‘Some Won’t Survive’: US Cuts Threaten South Africa’s Young HIV Patients

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Elsie has been receiving calls from desperate children who are still receiving HIV treatment for the past two months who are not allowed to assist her.

The lively 45-year-old aid worker used to spend her days visiting HIV patients in Msogwaba township, which was located about 300 kilometers (190 miles) east of Johannesburg, to treat patients who had been diagnosed with HIV.

Elsie, a 45-year-old aid worker who uses a pseudonym to protect her anonymity, used to spend her days wandering the dusty streets of Msogwaba township, close to Mbombela, to visit hundreds of children living with HIV. She poses for a photo at her home on March 13, 2025. (Photo by Phill Magakoe/AFP)

Elsie has been forced to stay at home and be unable to contact her patients since President Donald Trump cut off funding for US foreign aid in late January.

She recalled that I was helping 380 kids and making sure that each and every one of them was treated unfairly or violated.

We teach them to love themselves and accept who they are as they are. They are my own children, I believe.

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Nearly 100, 000 people are supported annually by the non-governmental organization she worked for, many of whom are HIV-positive children, orphans, and children-headed households, a name she did not want to reveal in case of repercussions. More than $3 million in funding was provided by USAID to the organization each year.

One of the more than 100 community health workers was tasked with keeping track of the children, keeping track of their well-being, and ensuring that they could receive the lifelong care they needed to stay healthy and prevent the virus transmission.

On March 12, 2025, a patient is presenting a Vulante tablet, a medication that includes a combination of lamivudine and tenofovir disoproxil fumarate, which is used to treat HIV in adults 18 years and older at his home in Msogwaba township near Mbombela. (Photo by Phill Magakoe/AFP)

She fears the worst because she is now unable to go see them.

She sighs, “I worry that their medication won’t work.” She claims that some children have vanished since the program ended. She fears that other people might miss their hospital visits.

We are familiar with each and every one of those children and their issues. Some of them “won’t survive.”

More than just medicine,

According to government data, around 13% of the country’s population, or 7.8 million people, are affected by the virus, making it one of the world’s highest rates.

In the nation, there were 640, 000 children who were orphaned by the virus in 2023.

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The government has assured that the government’s antiretroviral (ARV) rollout won’t be impacted by the budget cuts. It launched a campaign in February to increase the lifesaving treatment’s reach, which is already available to 5.9 million patients, to 1.1 million more by the end of the year.

Because almost 90 percent of the country’s current treatment is funded by the fiscus and the government budget, health department spokesman Foster Mohale told AFP, “The country has the capacity to provide… HIV treatment to people living with it.”

However, one of the funding cuts was the US President’s Emergency Plan for AIDS Relief (PEPFAR), which supported numerous programs aimed at preventing, counseling, and monitoring, and accounted for 17% of South Africa’s overall HIV response.

Sibongile Tshabalala-Madhlala, the head of the leading HIV advocacy group Treatment Action Campaign, said, “It’s about much more than medicine.”

“It’s about a person walking into a nice room with a nurse.” It involves comprehending the needs and challenges faced by those who have HIV. It’s about keeping people in care, and preventing it.

She fears that the funding cuts will have a significant impact on human resources in already overcrowded and understaffed hospitals, including by extending waiting times.

According to Health Minister Aaron Motsoaledi, the PEPFAR cuts alone caused 15, 000 workers to lose their jobs.

‘Abandoned’

In a study that was published in the Annals of Internal Medicine in February, it was suggested that South Africa’s elimination of all PEPFAR funding would result in more than 600,000 additional HIV-related deaths over the course of the next ten years.

Tshabalala-Madhlala told AFP she believes “people will die,” despite the Department of Health’s claim that this figure was merely “assumptions.”

“People won’t be able to miss their appointments to get their medication.” Some people already have ARVs. We will see a rise in infection rates and more deaths linked to HIV as a result of this disruption, she predicted.

'London Patient' Likely To Be Cured Of HIV — An AIDS symbol is displayed on the North Lawn of the White House in Washington, DC during World AIDS Day in this file photo taken on December 1, 2010. AFP / Jewel SAMAD

A scrawny 17-year-old in Msogwaba sits in his mother’s home on a dirt road and holds his head in his hands. Elsie worries about the teenager’s upcoming appointment because he allegedly has autism.

Elsie would have taken him to the clinic in the past. His mother, who cannot afford to take a day off from work to accompany her son, sighed. “She helped him a lot whenever he was struggling. We feel as though we have been abandoned.

Elsie expressed similar feelings to her. They really believed in me, and I was forced to leave.