Following US President Donald Trump’s decision to cut crucial funding worth millions to SA’s HIV prevention programme this year, the Eastern Cape government has dug deep to provide nearly R100m to close the gap.
In January, the Trump administration halted close to $440m (R7.4bn) in funding for SA’s antiretroviral (ARV) treatment programme through Pepfar — the US President’s Emergency Plan for Aids Relief — set up by former president George W Bush.
The suspension led to the loss of critical health sector jobs and the curtailing of essential services.
Some workers were attached to NGOs that closed down due to a lack of funds, while others operated from government clinics, mostly in the province’s rural areas.
During the tabling of his mid-term budget speech on Thursday, finance MEC Mlungisi Mvoko announced that more than R94m had been allocated as emergency funding to respond to Pepfar’s withdrawal.
The funds will be administered by the provincial health department, which received a R963.8m mid-term budget allocation.
However, Mvoko said R514.2m of that amount would be allocated to settle accruals and ensure continuity of health services.
A total of R108.6m was allocated to employ 429 health professionals, and R107.5m to assist in absorbing 3,971 community health workers.
NPO One to One Africa, affected by Washington’s Pepfar withdrawal, said the funding was crucial for the fight against HIV.
The organisation provided critical health services to rural communities, particularly in the OR Tambo district, through its “Enable” programme for maternal and child health, including HIV and TB prevention.
One to One Africa head of business development Valerie Govender said the withdrawal of Pepfar funding had placed immense strain on organisations that delivered HIV-prevention services in last-mile rural communities.
“Pepfar’s long-standing investment enabled consistent outreach, testing and adherence support in areas where health systems are weakest,” she said.
“We welcome the MEC’s emergency allocation of R94m, which will help sustain services in the short term — but the desperate need grows with each passing day.
“This funding cannot fully replace the scale and stability needed in the communities we serve.
“For families living beyond the tarred roads, continuity of HIV prevention requires not only emergency relief but sustained, multiyear investment.”
Govender said the organisation remained committed to working with the government and its partners to ensure that families in the hardest-to-reach areas continued to receive the HIV services they needed.
“We invite the MEC to partner with us to see tangible change in communities that need it most.”
In his speech in Bhisho, Mvoko said the allocations were aimed at safeguarding essential services, strengthening institutional capability and sustaining priority provincial programmes.
The education department was allocated R390.8m to retain and appoint educators.
In addition, the department received R281m through the ECD grant to increase per-child subsidies and expand early learning for children under five.
This allocation is based on the number of children targeted for support, with up to R8m allowed for administration.
Both the annual report and the mid-term oversight report paint the same picture: a treasury that cannot spend its own budget, cannot enforce compliance across departments, cannot strengthen municipalities, cannot ensure procurement fairness and cannot implement its own recommendations.
— MPL Simthembile Madikizela
The provincial legislature is allocated R19.3m, mainly for transfers to political parties, voter education campaigns ahead of the 2026 local government elections, National Council of Provinces legislative processes, the establishment of the Ad Hoc Committee on TB and Customary Initiation, and implementation of the Eastern Cape Money Bills Act.
The public works and infrastructure department received R11.3m, front-loaded from the 2026/2027 allocation to support progress on the Legislature Office Block project.
Mvoko said this responded to improved contractor performance after payments resumed in 2025/2026 following delays in 2024/2025.
“These funds will be earmarked to ensure they are not diverted to other departmental cost pressures.”
Co-operative governance and traditional affairs receives R1.8m for additional disaster-relief trucks and R3.1m for the summer initiation programme.
Economic development, environmental affairs and tourism received a R42m allocation for key interventions, including R21.5m for the N2 Biodiversity Offset Project, R13.1m for Eastern Cape Parks and Tourism Agency personnel shortfalls and R5.6m for hosting the 2025 SA Auto Week through the Eastern Cape Development Corporation.
Mvoko said the adjustment budget and medium-term budget policy statement were a call to action.
“It is a blueprint for a province determined to overcome fiscal constraints, inefficiencies and service delivery backlogs.
“It is a statement of our commitment to a capable, ethical and developmental Eastern Cape, where every citizen can access quality services, participate in economic opportunities and enjoy dignity in their daily lives.”
However, the provincial EFF rejected the adoption of the report.
MPL Simthembile Madikizela said they were “reports of stagnation, repeated administrative failure and a government that has normalised underperformance as if the people of this province are undeserving of seriousness and urgency”.
“Both the annual report and the mid-term oversight report paint the same picture: a treasury that cannot spend its own budget, cannot enforce compliance across departments, cannot strengthen municipalities, cannot ensure procurement fairness and cannot implement its own recommendations.”
DA MPL Malcolm Figg said the medium-term budget policy statement revealed a provincial fiscus under severe strain.
The treasury’s own figures showed total transfers to the Eastern Cape amounted to R99.6bn, while adjusted payments would reach R101.9bn, creating a financing gap of more than R2bn that could be closed only through roll-overs, cash flow adjustments and a drawdown of reserves.
“When a province must rely on one-off interventions to plug holes in its budget, it is the public who feel the consequences.
“Pressure on cash flow affects the ability of departments to pay suppliers on time, maintain clinics and schools and keep essential programmes running.
“Families already living with poor service delivery experience further instability when budgets don’t keep pace with the demands placed on them.”
Daily Dispatch
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