US President Donald Trump has directed a sudden termination of all USAID-funded HIV programs in South Africa, impacting numerous organizations that provide crucial health services. These programs, part of the President’s Emergency Plan for AIDS Relief (PEPFAR), were informed overnight that their funding had been permanently withdrawn.
The official letters, which cited a misalignment with US government priorities, instructed the organizations to cease all operations, terminate contracts, and avoid incurring additional costs beyond unavoidable expenses linked to the termination. PEPFAR, launched in 2003, has been instrumental in combating HIV in South Africa, which has received approximately $8 billion in funding since the program’s inception.
The closure affects several prominent South African health initiatives, including the Anova Health Institute, which has been pivotal in providing HIV testing and treatment in under-resourced clinics. Other affected projects include the Accelerating Programme Achievements to Control the Epidemic (Apace), which supports HIV testing, treatment, and tuberculosis (TB) care.
Although the termination notices have been confirmed by multiple organizations, there is uncertainty about whether all USAID-funded projects received similar directives. Reports also indicate that other countries in Africa, such as Kenya and Malawi, have faced similar funding cuts.
These abrupt decisions have sparked widespread concern from South African health experts, activists, and NGOs. Many are calling on the South African government to urgently intervene and develop a contingency plan to prevent further health crises. Experts warn that the cuts could lead to an increase in HIV-related deaths and disrupt critical healthcare services for vulnerable populations.
The Trump administration’s actions come after a global freeze on US aid funding in January 2025, followed by limited waivers for some programs. However, many projects, including those funded by the Centers for Disease Control and Prevention (CDC), continue to operate under a court order.
As health advocates criticize the South African government’s lack of response, the urgency of addressing this funding gap has never been clearer. With lives at stake, the call for immediate action and transparent communication from both the US and South African governments grows louder.