Early Online

Securing our HIV response: The PEPFAR crisis in South Africa

Authors

  • A Grimsrud International AIDS Society, South Africa
  • L Wilkinson International AIDS Society, South Africa
  • Y Raphael Advocates for the Prevention in HIV in Africa, South Africa
  • S Tshabalala Treatment Action Campaign, South Africa
  • A K Moses Aurora Kaleidoscope Movement, South Africa
  • F Hassan Health Justice Initiative, South Africa
  • K Buthelezi Sisonke, South Africa
  • K Rees Anova Health Institute, and Department of Community Health, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
  • L-G Bekker The Desmond Tutu HIV Centre, University of Cape Town, South Africa [email protected] https://orcid.org/0000-0002-0755-4386

DOI:

https://doi.org/10.7196/SAMJ.2025.v115i3.3216

Keywords:

HIV response , PEPFAR, Funding Freeze, USA

Abstract

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Author Biographies

  • A Grimsrud, International AIDS Society, South Africa

    Lead Technical Advisor, International AIDS Society

  • L Wilkinson, International AIDS Society, South Africa

    Differentiated Service Delivery Technical Consultant, IAS 

    Research Associate, School of Public Health

  • Y Raphael, Advocates for the Prevention in HIV in Africa, South Africa

    Executive Director, APHA

  • S Tshabalala , Treatment Action Campaign, South Africa

    National Chairperson, Treatment Action Campaign

  • A K Moses, Aurora Kaleidoscope Movement, South Africa

    Founder and CEO, Aurora Kaleidoscope Movement

  • F Hassan, Health Justice Initiative, South Africa

    Director, Health Justice Initiative

  • K Buthelezi, Sisonke, South Africa

    National Coordinator, SWEAT

  • K Rees, Anova Health Institute, and Department of Community Health, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa

    Public Health Specialist, ANOVA Health Institute, Dept of Community Health, School of Public Health, University of the Witwatersrand, RSA

  • L-G Bekker, The Desmond Tutu HIV Centre, University of Cape Town, South Africa [email protected]

    Director, the Desmond Tutu HIV Centre, University of Cape Town 

    CEO, The Desmond Tutu Health Foundation, RSA

References

1. Tram KH, Ratevosian J, Beyrer C. By executive order: The likely deadly consequences associated with a 90-day pause in PEPFAR funding. J Int AIDS Soc 2025;28(3):e26431. https://doi.org/10.1002/ jia2.26431

2. KFF. The US President’s Emergency Plan for AIDS Relief (PEPFAR). KFF, 2024. https://www.kff.org/ global-health-policy/fact-sheet/the-u-s-presidents-emergency-plan-for-aids-relief-pepfar (accessed 4 March 2025).

3. Ratevosian J, Millet G, Honermann B, Bennet S. PEPFAR under review: What’s at stake for PEPFAR’s future. Lancet 2025;405(10479)603-605.

4. Johnson L, Dorrington R. Thembisa version 4.7: A model for evaluating the impact of HIV/AIDS in South Africa. Thembisa Project, 2024. https://thembisa.org/content/downloadPage/Thembisa4_7report (accessed 4 March 2025).

5. Chigwedere P, Seage GR, Gruskin S, Lee TH, Essex M. Estimating the lost benefits of antiretroviral drug use in South Africa. J Acqu Immune Deficiency Syndr 2008;49(4):410-415. https://doi. org/10.1097/qai.0b013e31818a6cd5

6. Gandhi AR, Bekker L-G, Paltiel AD, et al. Potential clinical and economic impacts of cutbacks in the President’s Emergency Plan for AIDS Relief Program in South Africa: A modeling analysis. Ann Intern Med 2025 (epub 11 February 2025). https://doi.org/10.7326/ANNALS-24-01104

7. Pike C, Bekker L-G. Interrogating the promise of long-acting HIV pre-exposure prophylaxis. Trends Mol Med 2023;29(2):93-98. https://doi.org/10.1016/j.molmed.2022.11.003

8. Hero. South African HIV investment case 2023. Hero, 2023. https://www.heroza.org/wp-content/ uploads/2024/01/HIV-Investment-Case-2023-Full-Report-v1.2.pdf (accessed 3 March 2025).

9. Doan TM, Shin HB, Mehta NK. To what extent were life expectancy gains in South Africa attributable to declines in HIV/AIDS mortality? Demogr Res 2022;46(18):543-555.

10. Johnson LF, Dorrington RE. Modelling the impact of HIV in South Africa’s provinces: 2024 update. Centre for Infectious Disease Epidemiology and Research, 2024. https://thembisa.org/content/ downloadPage/Province2024 (accessed 4 March 2025).

11. Pillay Y. This is how South Africa can meet its targets. Spotlight, 15 January 2024. https://www. spotlightnsp.co.za/2024/01/15/opinion-yogan-pillay-this-is-how-sa-can-meet-its-hiv-targets (accessed 4 March 2025).

12. World Health Organization. Policy Brief: Supporting re-engagement in HIV treatment services. Geneva: WHO, 2024.

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Published

2025-03-10

Issue

Section

Editorials

How to Cite

1.
Grimsrud A, Wilkinson L, Raphael Y, Tshabalala S, Moses AK, Hassan F, et al. Early Online: Securing our HIV response: The PEPFAR crisis in South Africa. S Afr Med J [Internet]. 2025 Mar. 10 [cited 2025 Mar. 26];115(2):e3216. Available from: https://samajournals.co.za/index.php/samj/article/view/3216