International
-Sathish Raman
In
a
rural
village
in
South
Africa’s
KwaZulu-Natal
province,
19-year-old
Nozuko
Majola
faces
a
dilemma.
She
is
unsure
if
she
can
afford
the
hour-long
journey
to
collect
her
essential
HIV
medication.
The
roads
to
her
home
are
rough
and
untarred,
making
deliveries
difficult.
Majola
is
among
millions
affected
by
the
freeze
on
US
foreign
aid,
raising
concerns
about
treatment
defaults
and
increasing
infection
rates.
image
The
Human
Sciences
Research
Council
reported
that
KwaZulu-Natal
had
the
second-highest
HIV
prevalence
in
South
Africa
in
2024,
with
16%
of
the
population
affected.
An
estimated
1,300
young
people
contract
HIV
weekly
in
this
region.
In
2022,
the
province
also
recorded
the
highest
number
of
people
living
with
HIV,
approximately
1.98
million.
Impact
of
Aid
Freeze
on
HIV
Programmes
South
Africa
has
over
7.5
million
people
living
with
HIV,
more
than
any
other
country.
Around
5.5
million
South
Africans
receive
antiretroviral
treatment,
funded
partly
by
the
President’s
Emergency
Plan
for
AIDS
Relief
(PEPFAR).
This
programme
contributes
over
USD
400
million
annually
to
South
Africa’s
HIV
initiatives,
accounting
for
about
17%
of
total
funding.
Globally,
PEPFAR
is
credited
with
saving
at
least
26
million
lives
since
its
inception
in
2003,
according
to
the
UN
AIDS
agency.
However,
a
recent
federal
court
ruling
temporarily
lifted
the
funding
freeze
imposed
by
former
US
President
Donald
Trump.
Despite
this,
many
aid
groups
have
already
closed
their
doors,
leaving
patients
to
seek
help
from
overwhelmed
public
health
facilities.
Challenges
Faced
by
Local
Communities
In
Umzimkhulu,
where
unemployment
is
high
and
many
rely
on
subsistence
farming
and
welfare
grants,
the
aid
freeze
has
severely
disrupted
lives.
“Things
will
be
tough
around
here,” Majola
said.
“A
lot
of
people
will
default
on
their
treatment
because
we
really
struggle
with
transport.”
Mobile
clinics
rarely
visit
these
remote
areas.
The
suspension
has
also
affected
nearly
15,000
health
workers
whose
salaries
were
funded
through
PEPFAR.
In
Umgungundlovu
district,
which
has
the
highest
number
of
HIV
cases
in
South
Africa,
counsellors
are
trying
to
find
ways
to
support
patients
like
Majola
amid
dwindling
resources.
Strain
on
Healthcare
Facilities
A
manager
at
a
local
health
clinic
expressed
concern
over
increased
administrative
workloads
after
PEPFAR-funded
staff
left.
“People
who
were
doing
administration
and
data
capturing
have
left,” said
the
manager
anonymously.
“We
are
a
small
facility
and
cannot
handle
such
a
workload.”
Nozuko
Ngcaweni
has
been
on
HIV
treatment
for
nearly
three
decades.
Her
community
is
already
feeling
the
impact
of
the
aid
suspension,
with
many
missing
their
treatment
appointments.
“Not
long
ago,
we
aimed
for
an
HIV-free
generation
by
2030,”
she
said.
“But
if
things
remain
as
they
are,
we
will
not
achieve
that.”
Future
Prospects
for
HIV
Response
Mzamo
Zondi
from
the
Treatment
Action
Campaign
monitors
the
situation
in
Umgungundlovu.
He
warns
that
efforts
to
control
new
infections
may
falter
due
to
the
funding
crisis.
“Our
response
to
HIV
is
likely
to
falter
as
we
struggle
to
stop
newly
infected
cases,” he
stated.
“This
is
a
matter
of
life
and
death.”
The
ongoing
challenges
highlight
the
critical
need
for
sustained
support
and
funding
to
combat
HIV
effectively
in
South
Africa
and
beyond.
