South African experts worry as U.S. cuts HIV treatments to begin biting

Gugu once collected antiretrovirals from a USIA-funded clinic in central Johannesburg.

But when President Trump’s aid cuts were announced earlier this year, she and thousands of other HIV-positive patients across South Africa suddenly faced an uncertain future.

Gugu is lucky that this is the clinic where she gets the medications, helping to suppress her symptoms to contact her before closing.

“I’m one of the people who can take medication in bulk. I usually collect prescriptions for three months. But before my clinic closed, they gave me medication for nine months.”

She will run out of antiretroviral (ARV) in September and then plans to go to her local public hospital for more.

The 54-year-old, a former sex worker, found out she had quit HIV positive.

She coughed ten years ago and initially thought it was tuberculosis. She went to a doctor and told her she had a chest infection and treated her for it.

But when treatment failed, she went to the clinic for HIV test.

“At that time I thought I was HIV positive, I told the nurse.”

She was right and she has been on ARV ever since. We are not using her real name according to her request.

She is currently a project coordinator for NGOs.

“We help pregnant sex workers get ARV to ensure their children are born with HIV negative. We also conduct family visits to make sure mothers take medication on time and take care of the baby when they are checking each month.”

Many HIV-positive sex workers in South Africa rely on private clinics funded by the now-extinct U.S. government aid agencies to get their prescriptions and treatments.

But most facilities were closed after U.S. President Donald Trump cut most foreign aid earlier this year.

Gugu believes that if their ARV can no longer be obtained from the clinic, many sex workers may be discouraged from going to public hospitals.

“The problem with going to public hospitals is the time factor. To repair in these facilities, you have to arrive at 4 or 5 a.m. and they may spend the whole day waiting for their medication. For sex workers, time is money.”

She added that she recently went to a local hospital with some friends to register for her details and build relationships with employees.

“The nurse who attended ours was very rude. She told us there was nothing special about sex workers.”

She believes this may lead to drug treatments that many sex workers default, especially because their hospital profiles contain a lot of personal information, so the concern is that sometimes nurses at these local clinics are not always the most sensitive to processing such information. ”

In a report released Thursday, the joint agency responsible for the fight against HIV/AIDS did not select the United States, but said that the sharp cuts from many donors have sent shockwaves around the world. “Stunning Progress” to Solve Disease Risk Reversal.

“There has been a 40% reduction in new HIV infection since 2010, and 4.4 million children have been exempted from access to HIV since 2000. More than 26 million lives have been saved,” Unaids said.

Unaids said the number of new HIV infections and AIDS-related deaths had fallen to a minimum in more than 30 years before funding was cut.

All data released in the report comes from data from U.S. and other donors cut funding earlier this year. But this does emphasize how much progress may be lost due to the results of these cuts.

The number of new infections in sub-Saharan Africa has dropped by 56%. The region remains the center of the pandemic – half of all new infections last year were from the mainland. However, compared with 2010, four African countries – Lesotho, Malawi, Rwanda and Zimbabwe – are expected to drop by 90% in 2030.

Another success story in Africa is the manifestations of antiretrovirals that help suppress HIV symptoms. With other medical advances in the field, they also increase life in sub-Saharan Africa from 56 years in 2010 to 62 years in 2024.

The turnaround began when then-U.S. President George W. Bush launched an ambitious plan in 2003 to fight AIDS/AIDS, saying it would serve the “strategic and moral interests” of the United States.

Known as the President’s Emergency Plan for AIDS Relief (PEPFAR), it has led to an investment of more than $100 billion (£74 billion) in global HIV/AIDS response – any country’s biggest commitment to address a disease in the world.

There are about 7.7 million people with HIV in South Africa, the largest number in the world. According to UNAID.

The United Nations agency added that since 2010, the number of AIDS-related deaths has dropped by 66%, with about 5.9 million receiving antiretroviral treatment.

The South African government said PEPFAR funding contributed about 17% to its HIV/AIDS program. The money is used for a variety of projects, including operating a mobile clinic to make patients more accessible to treatment.

The Trump administration’s cuts have attracted attention that infection rates may soar again.

Professor Lynn Morris, vice president of Witters University in Johannesburg, told the BBC: “I think we will start to see the number of HIV infections, the number of tuberculosis cases, the number of other infectious diseases.”

“And, we’re going to start seeing a reversal of stories that are essentially truly successful. We’ve got some of these things in hand.”

Gugu pointed out that treatment is a matter of life and death, especially for vulnerable groups such as sex workers.

“People don’t want to default on their ARVs. They’re afraid that if they can’t access them, they’ll die.

The cuts also impact research aimed at finding HIV vaccines and treating AIDS.

Professor Morris added: “The long-term impact is that we won’t receive new vaccines for HIV.”

“We won’t continue to circulate viruses. Even new viruses that may appear, we won’t have the surveillance infrastructure we once had.”

South Africa has been one of the global leaders in HIV research. Many drugs that help prevent the virus and benefit people around the world have been tested in South Africa.

This includes PREP (Pre-prevention prevention), a drug that prevents HIV-negative patients from capturing the virus.

South Africa has also tried another breakthrough preventive drug released this year, twice a year, which can provide full protection for HIV.

In a laboratory on the health science campus of Wits University, a small group of scientists are still working on vaccines for HIV vaccines.

They are part of the Brilliant Consortium, a group of laboratories that develop vaccines in eight African countries.

“We are developing a vaccine test to understand how it works, and then we do the tests on humans,” Abdullah Ely, an associate professor at Wits University, told the BBC in his lab.

“The program is conducted in Africa based on research conducted by Africans because we hope that the study will actually benefit our communities and all of humanity.”

But U.S. funds cut their work.

“When the stop order comes, it means we have to stop everything. Only some of us are able to get the extra money so we can keep working. This has brought us back for months, maybe even a year,” Professor Ely said.

The lab lacks funding to conduct clinical trials planned later this year.

Professor Ellie said: “This is a very huge loss for South Africa and the continent as a whole. This means that any potential research from Africa must be tested in Europe or the United States.”

In June, the university asked the government to release R4.6 billion ($260 million; £190 million) over the next three years to cover some of the money lost by the U.S.

“We beg for support because South Africa is leading in HIV research but has not led itself. This has had an impact on practice and policies throughout the world,” said Dr. Phthiwe Matutu, President of the University of South Africa.

South African Health Minister Aaron Motsoaledi announced on Wednesday that some alternative funding has been obtained.

He said the Bill and Melinda Gates Foundation and Wellcome Foundation have agreed to donate R100m immediately, and the government will receive R400m in the next three years.

This will bring the total to R600 million, down from the R4.6 billion requested by researchers.

As for Gugu, she hopes to discover HIV/AIDS treatments when she is older, but she is not very optimistic now.

“I take care of a nine-year-old. I want to live as much as possible,” she told the BBC.

“It’s not just a question, we have to think about how it will affect the next generation of women and young people.”