Latest DFID figures indicate that more than a fifth of its aid to Southern Africa goes on HIV programming. A loss of support could put millions of lives at stake if prevention services are jeopardised and new infections increase as a result. South Africa has made real strides when it comes to investing in its national HIV response but there is still a long way to go to ensure universal access to treatment and care for all.
HIV and South Africa
South Africa may have the largest economy in sub-Saharan Africa but it continues to suffer one of the highest levels of inequality in the world. One in six South Africans live in extreme poverty earning less than a dollar a day. This is exacerbated by the fact that the country also has the largest HIV burden globally with more than five million people living with the virus. More than a quarter of a million South Africans died from AIDS-related causes in 2011, an almost unthinkable statistic especially when we have the scientific knowhow and tools to be able to prevent new infections.
Impact of cut?
Withdrawing aid to middle income countries like South Africa altogether risks seeing investment made in the HIV response to date, as well as subsequent gains including broader health outcomes, undermined and worse rendered ineffective. The headway that has been made there in reducing HIV-related maternal mortality among women and the decrease in HIV transmission from parent to child could be lost altogether if international donors like the UK do not continue to invest in interventions that are known to work and save lives.
According to Shaun Mellors, the Alliance’s Associate Director for Africa and himself South African: “In the last few years South Africa has become home to the world's biggest programme of HIV treatment, and life expectancy has increased five years. Withdrawing aid now would be a mistake. Justine Greening, the International Development Secretary, has talked widely of needing to transform the lives of women and girls in the south and yet this latest announcement is a real blow given that women in their 20s in South Africa are worst affected by HIV with prevalence rates of up to 40%.”
It’s not yet clear what the UK government means by the “new relationship [between the UK and South Africa] is based on sharing skills and knowledge” but we urge them not to punish economic growth by withdrawing aid from South Africa prematurely. Community-based organisations play a crucial role in the national HIV response and in delivery of services but many rely on international support to enable them to play that role.
Mellors continued: “Aid should not be based on country income alone but rather on addressing the greatest need and targeting the most vulnerable and marginalised. Funding for HIV prevention, treatment, care and support programmes for those groups most at risk of the epidemic – women and girls, sex workers, men who have sex with men, transgender people, people who inject drugs – needs to be scaled up not down if we are to really break the back of the epidemic once and for all.”