Health Minister Dr Aaron Motsoaledi has confirmed that the US President's Emergency Plan for AIDS Relief (Pepfar) funding is currently under review, impacting crucial HIV and Aids programmes across 27 high-burden districts in the country.

This comes amid broader geopolitical tensions and possible shifts in US global health funding strategies.

In an interview on Newzroom Afrika, Motsoaledi revealed that he is scheduled to meet with officials from the US Embassy in South Africa to discuss the developments. However, he emphasised that these officials are not decision-makers, and that the ultimate outcome of the funding review will be determined in Washington over a 90-day period.

While acknowledging the importance of Pepfar’s contribution, the minister clarified that the South African government funds 80% of its HIV and Aids programmes, including the purchase of antiretroviral (ARV) drugs.

"Eighty percent of all ARVs you see being consumed by people who are living with HIV and Aids are bought from our own fiscus, with 10% coming from the Global Fund," he said. Pepfar specifically funds additional personnel and operational expenses in high-burden districts.

Pepfar currently supports 15,154 healthcare workers, including data capturers, professional nurses, lay counsellors, clinical associates, social auxiliary workers, pharmacy assistants, staff nurses, and pharmacists.

"Out of 271,660 health workers managing HIV and Aids daily, 256,452 are funded by our own fiscus," Motsoaledi explained.

Addressing concerns about dependency on foreign aid, the minister suggested that South Africa could reduce its reliance on external funding through the implementation of the National Health Insurance (NHI) system.

"If we have used our money impeccably, we won’t need outside funders," he asserted, emphasising that South Africa already allocates 8.5% of its GDP to healthcare - higher than several BRICS nations such as Russia (7.2%) and China (6.5%).

Responding to questions about potential alternative funding from BRICS partners, Motsoaledi pointed out that South Africa is also supported by the Global Fund, which provides $7 billion every three years to fight HIV, Aids, TB, and malaria.

"Global Fund meets every three years and looks at the country with the biggest burden. South Africa carries the heaviest burden in the world, and that’s why we are getting help," he said.

Motsoaledi made it clear that no final decision has been made regarding Pepfar’s future funding for South Africa.

"Nobody knows at the moment," he said, reiterating that the decision is under review and will be determined after the 90-day assessment process in the US.

"The most recent decision is that everything must go on in a review," he added, underscoring the uncertainty surrounding the programme's future.

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Health Minister Motsoaledi confirms review of Pepfar funding amid global health concerns