South Africa’s government has enlisted Deloitte & Touche to investigate the administration of United States Agency for International Development (USAID) grants for HIV/AIDS programmes, Health Minister Dr Aaron Motsoaledi announced on Monday.

This comes after US President Donald Trump temporarily suspended for 90 days the financial support for medication and some posts under the USAID, pending a review, due to concerns of massive corruption in its disbursement.

The US government-funded partners across South Africa have since received stop-work orders and been forced to begin retrenching vital health care staff. The result is an abrupt stop of service provision to improve conditions for South Africa’s most vulnerable. The fallout is already visible—health services disrupted, livelihoods lost, and lives at risk.

Health services began shutting down in mid-January, including HIV testing, treatment and prevention, sexual and reproductive health services, gender-affirming care for transgender and gender-diverse people, mental health, and harm reduction across South Africa.

“We are busy with this process; we have met many people and found the complexity of what is involved. We have hired Deloitte & Touche. They said it will take them about a month just to go into this thing. We have discovered that part of this money is not going to patients; again, it’s going to administration—huge amounts of money,” Motsoaledi said.

The government will today launch the 121 More People, a campaign to put that number of people on antiretrovirals (ARVs) so that their work on alleviating the impact of HIV/AIDS would not stop.

“In 2010, when we wanted to put up the world’s biggest HIV Counselling and Treatment campaign, we were asked the same question. The answer is simple: when people are dying, you don’t stop and ask these questions; you save lives and things will resolve themselves. I will give you that same answer today,” Motsoaledi said.

Wesley Solomon, a Life Sciences and Healthcare Leader at Deloitte Africa, confirmed the firm’s offer to assist the National Department of Health with data analysis if needed.

Project leaders in USAID-funded programmes reported a lack of communication from the organisation, despite requests for clarity. Some projects were instructed to submit budgets limited to services under a waiver.

The Board of Universities South Africa (USAf) warned that Trump’s aid withdrawal jeopardises joint programme gains, tarnishing the US’s global role in combating poverty and disease.

USAf chairperson Professor Francis Petersen noted previous collaboration with the US on HIV/AIDS research had helped to spur a massive ARV programme for nearly 6 million South Africans.

“In the short term, we need strong lobbying by our research partners in the United States to impress upon the Trump administration the interdependence of nations. The USA needs other nations as much as they need the USA,” he said, adding that the cuts highlight the urgency to diversify research funding.

The South African National AIDS Council’s civil society forum reported that 9 000 people in Mpumalanga, Limpopo, and Gauteng have lost access to needle exchange and opioid substitution therapy, risking HIV, hepatitis C, and overdoses. While some public clinics remain operational, most lack these services.

Francois Venter, an HIV clinician and director of Ezintsha research centre in Johannesburg, described the chaos.

“Health workers and people have no idea what is happening across the region. People are going to start dying soon,” he warned, noting decades-old systems unravelled in a week.

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