The impact of a flourish of the US president's pen in Washington a year ago continues to be felt on individual lives some 13,000km (8,000 miles) away in South Africa. There was a collective gulp among some in the health sector here when, hours after he was inaugurated, President Donald Trump signed an executive order freezing US aid commitments.
For South Africa, that meant the potential loss of an estimated $400m (£295m) that the US contributed each year to the country's HIV programmes – representing about a fifth of what it was spending on the issue. Last year, the government provided $46m in response to the US decision - just 11.5% of what was lost.
The US also agreed a 'bridge plan' of $115m that will last until the end of March in place of regular funding from the US President's Emergency Fund for Aids Relief (Pepfar). Since being set up by President George W Bush in 2003, the US government has invested over $110bn in the global HIV-Aids response through Pepfar, saving 26 million lives, according to the state department. Many of those lives were in South Africa as around 13% of the population are living with HIV, making it the country with the largest number of HIV-positive people in the world.
Enormous advances in treatment and prevention over the decades have ensured many are alive who would not be otherwise, but these are expensive and the loss of funding could put many at risk. Prof Linda-Gail Bekker, the head and co-founder of the Desmond Tutu Health Foundation and one of the world's top HIV researchers, highlights a reduction in testing and missing service gaps.
Health Minister Dr. Aaron Motsoaledi acknowledges the difficulty. Last year, researchers indicated that 180,000 new HIV infections emerged in the country, and there are concerns that the lack of funding will exacerbate this situation. The government hopes to secure new funding in its upcoming budget and is collaborating with other donors to alleviate the crisis left by the US cuts.
For South Africa, that meant the potential loss of an estimated $400m (£295m) that the US contributed each year to the country's HIV programmes – representing about a fifth of what it was spending on the issue. Last year, the government provided $46m in response to the US decision - just 11.5% of what was lost.
The US also agreed a 'bridge plan' of $115m that will last until the end of March in place of regular funding from the US President's Emergency Fund for Aids Relief (Pepfar). Since being set up by President George W Bush in 2003, the US government has invested over $110bn in the global HIV-Aids response through Pepfar, saving 26 million lives, according to the state department. Many of those lives were in South Africa as around 13% of the population are living with HIV, making it the country with the largest number of HIV-positive people in the world.
Enormous advances in treatment and prevention over the decades have ensured many are alive who would not be otherwise, but these are expensive and the loss of funding could put many at risk. Prof Linda-Gail Bekker, the head and co-founder of the Desmond Tutu Health Foundation and one of the world's top HIV researchers, highlights a reduction in testing and missing service gaps.
Health Minister Dr. Aaron Motsoaledi acknowledges the difficulty. Last year, researchers indicated that 180,000 new HIV infections emerged in the country, and there are concerns that the lack of funding will exacerbate this situation. The government hopes to secure new funding in its upcoming budget and is collaborating with other donors to alleviate the crisis left by the US cuts.
