The freezing of U.S. aid for key health programs in South Africa has left many local organizations in shock. The country has long been one of the main recipients of American international assistance, particularly through the U.S. Agency for International Development (USAID).
A significant portion of that funding has come from the President’s Emergency Plan for AIDS Relief (PEPFAR), a global health initiative launched in 2003. Over the years, PEPFAR has contributed approximately $8 billion—around 145 billion rands—to South Africa, including $440 million for the current U.S. fiscal year.
South Africa spends roughly $2.56 billion annually to combat HIV, and PEPFAR funding has played a crucial role in reaching underserved communities, such as children and pregnant women. USAID funds nearly half of the country’s health programs, making its support vital to public health efforts.
The situation took a dramatic turn when former U.S. President Donald Trump signed an executive order imposing a 90-day freeze on all foreign development aid pending review. In response, USAID issued notices to halt funding for key health programs in South Africa. Several local organizations fighting HIV/AIDS reported receiving emails informing them that their funding had been cut off.
The aid freeze has sparked outrage among healthcare workers, many of whom have criticized the South African government’s inaction. Groups like the Anova Health Institute, which had been assisting the public health system in tackling tuberculosis and HIV, have now lost all their funding.
“The axe has fallen—we went from funding suspensions to outright job losses,” said Mark Heywood, a prominent health and human rights activist.
Lynne Wilkinson, a public health specialist, warned of dire consequences, saying, “The entire HIV and tuberculosis response in South Africa’s public healthcare sector is at risk of collapse.” She stressed that decades of investment had gone into building systems that allowed partner organizations to fill critical gaps in the country’s fight against AIDS.
“These programs are being dismantled. There were already plans in place to make them more sustainable, so that the South African Ministry of Health could fully take over in the next five years,” Wilkinson added.
Beyond HIV and tuberculosis treatment, U.S. aid has also been essential in supporting survivors of gender-based violence. Linda-Gail Bekker, chief operating officer of the Desmond Tutu Foundation, warned that more than 80 clinics offering post-violence care to tens of thousands of victims would be forced to close.
“If these cuts remain in place, an additional 500,000 people could die over the next decade due to the loss of U.S. funding,” Bekker cautioned, pointing to numerous research projects that would also be affected.
South Africa has one of the highest HIV infection rates in the world, with 7.4 million adults living with the virus as of 2023. Ensuring continued funding for prevention, treatment, and access to antiretroviral drugs remains a critical challenge.
However, South African organizations are not the only ones feeling the impact of these cuts. The Trump administration confirmed that USAID has ultimately decided to cancel nearly 5,800 grants across multiple sectors worldwide.
