The Trump administration announced it will end funding of HIV programs in South Africa through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), a global program launched in 2003 that funds HIV efforts in numerous countries.
The Trump White House accuses the South African government of not protecting white-minority Afrikaners from discrimination related to affirmative action and land redistribution policies, reports Politico. The South African government rejects Trump’s claim.
Global HIV leaders say phasing out U.S. funding of HIV programs in the country will come with a steep price to the population.
“Please do not take money away because you are taking lives away,” Winnie Byanyima, the head UNAIDS, told BBC reporters during a U.N. High-Level Meeting on HIV and AIDS this week.
She noted that 17% of South Africa’s HIV funding comes from PEPFAR. “Taking it away is taking lifesaving support from the most vulnerable people, so that is sad,” she told BBC. “I would like the United States to reconsider their position.”
The United States’ funding phase-out was first reported June 18 by news outlet Semafor. “The United States has decided to initiate a phased drawdown of PEPFAR programming in South Africa following South Africa’s failure to make demonstrable progress on policy requests by the administration,” a State Department official told Semafor.
Semafor reporters Adrian Elimian and Nicholas Wu elaborated on the cause:
U.S.-South Africa relations have deteriorated since the start of the second Trump term. The US has accused South Africa of carrying out a “genocide” of its white population.
The countries have also squabbled over Pretoria’s affirmative action policies and a genocide case against Israel at the International Court of Justice. The administration expelled South Africa’s ambassador in Washington last year and hosted Afrikaner refugees it described as fleeing persecution.
An expert familiar with the issue told Semafor that ending PEPFAR funding to South Africa “could be catastrophic” without replacement. The move could cause a “cascading effect” leading to “a resurgence of HIV,” they said.
Several outlets have corroborated the news, including Politico, which noted that phasing out HIV funding in the country “is in line with President Donald Trump’s February 2025 executive order accusing South Africa of discriminating against its white Afrikaner minority and directing U.S. agencies to stop providing aid to the country unless it changes its policies.”
As a Senate aide underscored, according to Semafor: “None of these asks [by Trump] have anything to do with health. They’re all political.”
About 7.8 million people are living with HIV in South Africa, according to the World Health Organization—the highest number of any country. (In the United States, about 1.2 million people are living with HIV.) South Africa has been one of the main beneficiaries of U.S. funding for HIV programs under PEPFAR, noted Politico. In 2024, the country received $456 million in HIV funds from the United States. Last year, that sum dropped to $213 million. This year, the United States has sent $25 million to South Africa for HIV programs.
The U.S. State Department, which oversees PEPFAR, has already excluded South Africa from receiving 2 million doses of lenacapavir, a long-acting injectable known stateside as Yeztugo, a pre-exposure prophylaxis (PrEP) to prevent HIV in people at risk of contracting the virus.
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