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SA’s HIV/Aids programme ‘not collapsing’ amid fallout from US funding cuts — Motsoaledi

SA’s HIV/Aids programme ‘not collapsing’ amid fallout from US funding cuts — Motsoaledi
Tamsin Metelerkamp
By Tamsin Metelerkamp
15 May 2025
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Health Minister Aaron Motsoaledi has said South Africa’s HIV/Aids programme is not at risk of collapsing in the wake of the US government’s withdrawal of Pepfar, dismissing the ‘narrative’ of some health experts and activists who have criticised the Health Department’s response in recent months.

Minister of Health Aaron Motsoaledi assured South Africans on Thursday, 15 May that the country’s HIV/Aids programme was not at risk of collapsing due to the withdrawal of US foreign aid funding through the US President’s Emergency Plan for Aids Relief (Pepfar).

Speaking at a media briefing in Pretoria, he listed steps taken by the Department of Health to address the loss of aid, including assistance for members of key populations affected by the closure of Pepfar-funded clinics and new training programmes for health workers.

“Over the past three weeks there have been numerous media statements, articles and claims by prominent South Africans who are well known within the HIV/Aids [sector]. The general thrust of their narrative is that since the announcement on 20 January 2025 by President Donald Trump to withdraw funding from Pepfar, that the HIV/Aids programme has collapsed or is on the verge of collapsing,” Motsoaledi said.

“We wish to confirm today that the fight against HIV/Aids and TB is in our villages, in our communities and townships, and even on the streets of our country, and that is where our focus is, has been and... should be.”

Motsoaledi’s words appeared to be a criticism of health experts and activists who have been vocal in recent months about the need for a clear emergency plan from the government to address the loss of US funding for the HIV/Aids programme in South Africa.

Read more: South Africa’s HIV programme is collapsing — and our government is absent

Read more: Pressure mounts on Health Minister Motsoaledi to remedy ‘catastrophic consequences’ of US aid freeze

In an opinion piece for Spotlight in late April, Wits University clinician researcher Professor Francois Venter said Motsolaedi had showed a lack of “leadership, communication or urgency” in the crisis, adding that “South African health and political leadership has not produced a plan, despite civil society repeatedly pleading for transparency”.

Other health activists have spoken out about the Health Department’s allegedly slow pace of enacting contingency plans on the ground.

Plugging the Pepfar gap


Pepfar funding made up R7.9-billion of South Africa’s R46.8-billion HIV/Aids programme. It supported the Health Department in 27 high-burden HIV/Aids districts, according to Motsoaledi.

Across these districts there were 12 NGO-managed, specialised clinics serving key populations through Pepfar funding, which supported 63,322 individuals, he continued.

“When the Pepfar-funded clinics were closed, we removed the files of these people from those clinics to the nearest public health facilities, and we can confirm today that all 63,322 files belonging to these key populations were moved to public health facilities.”

The minister added that 34 facilities funded by the Global Fund and four NGOs supported by the South African government had continued to provide uninterrupted services for members of key populations living with HIV/Aids.

Of the 271,606 people working in the HIV/Aids programme across the 27 districts, 15,539 were funded by Pepfar, continued Motsoaledi. 

“We can confirm today, unfortunately, 8,061 are out of their jobs,” he said. “The remaining 7,478… are still employed because they are funded through Centres of Disease Control, or CDC, at least until September this year.”

Pepfar funds were distributed to South African implementing partners by the US Agency for International Development (USAID) and the CDC. The USAID issued funding termination notices to South African partners in February.

Read more: ‘The axe has fallen’ — Trump’s USAID issues notices to terminate funding for key health programmes across SA

According to Motsoaledi, there is no plan to absorb the 8,061 unemployed health workers into the public health system at this stage, though he described them as “people of interest” in the Health Department’s talks with potential funders and National Treasury.

Motsoaledi said other steps taken by the department to address the loss of Pepfar funding included:

  • A sensitisation training programme for healthcare workers on the barriers affecting access to healthcare by key populations, which had reached 1,012 clinicians and 2,377 non-clinicians in seven provinces;

  • The establishment of “roving teams, specifically for patient monitoring and data capturing”, by eight provinces in which Pepfar was active;

  • Weekly meetings between the Department of Health and provincial health departments to verify reports around HIV counselling and testing; and

  • Numerous meetings with potential donors about additional funding to fill the gap left by Pepfar.


Among those Motsoaledi said he had engaged with on how to address the loss of Pepfar funding were private sector representatives; former US President Bill Clinton; the CEO of the Bill and Melinda Gates Foundation; and Minister of Finance Enoch Godongwana.

“I’ve given you a long list of funders we have met. There’s not a single one who said, ‘No, we won’t help.’ But up to today there’s not a single one who came to the party, either private funders or governments around the world,” he said.

He noted that the exception was the Global Fund, which pledged an additional R1-billion for the procurement of antiretrovirals.

“As we said before, we procure 90% of our ARVs [antiretrovirals] from our own government fiscals, and this is supported by 10% from Global Fund. And the Global Fund, after... the pullout of Pepfar, pledged R1-billion for more ARVs to be procured,” said Motsoaledi.

Close the Gap campaign


Motsoaledi spoke about the Close the Gap campaign, launched by the South African government, the Joint United Nations Programme on HIV and Aids (UNAIDS) and other stakeholders on 25 February to identify and support 1.1 million people living with HIV who know their status but are not yet on treatment.

UNAIDS has set 95-95-95 targets for 2030, calling on member states to ensure that 95% of people living with HIV know their HIV status, 95% of people who know their status are receiving HIV treatment, and 95% of people on treatment are virally suppressed. According to Motsoaledi, the numbers in South Africa stand at 96-79-94.

“While the plan [for the Close the Gap campaign] was to reach 1.1 million people by the end of December 2025, I can report to you now... that we have been able to reach 520,700 people living with HIV and Aids, and initiated them on treatment,” he said.

“This work has been made possible by the budget reprioritisation of an amount of R659-million from HIV/Aids conditional grants.

“We must commend the role players, especially civil society, because they helped in this massive mobilisation which has been taking place since March.”

As part of the Close the Gap campaign, the Health Department and the South African National Aids Council has been holding a series of roadshows to engage with stakeholders in the HIV/Aids sector across the provinces, from 8 April to 23 May. 

When asked about the mass layoff of health workers and possible loss of HIV testing capacity in health facilities as a result of the Pepfar cuts, Motsoaledi said: “I want to state it very clearly that I’ve never said everything is fine… All I said is that it’s wrong to say the… HIV/Aids programme in South Africa is collapsing, because it’s not.” DM

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