As US cash dries up South Africa's fight to stop Aids gets harder

February 6, 2026

President Trump's executive order freezing US aid one year ago severely impacted South Africa's HIV programs, threatening approximately $400 million in annual funding that represented a fifth of the country's HIV spending. While South Africa's government provided $46 million and the US approved a temporary $115 million bridge plan lasting until March, this falls far short of replacing the lost contributions from the President's Emergency Fund for AIDS Relief (Pepfar). The funding cuts have resulted in reduced testing, service gaps, and closure of mobile clinics that served vulnerable populations in townships, particularly young people seeking preventative treatments.

Who is affected

South Africans living with HIV (approximately 13% of the population, the largest number globally)
Young people in townships seeking preventative HIV medication, particularly women like 28-year-old Esethu and 19-year-old Okuhle
The Desmond Tutu Health Foundation (lost 40% of funding, approximately $8 million)
Wits RHI research institute
Mobile clinic users in dangerous townships like Philippi in Cape Town
HIV researchers and health workers in South Africa
Other charities that have closed their mobile clinics

What action is being taken

The Desmond Tutu Health Foundation is continuing to operate mobile clinics despite funding cuts
South Africa's government is working with other donors to fill the funding gap left by the US
The government is securing HIV medication through the Global Fund (900,000 doses of Lenacapavir for 450,000 people)
Health workers are providing preventative HIV medications including CAB-LA and information about Lenacapavir at mobile clinics
The US has entered into bilateral health deals with several African countries including Kenya, Malawi and Nigeria under the America First Global Health Strategy

Why it matters

South Africa has the world's largest HIV-positive population, and containing the epidemic there is crucial to ending it globally. The sudden funding cuts risk reversing decades of progress in HIV treatment and prevention that have saved millions of lives. Loss of funding affects critical "last-mile activities" like finding people who haven't come in for care and providing services through mobile clinics that reach vulnerable populations, particularly young people who avoid government facilities. The cuts also impact data collection systems needed to identify hotspots and track infection rates, making it impossible to know the full extent of damage or effectively target interventions. Without adequate prevention and treatment, new infections will likely increase from the 180,000 recorded last year, and people may default from life-saving treatments.

What's next

Health Minister Dr. Aaron Motsoaledi hopes the government will announce more HIV funding in its next budget
The Global Fund's 900,000 doses of Lenacapavir are due to be rolled out within months
The US bridge plan of $115 million will last until the end of March, after which funding remains uncertain

Read full article from source: BBC