On April 30, the UK’s International Development Secretary, Justine Greening, announced that Britain’s bilateral development programme in South Africa would end in 2015, on the grounds of South Africa’s enormous political and economic progress. The withdrawal decision, however, was regarded as “unilateral” by South Africa’s Government, who claimed it would have “far-reaching implications” and would be “tantamount to redefining” the two countries’ relationship. In response, the UK Foreign Secretary William Hague said that the UK would clear up any confusion with the South African Government.
Disappointingly, the essential issue of health has not been part of the discussion. This bilateral development programme, currently worth £19 million annually, will focus in its final 2 years on finishing projects that will help reduce the number of women dying in childbirth by more than 10% and also that support businesses. Although important gains have been achieved during South Africa’s health system transition, as detailed in The Lancet’s 2012 Review on South Africa’s health, there has been no change in HIV prevalence in young pregnant women since 2006 and no progress towards Millennium Development Goal (MDG) 5 to improve maternal health, while progress towards MDG 6 (to combat HIV, AIDS, malaria, and other diseases) is insufficient. Considering the current maternal health status in South Africa, can the £19 million per year package help achieve the target in reducing maternal death by 2015? Furthermore, “UK aid is helping to provide life-saving medicines to people living with HIV in South Africa, so the UK must ensure that this announcement doesn’t put these lives on the line”, said Oxfam’s head of Development Finance and Public Services, Emma Seery, in response to the announcement.
Health is without doubt a key part of the UK—South African bilateral partnership. While the UK and South Africa are trying to resolve this misunderstanding, it is crucial for both sides to assess how important the UK’s aid is to health care in South Africa and the implications for global health from stopping aid. The end of aid must never cost lives.