South Africa's HIV crisis deepens as U.S. cuts lifesaving PEPFAR funding

South Africa faces major disruptions to its HIV programmes after the U.S. withdrew PEPFAR funding. The Anova Health Institute has already shut down its PEPFAR-backed services and let go of around 3,000 health workers. The move follows a political dispute between the two countries earlier this year. In January 2025, the U.S. halted financial aid to South Africa over political disagreements, including land expropriation laws. The Trump administration also demanded that senior South African officials condemn the controversial song 'Kill the Boer' as a condition for continued PEPFAR support. As a result, the U.S. began phasing out its annual contribution of over $400 million to the country’s HIV programmes.

PEPFAR funding previously covered about 17% of South Africa’s HIV programme budget, excluding antiretroviral drugs. The withdrawal has severely affected prevention services, particularly for high-risk groups. Most PEPFAR-funded programmes are set to close by the end of September 2025.

In response, South Africa has allocated a $45 million emergency fund to fill some of the gaps. However, the shutdown of support facilities and job cuts for front-line workers have already taken effect. The funding withdrawal has left thousands without work and disrupted critical HIV services. With around 8 million people living with the virus, South Africa now faces the challenge of sustaining its HIV response without U.S. support. The emergency fund aims to address immediate shortfalls, but long-term solutions remain uncertain.