U.S. Cuts HIV Aid to South Africa, Leaving Millions at Risk by 2025

The U.S. has begun withdrawing financial support from South Africa, affecting key health programmes. In January 2025, President Donald Trump halted aid, citing concerns over Black Economic Empowerment policies and land expropriation laws. The move has triggered significant disruptions in the country’s HIV response efforts. The U.S. State Department is now phasing out the President’s Emergency Plan for AIDS Relief (PEPFAR) in South Africa. Most of its programmes are set to close by September 2025. PEPFAR previously covered about 17% of the national HIV programme budget, excluding antiretroviral drugs.

The withdrawal has already led to the closure of support facilities in 27 districts. Frontline workers and volunteers have lost their jobs, while HIV prevention services have been severely reduced. Civil society groups, including Section27, report that adolescent girls and women are among the hardest hit.

Before the cuts, the U.S. demanded that senior South African officials publicly condemn the song 'Kill the Boer' to prevent the withdrawal. South Africa, which has the world’s largest HIV-positive population at around 8 million people, announced a $45 million emergency fund last year to address the gaps left by PEPFAR. The health department has also been developing a self-reliance plan since January 2025 to lessen the impact. The phase-out of PEPFAR funding is expected to conclude by September 2025. South Africa’s emergency measures aim to fill the financial void left by the U.S. withdrawal. The country now faces the challenge of sustaining its HIV programmes without external support.