South Africa Reaffirms Commitment to HIV/AIDS and TB Response Amid PEPFAR Withdrawal
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Cape Town – 16 May 2025 — Health Minister Dr Aaron Motsoaledi presented a detailed update to Parliament on Friday regarding the status of South Africa’s HIV/AIDS and tuberculosis (TB) campaign in the wake of the United States’ withdrawal of PEPFAR (President’s Emergency Plan for AIDS Relief) funding.
The presentation, aimed at addressing widespread claims that the programme has collapsed, emphasized continued efforts by the Department of Health to sustain and expand treatment, despite the funding shortfall.
Historic Progress
Dr Motsoaledi outlined the trajectory of South Africa’s HIV/AIDS response since 2010, when the country faced one of the world’s highest HIV burdens. A shift from voluntary counselling and testing (VCT) to HIV counselling and testing (HCT) enabled mass outreach. Within 18 months, the campaign had reached 18 million people and initiated the world’s largest antiretroviral therapy (ART) programme.
As of 2025, 5.9 million of South Africa’s estimated 7.9 million people living with HIV are on treatment. Key health indicators have shown improvement: life expectancy has increased from 54.7 years in 2010 to 66.5 years in 2024, and maternal mortality has dropped significantly. HIV transmission from mother to child has been reduced from 70,000 cases in 2004 to just 643 in 2025.
PEPFAR’s Exit and Government Response
PEPFAR had supported services in 27 high-burden districts across eight provinces, including 12 specialized clinics serving key populations such as sex workers, transgender individuals, and people who inject drugs. The Department of Health confirmed that after the closure of these clinics, records of over 63,000 patients were transferred to public health facilities, with efforts underway to maintain continuity of care.
Dr Motsoaledi stated that services for key populations are being supported through other funders, including the Global Fund, and by government-funded NGOs. Between January and March 2025, 88% of the department’s target of 154,298 clients from key populations were reached in high-transmission areas.
Capacity Building and Data Management
In response to the funding withdrawal, the government launched sensitization training for healthcare workers to reduce stigma and improve services for marginalized groups. Over 3,300 staff have been trained to date. Additional personnel have been deployed to enhance data capturing and patient tracking.
Close the Gap Campaign
The “Close the Gap” campaign, launched to find and treat 1.1 million HIV-positive individuals not yet on ARVs, has already reached over 520,000 people. The Department reported that R659 million was reprioritized from HIV/AIDS conditional grants to fund this effort. The campaign has been endorsed by multiple partners, including SANAC, UNAIDS, and the Global Fund.
Sustaining ARV Supply
South Africa currently procures 90% of its ARVs through the national budget, with the Global Fund contributing 10%. An additional R1 billion has been pledged by the Global Fund to support ARV procurement.
Call for Unity
Dr Motsoaledi concluded by urging unity and collaboration, warning against disinformation that could jeopardize international funding. He emphasized the role of SANAC in coordinating national efforts and stressed that the real challenge is not political disagreement but the shared fight against HIV/AIDS and TB.
“No single South African can claim that SANAC doesn’t represent them,” Motsoaledi told the committee. “The fight against HIV/AIDS is not in buildings — it’s in our communities, and it is far from over.”
