In a devastating move for South Africa’s healthcare sector, former US President Donald Trump rescinded all USAID grants supporting HIV/AIDS programs in the country. The decision, announced on Thursday, has put thousands of healthcare jobs at risk and threatens the progress made in battling the epidemic.
Health activists warn that the cuts could reverse years of hard-won gains, leaving vulnerable populations without essential medical support.
SA’s HIV/AIDS fight faces major setback
Although South Africa relies less on donor funding than other African nations, it still has the highest HIV burden in the world, with 7.8 million people living with HIV. Of these, 5.7 million are on antiretroviral treatment.
The cuts will impact non-governmental organisations (NGOs) funded by the US President’s Emergency Plan for AIDS Relief (PEPFAR), which provides technical support, treatment, and research for HIV prevention. It will also halt funding for groundbreaking HIV vaccine trials and combination clinical trials for contraception and pre-exposure prophylaxis (PrEP).
Linda-Gail Bekker, COO of the Desmond Tutu HIV Foundation and a member of the Community Health & HIV Advocates Navigating Global Emergencies (CHANGE) lobby group said this “lets the tiger out of the cage again”.
Mass Job Losses and Service Disruptions
The funding cuts have led to immediate job losses, with one organisation confirming that it will have to retrench 2,800 out of its 3,000 employees.
Public health specialist Helen Rees expressed concern for affected healthcare workers, particularly community health workers and data capturers, who are unlikely to be absorbed into the public health system.
She said for patients and communities, critical services have already been impacted. These include following up on positive HIV tests for babies, monitoring potential meningitis cases, and providing care for pregnant women at risk of transmitting HIV to their babies.
Government Called to Action
The move comes after Trump’s 90-day freeze on foreign aid, which was initiated to assess its alignment with his “America First” policy. The US government had been expected to contribute R6.27 billion to South Africa’s HIV/AIDS response in the 2025/26 fiscal year.
Despite these cuts, South Africa’s National Treasury did not allocate additional funding for HIV/AIDS in its latest budget, sparking outrage from activists.
Sibongile Tshabalala, chair of the Treatment Action Campaign (TAC), said they are calling on the government to step up and do something about what is happening. She said we can’t afford to go back to those years, referencing the period before widespread access to treatment.
HIV Vaccine and Prevention Trials in Jeopardy
The South African Medical Research Council also confirmed that USAID had terminated funding for the Brilliant Consortium, a network of scientists across eight African countries preparing for a major HIV vaccine trial.
Glenda Gray, the council’s chief scientific officer, said the decision disrupts years of research that could have transformed HIV prevention.
What’s Next for SA’s HIV/AIDS Response?
While some funding from the US Centers for Disease Control (CDC) remains in place, the sudden loss of USAID grants has created an urgent crisis. Experts stress the need for immediate intervention from the South African government to prevent service interruptions and safeguard healthcare jobs.
Without alternative funding sources, the country’s HIV/AIDS response faces a dangerous backslide, putting millions at risk.
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