PEPFAR funding still constitutes nearly a quarter of AIDS funding in South Africa. It is critical for people living with HIV and communities impacted that this funding is used optimally and with the best possible impact. The AIDS response in South Africa stands on a precipice. South Africa has achieved a great deal. But the health system on which the response is built is crumbling and future scale up and progress are very much under threat. We cannot see the end of AIDS without a significant shift in how money for health in the country is invested. PEPFAR is a key part of that. TAC continues to lobby PEPFAR to re-think, re-prioritise, and re- imagine the role their funding can play in this country. Millions of lives depend on it.