- 700 jobs at risk as 10 NGOs face funding cuts, jeopardizing essential healthcare services.
- HIV and TB treatment programs threatened, with community-based services set to collapse.
- Western Cape Government implements urgent measures to maintain care, including multi-month medication dispensing and e-scripting.
The sudden withdrawal of USAID funding has sent shock waves through the Western Cape’s HIV/Aids and TB response programmes, jeopardising 10 non-governmental organisations (NGOs), nearly 700 jobs, and R360 million in essential healthcare support.
The impact is immediate and far-reaching, with thousands of vulnerable patients at risk as community-based services face collapse.
The Provincial Council on Aids and Tuberculosis convened last week to address the crisis, as government and civil society scramble to prevent setbacks in the fight against two of South Africa’s deadliest epidemics. Western Cape Premier Alan Winde did not mince words, calling the funding halt “heartbreaking and deeply unfortunate”.
“Our NGO partners play a critical role in tackling TB and HIV/Aids. This abrupt termination of funding has severely disrupted essential services and leaves many residents at risk,” Winde warned.
A joint presentation by the Western Cape Department of Health and Wellness and affected NGOs laid bare the scale of the crisis. The funding cut directly threatens nearly 700 jobs, many belonging to healthcare workers who provide testing, counselling, and medication distribution to underserved communities.
Western Cape Health and Wellness Minister Mireille Wenger described the situation as a major setback for public health, emphasising that NGO partners help bridge the gap between government services and community-based care.
“For years, we have worked side by side with NGOs to serve our communities with USAID support. Together, we have made remarkable progress in increasing the number of people on antiretroviral treatment (ART) while reducing new infections,” Wenger said. “However, this funding cut now places these hard-won gains at serious risk. Our healthcare system will face immense pressure as more patients are forced to rely on already overwhelmed clinics.”
Experts warn that disruptions in HIV treatment will inevitably impact TB control, as HIV-positive individuals are highly vulnerable to TB infections. Wenger stressed the danger of reversing progress made in both disease areas. “Since 2019, we have seen a steady increase in people staying on ART. This has been a crucial factor in stabilising the HIV/Aids epidemic in the Western Cape. But without the additional support from NGOs, we are deeply concerned that many patients will struggle to remain in care, leading to higher transmission rates and increased TB cases,” she explained.
TB remains one of South Africa’s leading causes of death, and the USAID funding had been instrumental in scaling up testing, treatment, and patient support programmes. The funding cut means fewer community outreach workers, fewer people getting tested, and longer queues at already strained healthcare facilities.
In an urgent bid to contain the fallout, the Western Cape Government is implementing several key measures, including multi-month dispensing of medication, repeat prescription collection strategies, a 28-day grace period for late ART collections, automatic script renewals, and an accelerated rollout of e-scripting to digitise medical records and prescriptions.
Wenger also engaged the National Department of Health, which has committed to fast-tracking the digitisation of records and prescription services to ease clinic congestion. “We are doing everything we can to ensure there is no interruption in healthcare services,” she assured.
The Western Cape now faces a shortfall of R350 million, needs to stabilise HIV and TB services. The provincial government is also exploring alternative funding sources, both locally and internationally. USAID’s historical contribution to South Africa’s TB programme has been significant, amounting to $94 million (R1,8 billion). The suddenness of the funding freeze has left many unanswered questions, as provincial officials work rapidly to understand the full implications and develop long-term solutions.
Despite the uncertainty, Wenger urged patients to stay on treatment. “To anyone on ART: do not lose hope. Your medication is still available at our healthcare facilities. We have measures in place to ensure that you continue receiving your treatment. Staying on your medication is vital – not just for your own health, but for preventing the spread of HIV,” she emphasised.
Winde underscored that this crisis is not just about funding, but about the lives impacted. “For many of the individuals working in this space, this is more than a job; it’s a passion and a deep commitment to their communities. This funding cut doesn’t just threaten jobs, it threatens the well-being of thousands of residents who rely on these services,” he said. “We will do everything we can to protect the progress we have made in fighting TB and HIV/Aids. We are working closely with our partners to find solutions and ensure every resident receives the healthcare they need.”
As the province races against time, the biggest question remains: Will new funding come in time to prevent a healthcare disaster?
