The United States has announced plans to phase out funding for HIV and Aids programmes in South Africa, a move that further strains relations between the two countries and raises concerns about the future of one of the world’s largest HIV treatment efforts.
The decision comes as the administration of Donald Trump continues to criticize South African government policies, particularly those affecting the white Afrikaner minority. Washington argues that South Africa has failed to address concerns raised by the US regarding equal opportunities and the treatment of certain communities.
South Africa is home to more than eight million people living with HIV, the highest number globally. For years, the country has benefited from substantial support through the President’s Emergency Plan for AIDS Relief (PEPFAR), a US-funded initiative that contributed an estimated $400 million annually toward HIV prevention, treatment and support programmes before funding reductions began.
A US State Department official confirmed that a gradual withdrawal of PEPFAR funding would now move forward. According to the official, the decision reflects South Africa’s lack of progress on policy issues raised by Washington and is intended to encourage greater financial independence from American assistance.
The US administration maintains that South Africa, as a middle-income economy, has the capacity to finance and manage its own health programmes without relying heavily on foreign support. Officials have framed the funding withdrawal as part of a broader strategy aimed at promoting long-term self-sufficiency.
South Africa’s health ministry said it had not received formal notification of the latest decision but emphasized that preparations for reduced foreign assistance have been underway for some time. The ministry noted that the country’s life-saving antiretroviral treatment programme is primarily funded by the South African government and would continue operating despite changes to external funding.
Relations between Washington and Pretoria have deteriorated significantly since Trump’s return to office. Shortly after his inauguration, the US president signed an executive order criticizing several South African policies, including Black Economic Empowerment measures designed to address inequalities created during the apartheid era.
The White House has also expressed concern over South Africa’s diplomatic positions, including its legal action against Israel at the International Court of Justice and its relationships with countries such as Iran. US officials have cited these issues as contributing factors behind the broader reassessment of bilateral assistance.
Trump has repeatedly claimed that white South Africans face systematic persecution and has alleged that a “white genocide” is taking place in the country, claims strongly rejected by the South African government. Pretoria insists that its policies are aimed at addressing historic inequalities and promoting social and economic inclusion.
Efforts to repair relations between the two nations have produced limited results. Previous meetings between South African President Cyril Ramaphosa and Trump failed to resolve major disagreements, while the United States also declined to participate in a G20 gathering hosted by South Africa last year.
Health experts are now closely monitoring the impact of the funding withdrawal. While South African authorities insist that essential treatment services will continue, concerns remain about prevention programmes, community outreach initiatives and support services that have relied heavily on American financial assistance.
The phased reduction marks a significant turning point in US-South Africa relations and could reshape the future of HIV prevention and treatment efforts in a country that remains at the centre of the global fight against the disease.
