When the funding stops: the children behind the numbers

Foreign aid cuts threaten the futures of vulnerable children and families empowered by community health workers in Khayelitsha.

In the informal settlements of Khayelitsha, a quiet revolution has been unfolding – one driven by compassion, persistence and the belief that every child deserves a chance to fulfil their potential. Through the tireless work of community-based organisations like Empilweni, and with support from NACOSA’s Orphans and Vulnerable Children Programme, lives have been transformed, often against the steepest of odds.

But now, this hangs in the balance.

Foreign aid cuts mean that the very services which brought hope to children and families are under threat.

A grandfather’s quiet heroism

In a tiny shack in Khayelitsha, an elderly man called Mr Xolile* found himself caring for his two young grandchildren after their mother vanished without a trace. The eldest, just 7 years old, was living with HIV but had defaulted on treatment. The youngest, aged 5, had no birth certificate, no name on official records and had never seen the inside of a clinic.

Through the programme’s child and youth care workers, Mr Xolile was given support he never knew existed. His grandson was re-linked to HIV care. The youngest was registered for the first time and given the immunizations he had missed. With ongoing home visits and psychosocial support, this small family began to thrive.

But if the programme ends, so too does the support that keeps these children healthy.

Healing starts with trust

Foster mother, Ms Mandisa*, was initially wary of community workers showing up at her door. Years of stigma around HIV had made her afraid to engage. But inside her home, a six-year-old child was silently slipping away – off HIV treatment and later diagnosed with TB.

Because someone didn’t give up, that child is now back on treatment and full of energy. The once-reluctant foster family have become vocal advocates in their community. Yet without continued support, such fragile gains could vanish in an instant.

Disclosure and the cost of silence

A 16-year-old girl walked into a health clinic for family planning. She was being responsible by making sure she was protected. She left with an HIV diagnosis she didn’t understand. She had never had sex. The truth, uncovered with the guidance of a care worker, was heart-breaking: her mother, who had tested HIV positive during pregnancy, had never disclosed it. The girl had been unknowingly living with HIV for years.

Thanks to the sensitive work of Empilweni, mother and daughter now face the future together – on treatment, supported and no longer in silence.

But what happens to others like them if Empilweni’s doors are forced to close?

Simple systems, big results

In another corner of Khayelitsha, an elderly grandmother cares for six foster children. Two had defaulted on treatment for HIV. None had birth certificates. The burden on this ageing caregiver was overwhelming until help arrived.

A simple calendar system, regular visits and shared education about HIV turned chaos into care. All six children are now on track.

But systems don’t sustain themselves. Funding does.

These are not just stories – they are lives.

Lives that have been stabilised, empowered and given dignity. With cuts to foreign aid funding, organisations like Empilweni will no longer be able to reach the families who need them most.

NACOSA is immensely grateful for the support of local foundations – like the HCI Foundation – who have stepped in to support the programme’s work with adolescents and children living with HIV. But the funding gap is too big for a single local donor.

We urge policymakers, other local donors and the global community to look beyond the spreadsheets. See the faces. Hear the stories. And remember what’s at stake: the gains we have so carefully made over the past ten years in our progress towards the end of AIDS.

*Names have been changed to protect identities.

Watch Thabiso’s story, a Grade 11 student from Cape Town. 👇🏾👇🏾