US to Phase Out HIV Funding for South Africa Amid Rising Political Tensions

US to Phase Out HIV Funding for South Africa Amid Rising Political Tensions

The United States government has announced plans to gradually end funding programmes supporting South Africa’s fight against HIV and AIDS, marking a major shift in a long-standing health partnership between the two countries.

For years, South Africa has been one of the biggest recipients of HIV-related assistance through the President’s Emergency Plan for AIDS Relief (PEPFAR), which contributed roughly $400 million annually. The programme has played a significant role in supporting treatment and prevention efforts in a country where more than eight million people are living with HIV—the highest number in the world.

A US State Department spokesperson linked the decision to what it described as South Africa’s failure to meet certain policy expectations, adding that the move is intended to encourage “self-reliance” and reduce dependency on American aid. The department also argued that South Africa, as a middle-income country, should be capable of fully funding its own health systems.

The decision comes amid increasingly strained diplomatic relations between Washington and Pretoria. Since returning to office, US President Donald Trump has taken a more confrontational stance toward South Africa, including allegations that the country’s policies disadvantage white landowners—claims strongly rejected by the South African government.

The US administration has also previously referenced South Africa’s foreign policy positions, including its case against Israel at the International Court of Justice and its ties with Iran, as points of concern.

In response, South Africa’s government—led by President Cyril Ramaphosa—said it had not received formal notification of the funding withdrawal but insisted it has already been working toward greater independence in financing its HIV response. Officials also stressed that antiretroviral treatment remains largely funded through domestic resources.

The planned “phased drawdown” of PEPFAR support raises concerns among public health experts, given its historical role in sustaining HIV treatment programmes in South Africa and beyond.