Cancellation of the US President’s Emergency Plan for Aids Relief (Pepfar) funding to South Africa could lead to between 150,000 and 295,000 additional HIV infections by the end of 2028, if the South African government fails to fund some of the services, BusinessLIVE reports.
According to Spotlight and GroundUp, this is among thepreliminary findings of a new modelling study commissioned by the national health department on the impact of Pepfar funding cuts.
The study was authored by researchers at the University of Cape Town (UCT) and Wits University. Pepfar is a multibillion-dollar US initiative that supports HIV-related services globally, but which has been significantly slashed by the Trump administration since February.
In 2024, roughly 78% of all people who had HIV in South Africa were on antiretroviral (ARV) treatment. This figure has been steadily rising over time. By 2026, it was expected to climb to 81%, according to Dr Lise Jamieson, lead author of the local modelling study.
But this trend will be reversed if the entire Pepfar programme is cancelled and the government fails to step in. ARV coverage among people with HIV would drop to 70% by 2026, according to the study. Under the model’s more pessimistic scenario, the figure would drop even lower — to 59% by 2026.
This is partly because some people living with HIV in South Africa get their ARVs directly from Pepfar-funded drop-in centres. If these centres close down, some patients may stop taking their ARVs. Indeed, this is precisely what happened after one centre in Pretoria stopped providing services.