Trump Administration Ends $8 Billion PEPFAR Program in South Africa as Policy Disputes Deepen
Updated
Updated · Semafor · Jun 19
Trump Administration Ends $8 Billion PEPFAR Program in South Africa as Policy Disputes Deepen
3 articles · Updated · Semafor · Jun 19
Summary
$8 billion in cumulative US HIV/AIDS aid to South Africa is set to be phased out, with the Trump administration aiming to close PEPFAR there by early next year.
State Department officials tied the move to Pretoria's failure to meet US policy demands, including reducing ties with Iran, ending Black Economic Empowerment policies and addressing the "Kill the Boer" chant.
Program awards are expected to wind down later this year, though funding for healthcare workers will continue into 2027; Ambassador Leo Brent Bozell III is expected to deliver the decision to South African health officials next week.
About 8 million people in South Africa live with HIV, and one expert warned ending the program without replacement could trigger a resurgence of infections.
The cut comes as US-South Africa relations have worsened over affirmative action, Pretoria's ICJ case against Israel, and Washington's claims about persecution of white South Africans.
As America pulls its $400M in HIV aid, can South Africa’s health system survive the shock?
Is the US using life-saving HIV aid to punish South Africa for its foreign policy choices?
With foreign aid declining, is Africa's dream of health sovereignty a realistic goal or a looming crisis?
After a 34% US HIV Aid Cut: South Africa Faces a Public Health Emergency and Global Setback
Overview
In January 2025, the US abruptly withdrew HIV aid, dismantling key funding mechanisms like USAID. This triggered an immediate and escalating public health crisis in South Africa, causing widespread devastation to health services and infrastructure across Africa. South Africa’s national HIV response suffered significant disruptions, threatening to reverse years of progress. Essential services, especially HIV prevention and community testing, were severely curtailed, with funding for these areas expected to be cut by 24% by 2026. As a result, clinics and community organizations struggled to reach at-risk populations, conduct widespread testing, and maintain effective prevention programs.