Weeks after the administration of US President Donald Trump gutted the country’s aid programs, cancelling billions of dollars of funding used to fight HIV in Africa, mining companies and South Africa’s biggest health insurer are offering to help fill the gap.

Miners have for years provided drugs and treatment to combat HIV and tuberculosis in their workforces. Now they are being asked to consider rolling out that service to the communities near the mines, which are often in remote parts of the country and were benefiting from nurses and clinics funded with American money.

The Department of Health has asked “mining health services to consider being part of the drug distribution points,” the Minerals Council, which represents the biggest mining companies operating in South Africa, said in a response to a query. It has also asked mining companies to be “more involved in community outreach services as the Department of Health is unlikely to be able to fill this void.”

With almost half a million workers, many of them migrants from neighbouring countries or South Africa’s impoverished Eastern Cape province, mining companies and the health services they provide have for many years been a linchpin in the fight against HIV/AIDS. With 7.8-million people, or an eighth of the population, infected the country has the world’s biggest epidemic of the disease that attacks the immune system.

While South Africa, unlike many other African countries, buys almost all of the drugs used to combat HIV itself, it relied on the about 15 000 workers paid for by United States Agency for International Development and the President’s Emergency Plan for AIDS Relief, or Pepfar, to help distribute those drugs and administer treatment and counselling. South Africa was receiving more than $400-million in HIV funding from the agencies before the cancellation.

About 25 years of progress may be reversed and more than 610 000 HIV-related deaths may occur in South Africa in the next decade because of the aid cuts unless those gaps are filled, Linda-Gail Bekker, chief executive officer of the Desmond Tutu Health Foundation, said in February. There will be further pressure on the country’s already stressed public health service. A US-funded HIV vaccine trial, where the South African Medical Research Council had teamed up with scientists from eight countries on the continent, is also at risk.

Impala Platinum Holdings Ltd and other mining companies will meet with the government on Wednesday to discuss how to address the gaps left by the funding withdrawal. At the same time Discovery, the country’s largest medical-insurance provider, is working with affected organisations to offer technical support as well as holding talks with potential funders.

“We definitely do have the capacity and we are willing to explore together with the Department of Health, how we can help to extend that delivery of the services for them,” Bogosi Moagi, Impala’s group health executive, said in an interview.

The country also has has a severe TB epidemic, with about 427 new cases per 100 000 people in 2023. Many people infected with HIV fall ill with TB.

Impala is seeking to work with the health department to boost the number of caregivers who visit the infected in their homes in the communities in which it operates, Moagi said.

Covid-19 Response

This won’t be the first time private companies have worked with the government to combat a health crisis. In 2020, at the height of the Covid-19 pandemic, Discovery offered technical expertise and along with other companies they also gave some financial support. Impala was amongst the first private companies to have its operational sites accredited to become vaccination centers.

“This challenge is too big for any one player,” Andronica Mabuya, head of corporate and social investment at Discovery, said by phone. “It will need a very coordinated effort between government, private sector and civil society.”