South Africa grapples with HIV funding crisis after US aid cutoff

Until recently, the U.S. PEPFAR initiative covered approximately 17% of South Africa’s HIV budget. However, funding was significantly reduced after the Trump administration cut support to USAID, the world’s largest donor organization focused on health and humanitarian aid.

South Africa further strained relations with the U.S. after enacting the Expropriation Without Compensation Act—a policy impacting land ownership among white Afrikaners—which contributed to a substantial funding gap.

According to Reuters, HIV viral load testing in South Africa has declined drastically due to funding shortages. Medical professionals describe the situation as a worrying sign of strain on the healthcare system.

While Minister Motsoaledi acknowledged disruptions, he denied claims of a systemic breakdown, attributing the narrative to media misinformation.

“If the tests have gone down… we will try to correct it, but we do not think it is a train smash,” he told reporters.

Reuters also reported that 8,000 healthcare workers have lost their jobs after US funding ended, despite previously supporting 15,000 workers’ salaries. The health minister admitted there’s no clear plan in place for these workers.

“I’m not going to stand here in front of you and claim that we have got any plan for the 8,000 people beyond just speaking to funders and our own Treasury, which still have not yet responded on what’s going to happen,” he said.

His remarks sparked nationwide criticism, particularly from health sector professionals who accused the government of inadequately addressing the funding shortfall, warning that the impact is already being felt.

In response, HIV activists disrupted a parliamentary session in Cape Town, demanding immediate action. Fatima Hassan, founder of the Health Justice Initiative, stated, “The health minister is in denial, and once again, South Africa will have to deal with the harmful public health consequences of not just the Trump administration, but also our own government’s failure to plan adequately for months”

Recall that President Trump had previously expressed concerns about the hateful rhetoric and government policies fueling violence against certain white landowners in South Africa. The shutdown of HIV aid was reportedly part of a broader effort to address the alleged mistreatment of Afrikaners.

South Africa, once at the epicenter of the global HIV/AIDS epidemic, has made substantial progress in reducing infections and deaths over the past two decades.

However, despite this progress, the country still bears the world’s highest HIV burden, with one in five adults living with the virus.