21-05-2025
OPEN LETTER TO AARON MOTSOALEDI
Minister of Health Dr Aaron Motsoaledi's recent claim that over half a million people have been newly started on HIV treatment in less than six months has raised eyebrows. In this open letter, Anna Grimsrud and Sibongile Tshabalala-Madhlala, associated with CHANGE – South Africa, ask the minister to explain numbers.
Dear Minister Motsoaledi,
We write to you in response to your 15 May 2025 media statement and subsequent remarks in Parliament on the current status of the national HIV, Aids, and TB campaign.
You stated that since the launch of the Close the Gap campaign, 520 700 people have been initiated on HIV treatment, reaching 'more than 50% of the target'. You also stated that 5.9 million people are currently on antiretroviral therapy (ART).
However, at the campaign's launch on 25 February 2025, you reported the same number on HIV treatment - 5.9 million. This raises a critical question: if over half a million people have started or restarted treatment, why has the total number of people on treatment not increased?
If both figures are accurate, this would mean that approximately 520 000 people have been lost from care over the past few months - a deeply concerning and unprecedented level of attrition. We respectfully request that you provide the underlying data and clarify the current total number of people remaining on HIV treatment.
There are several reasons why we are concerned:
Static treatment numbers: As noted, the number on treatment was reported as 5.9 million in both February and May 2025. If 520 700 people have been initiated or re-initiated during this period, the same number must have exited care - a scenario that requires urgent explanation.
Slow growth in the number of people on treatment: According to official statements, the total number of people on HIV treatment increased by only 100 000 between March and December 2023 — from over 5.7 million to 5.8 million. The claim that the cohort has now grown by over 500 000 in a matter of months contradicts recent trends.
Declining lab numbers: National Health Laboratory Service data reported by the Daily Maverick and Reuters, show notable declines in viral load testing and early infant diagnosis in March and April 2025 compared to the same months in 2024. These indicators should increase alongside meaningful growth in treatment uptake — not decrease.
In light of these concerns, we believe it is essential that you provide a transparent accounting of the current number of people on treatment and the metrics being used to assess progress under the Close the Gap campaign. Specifically, we request data demonstrating that the programme is on track to meet its stated goal of increasing the number of people on treatment from 5.9 million to 7 million.
We share your commitment to a strong and effective HIV response, especially in this period of financial and operational strain. Like you, we believe it is vital that accurate and complete information is shared with the public and Parliament at this critical moment.
- Anna Grimsrud is an epidemiologist and writes in her personal capacity. Sibongile Tshabalala-Madhlala is openly living with HIV and currently serves as the national chairperson of the Treatment Action Campaign (TAC).' CHANGE is a coalition of more than 1 500 people from civil society organisations in South Africa and around the world. CHANGE stands for Community Health & HIV Advocate Navigating Global Emergencies.
*Published by GroundUp and Spotlight
