Health Minister Aaron Motsoaledi stated on Thursday that government would not allow its decades-long work in the fight against HIV/Aids and TB to collapse because US President Donald Trump decided to withdraw funding from the country.

Motsoaledi was responding to media reports that HIV testing and monitoring across the country had fallen since the US cut aid that funded health workers and clinics. Pregnant women, infants and youth are the most affected, previously unpublished government data shows.

South Africa has the world's highest burden of HIV, with about 8-million people - one in five adults - living with the virus. The US was funding 17% of the country's HIV budget until Trump announced the withdrawal of aid early this year.

Data from the National Health Laboratory Service showed that viral load testing had fallen by up to 21% among key groups in the last two months.

Motsoaledi said government has reduced deaths from HIV/Aids and TB, noting that when it started with the programme it needed R5.3-billion, however, currently government was now spending R46.8-billion, of which R7.9-billion was from United States President's Emergency Plan for AIDS Relief (PEPFAR).

This is the money Trump has withdrawn in aid.

“It is inconceivable that out of the R46.8-billion spent by the country on [its] HIV/Aids programme, the withdrawal of R7.9-billion by President Trump will immediately lead to a collapse of the entire programme, we believe it is inconceivable,” Motsoaledi stated.

He stressed that government would not allow its “work to collapse".

“If we do so, we [would] have thrown massive investment in time, money and human resources away, and at any rate, we do not want to go back to the period where death was the order of the day,” he said.

Briefing the media in Pretoria, Motsoaledi said many might have forgotten the real crisis brought by HIV/Aids, which was the biggest crisis globally, centered in South Africa, around 2010, where death was an everyday occurrence.

“…by that time the maternal mortality driven by this pandemic had reached a staggering 249 women per 100 000 live births, and the number of children born HIV positive was sky high,” he pointed out.

In response, the South African government launched the world’s biggest HIV counselling, testing and treatment campaign, with Motsoaledi noting that government had placed about 18-million people on antiretrovirals (ARVs) within just 18 months of its programme. 

He noted help from the Clinton Health Access Initiative, which helped decrease the cost of ARVs by 51%.

He highlighted that government also launched prevention of mother-to-child transmission, which he said resulted in the number of babies born HIV positive being reduced from 70 000 a year in 2004 to 1 079 in the 2020 financial year.

He said the figure now stood at 643 in the financial year ending March 2025.

He explained that the United Nations Programme on HIV and AIDS has calculated that to bring an end to Aids as a public health threat to the country, government must reach targets of 95-95-95.

“…meaning 95% of HIV positive people must know their status and 95% of those who are positive should be placed on ARVs and 95% of those who are on treatment should achieve viral support suppression, to stop transmission of the virus to other people,” he explained.