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The DA is pleased to see that the Director-General (DG) in the Department of Health (NDoH), Dr Sandile Buthelezi, has released clear guidance to about how health facilities should continue to provide uninterrupted HIV services in the wake of the abrupt freeze by the United States (US) government of PEFPAR-funded programmes in South Africa.

We welcome the clear delineation of critical services that must be maintained, including HIV testing, anti-retroviral treatment (ART) initiation, continued viral load testing, same-day ART scripting for patients who re-engage care, the management of advanced HIV disease and the provision of pre- and post-exposure prophylaxis (PEP and PrEP).  We also welcome the guidelines on facility-level task-shifting, so that enrolled nurses, nursing assistants and community health workers can assume responsibilities previously managed by PEPFAR-supported staff; and we further commend the DG for urging facilities to prioritise 3-month ART dispensing for all  ART patients and the call to implement 6-month ART dispensing for stable ART clients where sufficient stocks of treatment exist.

Many of these measures will ensure that patients need to visit facilities less often, will help decongest clinics and hospitals, and should be kept in place even if PEPFAR-funded healthcare workers are re-instated in the future.

The United States has been a longstanding and valued partner to South Africa. In 2024 alone, South Africa received $453 million in direct funding under the PEPFAR programme, with a projected $439 million allocated for 2025. This funding is vital to sustaining life-saving HIV/AIDS treatment and support services for the most vulnerable members of our society. In addition, millions of US dollars flow into South African NGOs and government departments for humanitarian and environmental programmes that directly benefit our most vulnerable communities.

Until the Trump administration’s decision to suspend PEPFAR funding, South Africans living with HIV/AIDS had the support of 15 145 PEPFAR funded HIV/AIDS response staff. The suspension of more than 15 000 jobs in the health care space is a grave concern in a country that already struggles with significant unemployment of healthcare workers, including doctors.

Despite ideological and policy differences within the GNU, the DA, alongside our coalition partners, is dedicated to upholding a robust and mutually beneficial partnership with the Trump administration.

We remain willing and eager to engage with American policymakers to provide clarity on South Africa’s current political context and to advocate for the continuation of vital aid and trade agreements.

The DA remains concerned that despite the announcement on 1 February 2025 of a waiver for critical PEPFAR supported HIV programmes worldwide, services on the ground have not yet resumed, putting thousands of people at risk every day.  We urge the NDoH to continue engaging with the American government to ensure that these services are reinstated, and to report back to the parliamentary health portfolio committee within the next two weeks about the progress of these engagements.

Issued by Dr Karl le Roux MP - DA Deputy Spokesperson on Health