In South Africa, a needle exchange program for drug users feels the effects of Trump’s aid cuts

(4 Apr 2025)
RESTRICTION SUMMARY:

++CLIENTS PLEASE NOTE: EDIT CONTAINS SHOT OF PEOPLE INJECTING THEMSELVES AND OTHERS++

ASSOCIATED PRESS
Pretoria, South Africa – 12 March 2025
1. Wide of drug users
2. Mid of drug addicts and users assisting one another with injections
3. Various of Nyaope (refers to a highly addictive cocktail street drug commonly found in South Africa) addict Phumulani Mahlangu putting away a used syringe
4. SOUNBITE (Zulu) Phumulani Mahlangu, Drug Addict:
“I don’t have an excuse to say that I struggled in life or anger or stress. I don’t want to lie. I was over-spoiled growing up. We are speaking now. I have three kids. The mother to my last born is the one who knew I was an addict. She tried to be patient and had faith in me. I ended up stealing money from her bank account.”
4. Various of health workers testing and checking on drug addicts’ vital signs at a make-shift clinic
5. SOUNDBITE (English) Likwa Ncube, Needles Exchange Leader:
“With the needles and syringes, because it’s not a treatment, it is actually, it can be viewed that you are enabling someone to use, but it’s the same argument we can have with condoms. When we distribute condoms, are we saying we are encouraging people to have sex? No. We are seeing the risk of having unprotected sex and therefore coming up with a way of saying let’s reduce the harm.”
5. Wide, zoom in of an addict throwing used needles into a bucket for safe disposal
6. Various of a healthcare worker placing needles, swabs and disinfectant into a plastic bag before handing it over to an addict
7. SOUNDBITE (Sotho) Dipolelo Lekota, Drug Addict:
“The staff from COSUP are really helpful to us. For instance, I am HIV Positive and they assist me with medication, we get pills, as well as needles and syringes so we don’t transfer illnesses to one another.”
8. Various of other healthcare workers and Clinical associate Molebatsi Maila placing medical supplies in a box
9. SOUNDBITE (English) Molebatsi Maila, Clinical Associate:
“We do see clients who are genuinely in a place where they really are tired. They really want to stop, they want to get out, they just don’t know how. And a lot of the times you find that these are people who have tried to stop by themselves, They’ve tried to go to rehab but along the way, relapsed. And because of lack of support and intervention, they are just back at square one. But we do also find that sometimes we find people who are just not ready to stop.”
8. Mid of addict injecting drug
9. Wide of drug users and addicts
STORYLINE:
A secluded corner surrounded by litter and makeshift structures on the outskirts of South Africa’s capital is home to dozens of people with drug addiction.

They inject themselves and each other with heroin-laden mixtures, some of them sharing needles.

A group of health workers has been making weekly visits to this and a dozen other places across Pretoria.

In the project backed by the University of Pretoria and the Tshwane municipality, they offer the chance to exchange needles for new, sterile ones.

Needle exchange is not a new idea globally, but such efforts have been jolted by the Trump administration’s decision to kill 83% of U.S. Agency for International Development programs around the world.

In South Africa, which has more people living with HIV than any other country, treatment for people with HIV has been hit hard. Users who share needles are especially at risk of such diseases.

The report said the country’s drug market for cocaine, heroin and methamphetamine is worth about 3.5 billion US dollars, and growing.

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