Currently, the TAC has just one-third of its 2015 budget, according to Mark Heywood, head of public interest law organisation Section27. Donor funding cuts have forced the AIDS advocacy organisation to cull staff and cut programming at least twice in recent years.

Heywood says the organisation, once dubbed the world’s “beacon of HIV activism” by former United Nations Special Envoy on AIDS in Africa Stephen Lewis, cannot survive another downscaling.

“If we get to the beginning of 2015 still with one-third of the budget and have to discuss scaling back the TAC, then actually we might as well discuss closing the TAC,” Heywood told Health-e News. “The TAC cannot survive another scale down.”

“Scaling back causes rupture, demoralisation and programmes to be interfered with at a critical time… it usually takes several years to recover from,” said Heywood, speaking on the final day of the bi-annual Southern African HIV Clinicians Society Conference, which closed in Cape Town this weekend.

[quote float=”left”]“The TAC cannot survive another scale down”

At the meeting, HIV physicians noted a renewed need for the TAC’s brand of patient treatment education with the January introduction of earlier HIV treatment as well as the need for antiretroviral (ARV) patients to begin demanding annual viral load tests from doctors. Viral load testing, which measure the amount of HIV in a person’s blood, is the best way for doctors to check whether patients are responding to treatment or if they need to be switched to a different kind of ARV treatment.

As more donors pull out of South Africa, Heywood said sustaining the HIV response – and the work of HIV advocacy organisations like the TAC – would be up to South Africans.

“Civil society brought the notion for the first time that people with diseases, people living with HIV should be consulted and should be part of planning, should be part of response,” he said. “Increasingly, this is being overlook and civil society is being marginalised form debates and policy making…”

The TAC is selling its iconic “HIV positive” shirts – which have been even worn by Nelson Mandela –  as part of a fundraising campaign that includes online donations via the fundraising site, GivenGain.

“Civil society brought to the AIDS epidemic everything that now defines the response to the epidemic in South Africa,” Heywood told Health-e News.

Edited versions of this article first appeared in the 30 September editions of The Star, Cape Times, Pretoria News and Mercury newspapers.

[Updated 8:25 pm 30 September 2014. In response to this story, TAC released a press statement saying that “despite severe financial challenges, the TAC is not facing imminent closure. However if we have not raised the funding required by February 2015 we will have to make tough decisions.”]