U.S. Cuts PEPFAR Funding to South Africa, Threatening HIV Response

The U.S. has begun withdrawing its PEPFAR funding from South Africa, with most programmes set to end by September 2025. The decision follows political tensions, including disputes over land expropriation laws and South Africa’s stance on Israel. President Donald Trump halted financial aid in January 2025, triggering widespread consequences for the country’s HIV response. The U.S. State Department demanded that senior South African officials publicly condemn the controversial song 'Kill the Boer' to avoid the withdrawal. Without this condition being met, the phase-out of PEPFAR continued, affecting critical health services.

PEPFAR previously covered about 17% of South Africa’s HIV programme budget, excluding antiretroviral drugs. The funding cuts have already led to the closure of support facilities and job losses for front-line workers and volunteers across 27 districts. Anova Health Institute alone has laid off around 3,000 health workers and stopped PEPFAR-funded programmes since last year.

HIV prevention services in high-prevalence areas have suffered the most. Civil society groups report that adolescent girls and women are the first to feel the impact. In response, South Africa has allocated a $45 million emergency fund to fill some of the gaps left by the withdrawal. South Africa, home to approximately 8 million people living with HIV, now faces a growing crisis in its HIV response. The loss of PEPFAR support has disrupted services, cut jobs, and left vulnerable groups at greater risk. The government’s emergency funding aims to address the most urgent shortfalls.