Extension of US's Aids relief programme Pepfar hangs in the balance

Two men pump fists in front of the AIDS ribbon at Gugu Dlamini park.

Friends from the Springfield area visited the AIDS ribbon site at the famous Gugu Dlamini park. File Picture: Tumi Pakkies/Independent Media

Published Feb 26, 2024


Amid tensions between the US and South Africa over the conflicts between Russia and Ukraine and Israel and Hamas, there is uncertainty over the five-year reauthorisation of the US President’s Emergency Plan for Aids Relief (Pepfar) programme.

Pepfar is up for reauthorisation for the 2025-2030 period.

Siphumelele Duma, a postdoctoral research fellow at the Institute for Pan-African Thought and Conversation at the University of Johannesburg, said there have been recent strong and apparent tensions in US/SA relations.

Relations between the two countries have been on a downward trend since the Russian “invasion” of Ukraine, he said.

This resulted from South Africa refusing to take a stance against Russia and instead lobbying for a negotiated settlement.

“This was not good enough for the US and its Western allies,” he said.

Duma said the other issue was South Africa taking Israel to the International Court of Justice on a genocide case.

“South Africa blatantly supporting the Palestinian cause and accusing Israel of genocide may not be received very well in Washington,” he said.

However, US Embassy spokesperson in South Africa, David Feldmann, said Pepfar remained committed to the partnership with South Africa and other countries around the world to end HIV/ Aids as a public health threat by 2030.

“All Pepfar country teams around the world are currently updating two-year plans approved in May 2023 in consultation with partner governments, civil society organisations, and other development partners,” said Feldmann.

“We recognise that a clean, five-year Pepfar reauthorisation is critical to end HIV/Aids as a public health threat by 2030 and for the programme to support all 55 Pepfar partner countries, including South Africa, in reaching the 95-95-95 UNAids HIV treatment targets by 2025.

“We are confident that those who support Pepfar in the US Congress will find a path to approving a clean, five-year reauthorisation of this critical and lifesaving programme,” said Feldmann.

Professor Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa (Caprisa), said if the five-year Pepfar programme was not reauthorised, it did not mean the work will stop. It was currently being authorised on a year-to-year basis depending on the budget available.

“However, when it has to be authorised every year, then politics plays a bigger role and we can expect more political interference in Pepfar and its goals.

“If Pepfar didn’t exist, it would have an impact on our Aids programme because it would mean that our government would have to find more money to make up for the shortfall.”

He added that he believed that the central issue holding up the reauthorisation of Pepfar were laws against abortion.

He said Pepfar funding cannot be used for abortion services but Republican politicians wanted a new restriction added which called for those receiving Pepfar funding to not provide abortion services at all even if funded by others .

Dr Munya Saruchera, director of the Africa Centre for HIV/Aids Management at Stellenbosch University, said South Africa has the largest population of people living with HIV and Pepfar works with local partners and the Health Department.

Pepfar has been partnering with the government to provide anti-retroviral treatment to more than 4 million people, he said.

He added that these activities are focused in 27 high-burden districts throughout South Africa.

Saruchera said Pepfar has made the largest contribution towards HIV/Aids testing, treatment and related support and that all its activities in South Africa are aligned with the National Strategic Plan for HIV, TB, and STIs.

The Mercury