More than two months after the abrupt withdrawal of Usaid funding left nearly 700 healthcare workers at risk and essential HIV/TB services in crisis, vulnerable children are now facing the most devastating fallout yet.
In a follow-up to our 11 March report, new testimony from affected families reveal the human cost behind the R360 million shortfall. Community-based organisations like Empilweni, funded through Nacosa’s Orphans and Vulnerable Children (OVC) Programme, are scaling back or shutting down, leaving children with HIV without psychosocial support, medical linkage, or basic legal documentation.
“These are not just numbers. These are children’s lives, teens finding out their HIV status for the first time, caregivers holding families together,” said Vuyi Skiti, head of monitoring and evaluation at Nacosa. “If we disappear, so does their safety net.”
The OVC Programme, supported through the US President’s Emergency Plan for Aids Relief (Pepfar), was instrumental in ensuring medication adherence, birth registration, school access and emotional well-being for some of the most marginalised children in the Western Cape. Western Cape Premier Alan Winde had previously described the funding cuts as “heartbreaking and deeply unfortunate”. Provincial Health and Wellness Minister Mireille Wenger warned that the collapse of NGO support would severely strain an already overburdened health system.
While the provincial government has since implemented urgent measures such as multi-month dispensing and e-scripting to ease clinic pressure, local partners say the gap left in community-based care is irreplaceable.
Nacosa and local organisations like Empilweni have called on international and local donors to help match emergency funding from the HCI Foundation, which stepped in to temporarily sustain adolescent-focused programmes. The Western Cape faces a R350 million shortfall to maintain stable HIV and TB care. Global solidarity is critical to prevent the reversal of years of progress.
Patients are urged to continue their antiretroviral treatment. “Stay in care, not just for your own health, but to protect your family and community,” Wenger said.
Nacosa’s collection of case studies, titled “When the Funding Stops: The Children Behind the Numbers”, offers a heart-wrenching look at the lives at stake. It’s available at https://www.nacosa.org.za/when-the-funding-stops-the-children-behind-the-numbers.
