Crisis in South Africa's HIV-AIDS Fight Amid US Funding Cuts

Sat Feb 07 2026 07:41:09 GMT+0200 (Eastern European Standard Time)

The reduction in US aid following significant policy changes has placed South Africa's already strained efforts to combat HIV-AIDS in jeopardy.

Recent cuts to US funding, including an estimated $400 million annually for South Africa's HIV programs, have severely impacted efforts to combat the epidemic. With the South African government contributing only a fraction to cover the losses, experts warn that results could be devastating leading to increased infections and a decline in essential health services.

The impact of a flourish of the US president's pen in Washington a year ago continues to be felt on individual lives some 13,000km (8,000 miles) away in South Africa.

There was a collective gulp among some in the health sector here when, hours after he was inaugurated, President Donald Trump signed an executive order freezing US aid commitments.

For South Africa that meant the potential loss of an estimated $400m (£295m) that the US contributed each year to the country's HIV programmes – representing about a fifth of what it was spending on the issue.

Last year, the government provided $46m in response to the US decision - just 11.5% of what was lost.

The US also agreed a bridge plan of $115m that will last until the end of March in place of regular funding from the US President's Emergency Fund for Aids Relief (Pepfar).

Since being set up by President George W. Bush in 2003, the US government has invested over $110bn in the global HIV-Aids response through Pepfar, saving 26 million lives, according to the state department.

Many of those lives were in South Africa as around 13% of the population are living with HIV, making it the country with the largest number of HIV-positive people in the world.

Enormous advances in treatment and prevention over the decades have ensured many are alive who would not be otherwise but these are expensive and the loss of funding could put many at risk.

Prof Linda-Gail Bekker, the head and co-founder of the Desmond Tutu Health Foundation and one of the world's top HIV researchers, says there is no doubt there has been a reduction in testing and gaps in services.

Among other services, the Tutu Foundation uses its money to fund mobile clinics for people unable or unwilling to go to government-funded ones.

Health Minister Dr. Aaron Motsoaledi is hopeful about new HIV funding in the upcoming budget, indicating that the government is working with other donors to fill the gap left by the US.

The cuts to funding also raise urgent concerns over the sustainability of existing HIV programs, especially as South Africa looks to address the rising number of infections.

If we do not close it down, we stand the huge risk of it continuing for decades, said Prof Bekker, emphasizing the importance of containing the epidemic in South Africa as part of the global response.