The United States government has announced that it will phase out funding for HIV and Aids programmes in South Africa, ending a longstanding partnership that has supported one of the world’s largest public health responses to the epidemic.
The decision marks a significant shift in US-South Africa relations. It raises questions about the future financing of HIV interventions in a country with more than eight million people living with HIV, the highest number recorded globally.
According to the US State Department, a “phased drawdown” of funding under the President’s Emergency Plan for AIDS Relief (PEPFAR) will begin following what it described as South Africa’s “failure to make demonstrable progress” on policy requests advanced by the current US administration.
Until 2025, Pepfar had provided an estimated US$400 million annually to support South Africa’s HIV response, accounting for roughly one-fifth of total spending on HIV programmes. Although the initiative received temporary continuation through a “bridge plan” last October, US officials have now confirmed that the arrangement will come to an end.
A State Department official said the move was intended to “foster self-reliance” and reduce dependence on American assistance, arguing that South Africa, as a “middle-income country”, is “more than capable” of financing its own health programmes.
The decision appears to be linked to broader diplomatic tensions between Washington and Pretoria.
Shortly after returning to office, US President Donald Trump signed an executive order alleging that “countless” South African policies had undermined equal opportunities and fuelled violence against “racially disfavored landowners”. The South African government has consistently rejected those assertions.
Pretoria maintains that its Black Economic Empowerment framework remains necessary to address structural inequalities inherited from the apartheid era. South African authorities have also dismissed repeated claims of a “white genocide” targeting Afrikaners, describing such allegations as unfounded. The genocide narrative has been widely discredited.
The executive order further cited South Africa’s case against Israel at the International Court of Justice and the country’s ties with Iran. The White House argued that these “unjust and immoral practices” justified withholding additional assistance.
Diplomatic efforts to repair bilateral relations have struggled to gain traction. Among them was a high-profile meeting at the White House between President Trump and South African President Cyril Ramaphosa, during which the US leader confronted his counterpart over allegations of white persecution in South Africa.
The strain in relations was also evident when the United States boycotted the G20 meeting hosted by South Africa last November.
South Africa’s Department of Health stated that it had not formally received notification regarding the latest funding decision. However, the ministry noted that it had “long been working on a self-reliance plan” to strengthen the sustainability of the country’s HIV response.
Source: BBC
