South Africa: The US government’s harsh decision to cut HIV funding programmes has been described as a “wake-up call” for South Africa, Health Minister Dr Aaron Motsoaledi conveyed. The move has sent shockwaves across the country, lifting fears of a major health crisis.
The cuts could lead to deaths, Dr Motsoaledi warned but confirmed that state-funded clinics would strive to ensure no patient is left without life-saving antiretroviral drugs (ARVs). The sudden termination of funding has pitched HIV organisations into chaos, with many scrambling to find alternative support for nearly 900,000 affected patients.
Kate Rees from the Anova Health Institute, one of the biggest recipients of US funding, likened the crisis to being “pushed off a cliff” rather than undergoing a careful transition.
The funding cuts target the US President’s Emergency Plan for AIDS Relief (Pepfar), a widely praised programme launched in 2003 by then-President George W. Bush. Pepfar has delivered vital resources for some of the world’s poorest populations, saving more than 25 million lives worldwide.
However, this decision is an element of a broader cost-cutting effort by the US government. The freeze on foreign aid payments, initiated by President Donald Trump on his first day in office last month, has already disrupted global health initiatives.
Dr Jean Kaseya, head of the Africa Centres for Disease Control and Prevention (Africa CDC), issued a stark warning, stating that, “The world is recreating with fire.” He cautioned that Western nations should not blame Africa if future pandemics occur due to the abrupt withdrawal of critical funding.
South Africa, one of the largest beneficiaries of Pepfar, receives around 17 percent of its HIV/AIDS funding from the programme. Of the eight million South Africans living with HIV, approximately 5.5 million rely on ARVs.
Affected organisations, including the Anova Health Institute, received termination notices. Dr Rees described the announcement as “one of the worst days” of her career, especially since there had been a strategy in place to gradually reduce donor dependence over the next five years.
Health experts warn that Pepfar’s support also plays an essential role in HIV cure research, and the funding cuts could set progress back by years. The Desmond Tutu Health Foundation estimates the impact could result in as many as 500,000 deaths.
South Africa’s leading AIDS lobby group, the Treatment Action Campaign (TAC), fears a return to the days when patients struggled to access essential treatment. TAC Chair Sibongile Tshabalala stated that, “We can’t afford to die. We can’t afford to go back to those years where we were suffering.”
She revealed that TAC had received a significant portion of its funding from Pepfar, with a smaller grant from the US CDC and the South African National AIDS Council (Sanac). While CDC funding will last until March, Pepfar’s immediate termination has already resulted in 101 job losses from TAC’s 189-member staff.
TAC employs individuals living with HIV to observe services at clinic levels, and Tshabalala, who has HIV herself, expressed deep concern over the future. She recalled the early 2000s when she struggled to access treatment, describing the current crisis as a painful reminder of that time.
Dr Motsoaledi acknowledged the dangers of relying on foreign aid but stressed that turning away funding had not been an option when Pepfar first launched. The abrupt termination concerns critical services such as community testing, tracing, and specialist clinics for pregnant women to prevent mother-to-child transmission of HIV. With uncertainty looming, health organisations are now in a race against time to find alternative funding sources and prevent a public health catastrophe.
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