US Halts HIV Funding for South Africa, PEPFAR Cut Sparks Fear

US stops HIV funding to South Africa under PEPFAR cuts, putting 800,000 patients at risk and sparking health crisis fears.

US PEPFAR HIV funding cut in South Africa affecting patients and clinics

The United States has officially stopped funding HIV programmes in South Africa.

The decision ends years of support through the U.S. President's Emergency Plan for AIDS Relief, known as PEPFAR, a programme credited with saving an estimated 26 million lives globally.

What happened

In January 2025, funding through PEPFAR was disrupted across partner countries. On January 20, 2025, a federal executive order froze all foreign aid programs, including PEPFAR, for 90 days, halting international HIV services funded by the US government.

A follow-up executive order on February 7, 2025, further halted financial aid to South Africa, leading to the termination of all USAID-funded programmes in the country by late February.

Why the US pulled out

The Trump administration notified the South African government that it would end PEPFAR because the country had failed to meet conditions set by the administration.

According to reports, the US cited South Africa's failure to protect white South Africans from violence and displacement as a key reason. A State Department spokesperson said, "South Africa is a middle-income country and is more than capable of supporting its own health programs".

The real impact on the ground

The cuts are already biting. A Lancet Regional Health study in KwaZulu-Natal found that 15 sampled clinics, representing 200 clinics serving 828,413 people with HIV in the province, reported service, operations or staffing interruptions due to funding cuts.

Clinics reported layoffs of data capturers and community health workers, longer wait times, and interruptions to patient tracing, HIV testing, and treatment services.

The researchers warned that instability in funding undermines far more than drugs — it breaks the labour force and patient support systems that keep treatment working.

What experts are warning

Modelling studies are stark. If services are not restored in South Africa, an estimated 601,000 HIV-related deaths and 565,000 new HIV infections will result over the next 10 years.

Across sub-Saharan Africa, the 2025 PEPFAR suspension jeopardizes HIV/AIDS care for 20.6 million people, including 550,000 children, and risks reversing decades of progress. Researchers project a potential resurgence of AIDS-related deaths to 630,000 annually.

For South Africa, which carries the world's largest HIV burden, the loss of US funding means clinics must now find money for staff salaries, testing kits, and prevention drugs like PrEP, or risk treatment interruptions.

Health advocates say the decision treats aid as political leverage, not a health lifeline. With donor money gone, South Africa's government faces urgent pressure to fill the gap or watch years of progress slip away.