7,000 HIV-Positive Children in Western Cape at Risk After USAID Funding Cuts

USAID’s abrupt funding termination leaves vulnerable children without essential HIV treatment support in South Africa.

USAID Funding Cuts Jeopardize HIV Treatment for Thousands of Vulnerable Children in Western Cape

Thousands of vulnerable children living with HIV in South Africa face a crisis following USAID funding cuts for critical health programmes. The termination of funding has forced the closure of essential services, leaving an estimated 7,000 HIV-positive children in the Western Cape at risk of treatment default.

USAID Programme Shutdown: A Crisis for HIV-Positive Children

The Networking HIV and AIDS Community of Southern Africa (Nacosa) was among the organisations impacted by the sudden USAID funding termination. The programme, which provided lifesaving support to orphans and vulnerable children living with HIV, had to halt operations, leaving these children without structured assistance to maintain their antiretroviral therapy (ARV) regimens.

Nacosa’s programme helped identify HIV-positive children in extremely precarious situations, often living with unemployed relatives in food-insecure households. The programme ensured they remained on their medication, flagged cases of abuse, and linked caregivers to social support services.

With 26,000 vulnerable children losing access to these services over 90 days, the impact is severe. Among them, 7,000 HIV-positive children are now at increased risk of missing treatment, leading to potential health deterioration and increased transmission risks.

HIV Testing in South Africa Severely Impacted

The USAID cuts have also dealt a devastating blow to HIV testing services. According to Professor Francois Venter of Wits University’s Ezintsha Research Institute, HIV testing in central Johannesburg has almost completely stopped, as USAID-funded counsellors were responsible for conducting most tests in high-risk areas.

Without these HIV counsellors, testing rates have plummeted in clinics, antenatal sites, and high-traffic community areas like taxi ranks. This means many HIV-positive individuals may remain undiagnosed, delaying access to essential treatment.

Impact on Survivors of Gender-Based Violence

Nacosa’s funding cuts also affected programmes assisting young women and survivors of gender-based violence (GBV) across seven provinces. These services helped victims access emergency medical treatment, HIV testing, forensic services, legal aid, and psychosocial support.

Now, GBV survivors must navigate the already overburdened public health system alone, facing long queues and multiple disclosures before receiving help. Experts warn that this will deter many from seeking the care they need.

A Public Health Crisis in the Making

With no intervention or alternative funding, the situation is expected to worsen. Public health experts caution that HIV treatment adherence rates among orphaned children will decline, potentially reversing years of progress in South Africa’s fight against HIV/AIDS.

While public clinics still provide ARVs, the lack of caseworkers to track missed appointments and offer psychosocial support could lead to a surge in treatment interruptions. This could increase drug resistance, higher transmission rates, and deteriorating health outcomes for vulnerable children.

What Happens Next?

USAID’s decision to terminate over 90% of its global health contracts has left South Africa scrambling to fill the void. Government and NGOs must urgently seek alternative funding to ensure vulnerable children continue to receive the support they need.

As HIV testing rates drop and treatment adherence declines, South Africa’s public health system faces mounting pressure. The hope now lies in securing emergency funding from alternative global health donors or local initiatives to sustain these critical programmes.

Final Thoughts

The abrupt termination of USAID funding has created a public health emergency in South Africa. The 7,000 HIV-positive children in the Western Cape left without support are at serious risk, and urgent intervention is needed to prevent further devastation.

Without immediate action, the consequences could be catastrophic for South Africa’s HIV response, putting thousands of lives in danger.

Also read: The Harsh Reality of Trump’s USAID Funding Cuts: Lives at Risk as HIV Programmes Shut Down