The AIDS epidemic in South Africa has been devastating. Factors like lack of awareness and the indifference of political leaders such as President Thabo Mbeki did not allow any kind of control. However, in the last few years there has been major progress in AIDS treatment and prevention thanks to President George W. Bush's Pefar program implemented in 2003.
New infections have gone down by a third, mother-to-child transmissions have dropped by 90 percent and life expectancy rose by almost 10 years. Around 2.4 million people are on antiretroviral medication and more healthcare workers are being trained in new facilities.
"We've managed a miracle," said Dr. Salim Abdool Karim, one of the country's leading AIDS researchers. "Undertaking is not a business you want to go into anymore."
Due to projected cuts to funding, things could take a turn for the worse. South Africa now pays 83 percent of its own costs for its AIDS health programs and Pepfar funding will probably drop from $350 million to $250 million by 2016. Pepfar workers say the money needs to be used to combat the disease in poorer countries like Cameroon and Burundi.
South Africa has always very quiet about the foreign aid it begrudgingly accepts. Dr. Aaron Motsoaledi, the country's health minister, believes it will be able to find the money to continue the program.
"It's a logistical problem," Motsoaledi told the New York Times. "Any country in the world would be shaken by putting 2.4 million people on treatment quickly. But it's not as if we have any choice. If we don't, they fill up the hospital beds and I.C.U.'s. It's becoming easier for Treasury to give me what I ask."
Dr. Ian Sanne, who runs the "Right to Care" AIDS treatment clinics, disagreed saying it's all because of Pepfar funding.
"We opened in 2004, with 100 percent Pepfar money," he said.
Sanne's clinics, which treat 203,000 patients, are getting hit with cutbacks. He will get "bridge money" to prevent layoffs, but said it doesn't ease his concern.
"Our stay of execution," her said, laughing.