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The United States government has announced plans to gradually withdraw funding for HIV and AIDS programmes in South Africa, ending a partnership that has contributed hundreds of millions of dollars annually to the country’s fight against the epidemic. South Africa, which has the world’s largest HIV-positive population with more than eight million people living with the virus, has relied on support from the US President’s Emergency Plan for AIDS Relief (PEPFAR) for nearly two decades.
The decision comes amid worsening diplomatic relations between Washington and Pretoria under the administration of President Donald Trump. US officials linked the funding withdrawal to what they described as South Africa’s failure to address concerns raised by the American government, including allegations that policies in the country discriminate against the white Afrikaner minority. The South African government has repeatedly rejected these claims, insisting that its policies are aimed at addressing long-standing inequalities created during the apartheid era.
The White House has also criticised South Africa’s foreign policy positions, including its legal case against Israel at the International Court of Justice and its relationship with Iran. US officials said the phased withdrawal of HIV funding is intended to encourage South Africa to become more self-reliant in financing its healthcare programmes, arguing that the country, as a middle-income economy, has the capacity to support its own public health initiatives.
In response, South Africa’s Health Ministry said it had not yet received formal notification of the decision but noted that the government has been preparing for reduced foreign assistance through a long-term self-reliance strategy. Officials also stressed that the country’s supply of life-saving antiretroviral drugs is primarily funded by the South African government and is expected to continue despite the loss of US support.
The move has raised concerns among health advocates about the potential impact on HIV prevention, testing, treatment support services, and vulnerable communities that have benefited from PEPFAR-funded programmes. While South African authorities insist that core treatment services will remain intact, experts warn that the withdrawal of funding could place additional pressure on the country’s healthcare system and affect efforts to curb new HIV infections.
