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By SITHEMBILE HLATSHWAYO | 2025-01-29
When the United States President Donald Trump issued an executive order to withdraw all funding, Emaswati held their collective breath.
Now, the country’s worst fears are being felt, following news of the suspension of HIV/AIDS funding by the United States (US).
In a report published by the New York Times on Monday, the White House budget office is reported to have ordered a pause in grants, loans, and other federal financial assistance, a sweeping move it deemed necessary to align programmes with President Trump's priorities.
In addition, a memorandum signed by the acting Director of the Office of Management and Budget at the Executive office of the president in Washington DC, Matthew J. Vaeth, indicated that the temporary pause of global health funding was effective as of yesterday (January 28) at 5pm.
The letter further noted that agencies must submit to OMB detailed information on any programmes, projects, or activities subject to the pause.
It also stated that President Trump was given a mandate by the American people to increase the impact of every federal taxpayer pound.
“Financial assistance should be dedicated to advancing administration priorities, focusing taxpayer funds to promote a stronger and safer America, eliminating the financial burden of inflation for citizens, unleashing American energy and manufacturing, ending ‘wokeness’ and the weaponisation of government, promoting efficiency in government, and making America healthy again,” reads part of the memorandum.
The President’s Emergency Plan for AIDS Relief (PEPFAR) is among the programmes that have been halted, pending a review of the initiatives.
Over 230 000 Emaswati, both adults and children, are currently living with HIV/AIDS according to global statistics.
National Emergency Response Council on HIV/AIDS (NERCHA) Information Centre Manager Sibusiso Ngubane stated that they had seen reports circulating in the media about the executive decisions taken by the newly sworn-in US president.
Following the news, Ngubane said they were still awaiting formal communication from their development partners, including UNAIDS and the US Embassy, regarding the way forward.
Currently, Ngubane said as an organisation, there was nothing they could say about the matter as they were still trying to ascertain what would happen going forward and how the decision would impact the country.
“Once our development partners communicate something, we may be able to clarify what has been communicated and how it will affect the country,” said the manager.
Principal Secretary in the Ministry of Health Khanya Mabuza, remarked that in light of the news, Eswatini needed to reposition itself and rethink its strategies. Mabuza noted that they were minimally aware of the pressure points and how they could destabilise HIV/AIDS efforts. He explained that, for instance, stopping people on treatment would mean that many would become ill and infectious.
“We have those programmes we know need to be implemented urgently; hence some will be executed in the mid-term, while others will be for the long term as they could have significant impacts on us.”
This, the PS stated, implied that Eswatini, they must ensure that treatment is not disrupted. He mentioned that the ministry was currently engaging and examining the programmes likely to be affected by the funding cut.
This, he said, would provide them with a clearer picture of who was impacted, as not all programmes were being halted. Mabuza indicated that the programmes likely to be affected had been identified.
“We need to qualify the services and also review their support plans and how they affect us as a country,” the PS stated.
Primarily, Mabuza said they would focus on the programmes that included lifesaving interventions and assess their costs to the country, as they were urgent.
The PS added that they would then consider educational programmes, behaviour change initiatives, rights, and many others. He emphasised the need to contemplate how these programmes would be mainstreamed or integrated within the next 90 days.
Mabuza expressed optimism as the country had begun integrating most of the HIV programmes.
“We are going to strengthen the integration of services and also assess what is needed in terms of staffing and running costs,” he assured.
He stated that Eswatini was on the path to sustainability but was looking towards 2030, where most programmes would be controlled locally.
Coordinating Assembly of Non-Governmental Organisations (CANGO) Executive Director Thembinkosi Dlamini stated that they were still trying to understand the impacts of the funding suspension and were attempting to unpack these ramifications.
Dlamini noted that they understood that if there were ongoing contracts, they should be maintained, whereas those that had not been issued should cease.
He warned that if the contracts were halted, it would have a devastating effect on the programmes, as PEPFAR contributed significantly to HIV/AIDS initiatives in terms of human resources and the procurement of commodities, which include antiretroviral treatment (ARVs), condoms, pre-exposure prophylaxis (PrEP), and PrEP rings, which were HIV/AIDS prevention methods.
The director stated that the suspension of PEPFAR funding could result in troubling outcomes in terms of sustaining the response to HIV/AIDS.
He highlighted that Eswatini, being among the first countries to reach the 95-95-95 targets, was opting to at least maintain the status quo rather than regress.
Dlamini cautioned that this current status would decline, even if the halted programmes resumed after three months, adding that some human resources would also be lost by then, including certain systems, such as the epidemiology department.
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He remarked that it would take considerable time to recruit staff once they were lost due to the funding halt.
He concluded that the suspension would have alarming effects on sustaining the response, especially given the fact that Eswatini was among the first countries to achieve the 95-95-95 targets.
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