is more resilient.' This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the
Mail & Guardian
7 days ago
- Politics
- Mail & Guardian
Small win for activists, but SA's HIV projects won't reopen
Activists helped save $400 million from being pulled out of Pepfar, but the Trump-era waiver banning support for groups with the highest chance of getting infected stays. (Flickr) The $400 million the United States Congress removed from a list of programmes from which the Trump administration will now take back previously approved but unspent funds doesn't mean HIV projects that have closed in South Africa, which were formerly funded by the US government, won't restart as a result of this decision. In fact, quite the opposite. The 'limited Pepfar waiver' that President Donald Trump Without a proper explanation for it, the $400 million seems to be a random amount that President Donald Trump's administration picked to take back from The amount is about 8.5% of Pepfar's Rescissions happen What the decision to remove the $400 million from the package does, however, mean is that activism could finally be starting to pay off. Activists have had hundreds of meetings with US senators and Congress committee chairs. There have been Opposition from within Trump's Republican Party against nonevidence-based cuts to a programme that has, for two decades, been supported by 'It's a small win within the bigger context, but nonetheless, a huge win for advocacy, and a reminder that activism is powerful and alive, and making an impact,' Jirair Ratevosian, a former head of staff at Pepfar and Bhekisisa at last week's Conference on HIV Science in Kigali. About But the Rescissions Act is, in itself, bad news. 'It opens the floodgates for the Trump administration to say 'we don't want this or that in the budget that Congress approved', says Mitchell Warren, the head of international advocacy organisation, Avac. 'It's trying to take the congressional power of the purse and put it in the executive branch to usurp the role of Congress in deciding how much money — and on what to spend it.' So how did this all happen, and does it hold any good in the long term for South Africa? We break it down. How did we get here? In the US, the Congress — But, as analysts at the In March, he signed the 2025 budget that Congress approved into law. Three months later, in June, he decided he wanted to change some of that and submitted Because there was a danger of them swinging the vote, the Republicans removed the $400 million from the Rescissions Bill and got the House to pass that too. All that's left is for Trump to now sign the Act. What was the $400 million that was removed from the Rescissions Act for? In short, no one really knows, because the Trump administration hasn't said what it was for — or what it plans to do with it. But what we do know is that the US law that governs rescissions, the We also know that the $400 million was part of the financial budget for 2025, says Warren, but because What will the $400 million now be used for? Again, no one knows. We don't even know if it will be used, because over the past few months, the Trump administration's main strategy has 'simply been to illegally impound funds — by announcing a 'funding freeze' or 'programmatic review' with no public notice at all — and force those harmed by the impoundments to pursue relief in court', the Centre on Budget and Policy Priorities But we do know what the money can't be used for. Unless the rules of Trump's In South Africa, for instance, Pepfar worked in the Now those projects, What do scientists and activists want the $400 million to be used for? Ratevosian says this moment should be used to gain Republican support to change the waiver rules, so that Pepfar money can cover more of the populations and services needed for HIV prevention. Lenacapavir, a pricey twice-a-year anti-HIV jab, which scientists believe could help to stop HIV in its tracks if it's rolled out properly, could be used to convince Republican Congress members, says Ratevosian. 'Pepfar has long wanted to get countries to transition to taking more ownership [read: pay more] for their HIV responses. So now activists are arguing: 'Preventing more new infections with the jab, will make it easier for countries to take ownership because the pandemic will be easier to manage.'' Warren says: 'If I were in charge, I would take the $400 million and double the two million people the Global Fund is planning to cover, because that's how you build a market, prevent new infections more quickly and drive the price down.' What will Pepfar look like in future? Trump's funding cuts didn't kill Pepfar — at least not in theory — but it's a shell of its former self. What it will look like, will depend on the size of its next budget (the Trump administration 'We're not going to get pre-January projects back; we have to build something different,' Warren points out. 'This has been the most seismic shift in democracy. We didn't think we lived in an earthquake zone, but January 20 [when Trump retook office] taught us: you need to be prepared for that earthquake and you therefore need a different infrastructure. 'In an earthquake you don't build back the same thing. You build better, something that is more resilient.' This story was produced by the . Sign up for the .
The Citizen
23-07-2025
- Health
- The Citizen
Health budget: R1.7 billion for new staff and millions granted by Gates foundation
Health minister Aaron Motsoaledi announced a R64 billion health budget and a R200 million HIV/ Aids research grant from international funders. The department of health plans to spend billions on recruiting new professionals and infrastructure development over the coming financial year. Health Minister Aaron Motsoaledi announced the coming years' objectives during his budget speech in parliament on Tuesday. The minister added that international organisations will plug the gap left in South Africa's HIV/ Aids programmes by the Pepfar decision. He conceded that the department did not have 'all the money' needed to achieve these objectives, but was in discussions with international and local funders. R64 billion budget Motsoaledi announced that the department had been allocated an overall budget of R64 billion for the 2025/26 financial year. The budget will be used by the department to achieve three main objectives; number one being a laying of the foundations for the National Health Insurance (NHI). 'There are people who believe that we have no plans nor inclination to do that. We want them to listen very attentively,' assured Motsoaledi. Ensuring adequate facilities and sufficient staff would be the backbone of NHI, the minister has earmarked R1.7 billion for the hiring 1 200 doctors and 450 nurses and support staff. A further R1.4 billion will be spent on absorbing 27 000 community health workers who had previously been employed by non-governmental organisations. To 'make public hospitals hospitable', R1.3 billion will be spent on beds, linen, towels, basin and other similar items. Infrastructure upgrade During the last financial year, Motsoaledi boasted that 47 existing clinics and 45 hospitals had been 'substantially' refurbished, while 403 public health facilities had been upgraded. Additionally, five new facilities were completed during the last financial year, and six are currently under construction, and 17 are in the design and development stage. 'These facilities and their placement are not a thumbs-up. We are using a digital system called the Health Infrastructure Portfolio System,' explained the minister. 'This digital system has a geographic information system, district information system and other data tools that help us understand and plan the health system,' he added. The department will also spend R3.75 billion paying accruals — expenses recorded but not paid in earlier financial years — for equipment and pharmaceuticals. The second of Motsoaledi's objectives is to implement 'serious reforms' in the private healthcare system — a goal he did not elaborate on. 'Please ignore those who want us to believe that there is nothing to fix in that sector,' he said. Pepfar replacement Third on Motsoaledi's list is the elimination of diseases such as HIV/ Aids, tuberculosis, malaria and some cancers. 'The time has now arrived to start dreaming about a future with a certain disease gone from our country,' Speaking on the impact of the Pepfar withdrawals, he stated the department would not allow South Africa's HIV programmes to collapse. He said negotiations with treasury had resulted in the allocation of R753 million for provincial and national HIV/ Aids-related support. This will be boosted by R100 million research contributions by both The Bill and Melinda Gates Foundation and London-based researchers the Wellcome Trust. The grants are conditional based on Treasury's commitment to double it, meaning the R200 million from the international funders will be backed by R400 million from Treasury, which is to be released more than three years for HIV/ Aids treatment. Part of this treatment will include the piloting of HIV/ Aids wonderdrug Lenacapavir, a twice-annually injection that claims to have a 100% success rate in preventing HIV/ Aids in women. NOW READ: Health minister weaponising racial bias report to push NHI, says IRR
