Bitter pill: US President Donald Trump’s decision to cut funding is having a devastating effect on the HIV/Aids facilities that relied on it.
President Donald Trump’s move to cut United States Agency for International Development (USAid) funding to nonprofit organisations is a “catastrophic” blow to health and environmental organisations in South Africa that depend on its almost $320 million annual injection for essential services, research and projects.
Given that their survival is at stake, many of these organisations were afraid to speak to the Mail & Guardian for fear of reprisals, should the US decide to reverse the decision. Many face the grim reality that they will have to close their doors if they cannot secure alternative financing.
The US government provides $320 million in aid to South Africa, of which $318.2 million flows from USAid, according to the state department.
The lion’s share of $265.6 million is allocated to health, followed by $33.45 million to programme support; $17.93 million to economic development; $3.512 million towards democracy, human rights and governance; $1.695 million to the environment; $1.259 to education and social services and $74 071 to humanitarian assistance.
Prior to the latest move, USAid had been providing the country with about 20% of its HIV/Aids funding, said Professor Glenda Gray of the University of the Witwatersrand’s Infectious Diseases and Oncology Research Institute.
The total budget for South Africa’s HIV response was about R30 billion a year in 2023, according to the Wits Health Consortium’s Health Economics and Epidemiology Research Office.
This included government spending, as well as R7 billion from the President’s Emergency Plan for Aids Relief (Pepfar) and R1.4 billion from the Global Fund.
Grey said the Wits Reproductive Health and HIV Institute, the biggest grant recipient of Pepfar, which channels funds though USAid and the Centers for Disease Control and Prevention, received a “stop work” email after Trump made the announcement on his first day in office on 20 January.
She said it remained unclear how the waiver US Secretary of State Marco Rubio had announced for “life-saving humanitarian assistance” would affect organisations’ ability to work.
Funding officers at USAid could not be reached for comment after the closure of the agency’s offices.
According to the waiver, life-saving humanitarian assistance is “core life-saving medicine, medical services, food, shelter and subsistence assistance, as well as supplies and reasonable administrative costs as necessary to deliver such assistance”.
It does not apply to “activities that involve abortions, family planning, conferences, administrative costs …gender or DEI [diversity, equity and inclusion] ideology programmes, transgender surgeries or other non-life-saving assistance”.
“It’s catastrophic for him to pull the plug on the funding, particularly for Africa, because a lot of countries rely on USAid funds for maternal and child health programmes, vaccination programmes and, obviously, for HIV programmes,” Grey said.
“For South Africa it is also so because, although it’s only just under 20% of the total HIV budget, that money went to parts of the country where the districts were heavily burdened with HIV,” she said.
The country had been receiving US funding for HIV/Aids since the mid-2000s, she said.
“It’s hard to say how that waiver translates into action because all the people who have USAid grants have been issued a letter that says pause or suspend work for the next 90 days ‘while we reassess’,” Gray said.
“Those 90 days are critical because programmes basically must stop, which means staff have to stop working. So, that’s obviously happened with Wits University because the university can’t bankroll the programme for 90 days while they wait for a decision on the waiver.”
She said the university had started Labour Relations Act section 189 talks with affected staff members to begin the retrenchment process, which could be reversed if the waiver took effect.
“The only way we will work is if there’s communication from programme officers instructing the teams to continue to work.
“But we don’t even know if they’re there. We don’t know if they’ve been let off. Basically, you can send emails to your programme officer but they don’t respond.”
The effect on the patients would be huge, Gray said.
“Clinics will disappear. Doctors in clinics will disappear, support staff, people who capture the data and people who do HIV testing.”
She had written to Health Minister Aaron Motsoaledi highlighting the effect on patient services and healthcare workers after conducting a limited survey of organisations, including the Health Systems Trust, Nova, the Centre for the Aids Programme of Research in South Africa, LGBTQ+ Well-Being, and Right to Care, to establish the extent of the crisis.
“About 5 626 people are affected and the salary costs for the stop orders is about R120 million a month,” she said.
Motsoaledi earlier highlighted that about 17 000 healthcare workers would be affected.
Research and development is also under threat, including the Brilliant Consortium, of which Gray is programme director, because it requires $46 million across eight countries — Nigeria, Uganda, Kenya, Tanzania, Zimbabwe, Zambia, Mozambique and South Africa.
“We were about to start an HIV vaccine trial and about to order vaccines to be manufactured and all of that’s been affected.
“People’s jobs are at stake, and people’s lives are at stake, and that’s a terrible position for any country to be in,” she said.
An Accountability Lab survey of 368 organisations around the world showed that the budgets of more than half were 100% affected by USAid’s stopwork order. The survey gathered data from nonprofit organisations (81%) and for-profit organisations (19%) that depend on funding to various degrees.
“One hundred and seventy-one respondents reported that between 50% and 100% of their budgets were affected. A quarter of respondents said that they only had a month’s worth of financial resources left,”Accountability Lab co-chief executive Jean Scrimgeour said.
“Overall, 50% or more of respondents said that they were likely to need to close by May.”
Scrimgeour provided the results of the survey during an urgent virtual meeting this week by Catalyst 2030, a global movement of social entrepreneurs, to discuss the USAid crisis. More than 290 representatives from organisations around the world, including South Africa, the US, the UK, Mauritius, Vietnam, Pakistan, Yemen and India, attended.
Some representatives said Trump’s executive order could be unconstitutional and that there was a possibility he could face legal challenges in the US to reverse the decision.
Environmental organisations have warned that the 90-day foreign aid freeze also threatens conservation work and climate action efforts.
Kishaylin Chetty, the senior conservation manager of sustainable financing at the Endangered Wildlife Trust, said it had “been affected quite significantly” by the funding freeze and certain projects have had to be put on hold.
“However, we have had to try mitigating the impact, readdressing plans and funding to ensure we can continue the critical conservation work over the three-month hold.
“We are not anticipating that the funding will be made available again. We have prepared for the worst and are actively pursuing other funding sources to ‘plug the gap’,” Chetty said.
(Graphic: John McCann/M&G)
To mitigate the financial problems arising from the funding freeze, the Endangered Wildlife Trust has already begun exploring alternative sources, seeking support from other international donors, private foundations and corporate partnerships.
In addition, it is enhancing local fundraising efforts to reduce future reliance on international funding.
The trust is also partnering with other NGOs to share resources and expertise, “thereby maintaining conservation activities where possible, despite financial constraints”.
The ramifications across the region have been significant “not just in terms of realigning salary support for staff already appointed to undertake activities but also maintaining our commitment to communities” in the projects affected by the funding freeze, Chetty said.
“There is a risk to our ability to conserve threatened species and ecosystems and enhance community livelihoods, but we are desperately diversifying funding sources and amending action plans to continue critical work.
“Our reputation and ability to deliver critical conservation actions are under pressure.”
The Endangered Wildlife Trust’s Birds of Prey Programme and LAWS Unit have been the most significantly affected by the funding freeze, which includes a hold from USAid, the Bureau of International Narcotics and Law Enforcement Affairs and the US Fish & Wildlife Service, Chetty said.
The Wildlife & Environment Society of South Africa is not receiving a grant from USAid or any other US agency “although we have been grateful recipients in the past of USAid, which funded a three-year stepping up to sustainability youth and community education programme”, spokesperson Morgan Griffiths said.
The United Nations Development Programme (UNDP) is funding its youth environmental reporters for advocacy project.
“While the USA’s withdrawal of funding from various global funding agencies does not affect this project, we believe the UNDP and other agencies will certainly have fewer funds for environmental education and climate action over the next few years, though this might change if global pressure and deals reverse the USA withdrawal decisions,” Griffiths said, referring to Trump’s exit from the Paris Climate Agreement.
While the Wildlife & Environment Society does not expect any financial shortfalls for its portfolio of education, advocacy and action projects, “we do see the pool of available global funds for climate action shrinking, making it far more competitive to secure future foreign funding”.
Indirect effects could affect the expansion of renewable energy generation in South Africa, “slowing our just transition and with it the availability of community development funds that are associated with these projects”, Griffiths said.
The Peace Parks Foundation, a nonprofit conservation organisation that facilitates the establishment and development of transfrontier conservation areas, is assessing the impact of the USAid funding halt, spokesperson Lésa van Rooyen said.
“At this stage, it is too early to determine the full extent of the ramifications for conservation efforts in Southern Africa.
“However, we remain committed to our mission and are actively exploring ways to mitigate any potential financial shortfalls to ensure the continued success of our projects,” she said.
Jeanne Poultney, of the Southern African Wildlife College, said it had received letters from government agencies, “saying that everything is on hold for 90 days”.
“What we’re a little concerned about is obviously the latest statement [from Trump on suspending all aid to South Africa] because it does impact not just government funding; it impacts funding through things like the International Rhino Foundation, [which is] based in the States as well.
“It’s a waiting game to just find out if it is just with reference to government funding, like for example, USAid,” Poultney said, “and if it is just the things like USAid, it does still affect us because we run a programme supported by WWF.
“A large chunk of their funding does come through for the Khetha Project, which is a large project being rolled out and that’s via USAid …
“We’re still trying to get to grips with how far that’s going to actually extend. There is a knock-on effect.”
Khetha, which was launched in 2018 and is supported by USAid, focuses on reducing the impact of wildlife trafficking on elephants and rhinos and people living in the South African and Mozambican areas of the Great Limpopo Transfrontier Conservation Area.
In its annual report last year, WWF-SA said its Khetha funding had been renewed, noting that international development finance is an important income stream for its environmental projects.
“During the year, we managed to secure a 2.5-year extension on the USAid Khetha programme, enabling WWF to continue its efforts to dismantle the illegal wildlife trade in and near the Great Limpopo Transfrontier Conservation Area,” it stated.
On the funding freeze, WWF-SA spokesperson Andrea Weiss said: “Our position is that we’re not going to be commenting at this time.”
The South African National Parks does not get direct funding from USAid, spokesperson Ike Phaala told the M&G.