By Lehlohonolo Lehana.
The Department of Health (DOH) says South Africa is aggressively advancing a self-reliance strategy to plug the funding gap left by the discontinuation of the US President’s Emergency Plan for AIDS Relief (PEPFAR).
This comes after the US State Department announcement that South Africa was being removed from the PEPFAR, because it had failed “to make demonstrable progress on policy requests by the administration.
While the US State did not specify the policy requests, the administration has in the past called on South Africa to repeal a law allowing for the expropriation of land without compensation, to exempt American companies from Black empowerment laws and to not align with U.S. enemies such as Iran.
More than eight million South Africans are living with HIV – the highest number of any country in the world.
Until 2025, the US was supporting South Africa’s efforts to deal with the virus with an estimated $400m (£300m) a year through Pepfar.
But since the inauguration of President Donald Trump, relations between the two countries have increasingly soured.
Shortly after he came into office, Trump issued an executive order alleging that “countless” South African policies dismantled equal opportunities and fuelled violence “against racially disfavored landowners”.
This is disputed by the South African government, which says its Black Economic Empowerment (BEE) policy is needed to correct economic inequality dating from the apartheid era.
Minister of Health Dr Aaron Motsoaledi has reassured South Africans that its plans to achieve more financial independence from external funding sources have been under development for some time.
While the department has not received a formal correspondence from the US Government, directly or indirectly, regarding what has been published in the media, this did not come as a surprise because the department has long been working on a self-reliance plan to minimise the impact of funding withdrawal since the initial freeze on foreign assistance and a cancellation of USAID grants in January 2025, said Motsoaledi.
“Thus, there is no need for public to panic because the transition plan has long been developed and the implementation has been ongoing,” he said.
The department acknowledged that PEPFAR funding was a “big contributor” to government’s HIV/AIDS response programme.
However, he said, the funding does not affect the provision of antiretrovirals (ARVs) because the country procures 90% of ARVs from government fiscus, supported by 10% from the Global Fund.
“It is important to remind the public that PEPFAR was supporting the Department of Health in 27 HIV/AIDS High burden Districts out of 52 districts in the country in 8 provinces, with the exception of the Northern Cape.”
“Public health facilities remain accessible for to clients, including those who used to receive health services from PEPFAR funded clinics.”
“The issue of HIV/AIDS response funding will be part of the United Nations High-Level Meeting agenda scheduled to take place on 22–23 June 2026, which Motsoaledi will participate in the debates in New York.”
The intention of the US government was to “foster self-reliance” and reduce dependency on American funding, they added, pointing out that “South Africa is a middle-income country and is more than capable of supporting its own health programs”.