Rex Tillerson. Picture: REUTERS
Rex Tillerson. Picture: REUTERS

The US government will continue to make substantial investments in SA to help control its HIV/AIDS epidemic, despite a policy shift in which the US will concentrate its support on 13 other high-burden countries.

The assurance is important — although SA funds the bulk of its HIV/AIDS programmes itself, the scale of the epidemic means international donors, of which the US is the biggest, play a critical role by providing 18.5% of the money available for programmes for the 2017-18 fiscal year, most of which comes from the US president’s emergency programme for HIV/AIDS relief.

On Tuesday, US Secretary of State Rex Tillerson announced a new strategy for the programme in which the US will focus its efforts on 13 high-burden countries that have the best chance of controlling their HIV epidemics by 2020. SA is not on this list.

The US relief programme will support 50 countries in total and will maintain life-saving treatment for the people it currently supports.

The overall funding available for it remains largely unchanged at about $6bn, after the US Senate appropriations committee last week scotched efforts by President Donald Trump’s administration to shave $1bn off the programme.

The US did not say which projects were to be cut in order to shift resources to the 13 focus countries: Lesotho, Swaziland, Botswana, Namibia, Zimbabwe, Ivory Coast, Kenya, Malawi, Haiti, Rwanda, Tanzania, Uganda and Zambia.

However, a senior state department official told Business Day that the US relief programme remained "deeply committed to its partnership with SA" and to controlling its HIV/AIDS epidemic.

Since SA had the world’s biggest HIV/AIDS burden — with 7.1 million cases — changing the course of its epidemic was vital for global control of the disease, the official said.

"The world must unite to support and accelerate the amazing leadership in SA … we must all ensure SA has the resources it needs to expand HIV/AIDS treatment and prevention services. The president’s emergency programme for HIV/AIDS relief will work aggressively with the government of SA and other partners to mobilise, and maximise the impact of, all potential sources of support for the country’s HIV/ AIDS response," said the official.

The US relief programme had increased its allocation to SA for 'the US 2017-18 fiscal year, which begins on October 1, said Department of Health deputy director-general for HIV/ AIDS, tuberculosis and maternal and child health Yogan Pillay.

The programme has provided $5.6bn to SA since 2004 and has gradually shifted its emphasis from providing treatment to technical support.

Data show five high-burden African countries are approaching control of their epidemics, demonstrating the effect of the support of the US and other governments: Swaziland, Zimbabwe, Malawi, Zambia and Lesotho. The data also show that Uganda’s previously expanding epidemic has stabilised.

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