The Western Cape Government (WCG) has welcomed measures announced by the National Department of Health to ensure uninterrupted HIV/AIDS treatment and services in response to the temporary suspension of some foreign aid by the United States.
However, provincial leaders warn that sustainable solutions are urgently needed to mitigate the long-term impact of the funding gap.
The measures introduced by the national government include a six-month antiretroviral treatment (ART) dispensation and a 28-day late collection allowance for refilling ARTs.
Additionally, the Western Cape will implement automatic ART script renewals through chronic dispensing units to reduce the strain on healthcare facilities.
The suspension of aid from the United States Agency for International Development (USAID) and the President’s Emergency Plan for AIDS Relief (PEPFAR) is expected to place further pressure on South Africa’s already burdened healthcare system.
While temporary measures will provide some relief, provincial leaders stress that a clear, long-term funding strategy is essential to safeguard healthcare services should the funding not be reinstated.
Despite a waiver for certain life-saving services, uncertainty remains over the full extent of affected programmes.
In response, the WCG has urged the national government to develop a coordinated and funded strategy to ensure the continued delivery of critical healthcare services.
Last week, the Western Cape MEC of Health and Wellness, Mireille Wenger, and Finance MEC, Deidré Baartman, formally requested their national counterparts to collaborate on a provincial strategy that mitigates the financial risks associated with the funding freeze.
USAID and PEPFAR funding supports both government and non-governmental initiatives in the province, playing a crucial role in HIV/AIDS and tuberculosis (TB) treatment and prevention. The Western Cape Department of Health and Wellness uses these funds for essential services such as testing, data analysis, mobile X-ray screenings, and community-based healthcare support.
Although the procurement of ART and the employment of clinical staff are primarily covered by the provincial budget, the loss of foreign aid will require adjustments to service delivery, increasing pressure on already overburdened clinics.
Wenger emphasized the significance of international partnerships in healthcare.
“It is our mission to build a healthier Western Cape where residents can thrive, and a healthy workforce can contribute to economic growth. While we have worked to reduce reliance on foreign aid, the funding received from USAID and PEPFAR has been vital in combatting the HIV/AIDS and TB epidemics. Without urgent action, we risk losing critical progress in this fight.”
Baartman outlined the fiscal risks, noting, “The USAID and PEPFAR funding freeze has widespread implications for the Western Cape Government’s budget, particularly in healthcare, social development, and economic growth. The financial risks include a shortfall in health services funding for the 2025/26 financial year and potential losses in funding for child services over the next three years.”
She added that the sudden loss of funding presents difficult financial decisions for the province, which is already facing budgetary constraints. “We urge national government to provide a unified strategy to help provinces navigate this uncertainty,” she said.
Premier Alan Winde reaffirmed the importance of international collaboration, stating, “The Western Cape Government is committed to fostering relationships with key international partners, including the USA, to drive economic and social development. The USA has played a vital role in supporting our healthcare initiatives, and we look forward to engaging with Washington to seek a resolution and ensure continued support for our most vulnerable communities.”
With the future of USAID and PEPFAR funding uncertain, the Western Cape Government is pushing for urgent, coordinated action to protect healthcare services and sustain the progress made in the fight against HIV/AIDS and TB.
