US to End HIV Funding for South Africa as Relations Between the Two Countries Continue to Deteriorate

The United States government has announced that it will begin withdrawing funding for HIV and Aids programmes in South Africa, ending years of support that helped finance efforts to combat one of the world’s largest HIV epidemics.

South Africa has more than eight million people living with HIV, the highest number recorded by any country globally. Through the President’s Emergency Fund for Aids Relief (Pepfar), the US had been contributing an estimated US$400 million annually to support HIV programmes in the country until 2025.

A US State Department official confirmed that a phased withdrawal of Pepfar funding will now begin. According to the official, the decision was linked to what the administration described as South Africa’s failure to make progress on policy requests made by the United States.

The official said the aim of the move was to encourage self-reliance and reduce dependence on American assistance. The US government argued that South Africa, as a middle-income country, is capable of financing its own healthcare programmes.

Relations between Washington and Pretoria have become increasingly strained since President Donald Trump returned to office. Shortly after taking office, Trump signed an executive order alleging that South African policies had undermined equal opportunities and contributed to violence against white landowners.

The South African government has rejected those claims. Officials have maintained that Black Economic Empowerment policies are intended to address economic inequalities created during the apartheid era and are necessary for broader economic transformation.

The executive order also raised concerns about South Africa’s case against Israel at the International Court of Justice and the country’s relations with Iran. The White House stated that these issues contributed to its decision to halt further assistance to South Africa.

President Trump has also repeatedly claimed that a “white genocide” is taking place in South Africa. Those claims have been widely discredited. However, the administration established a refugee programme for Afrikaners, descendants of European settlers, who are currently among the few refugee groups being accepted into the United States.

Although Pepfar funding represented about 20 percent of South Africa’s HIV programme spending, the country’s Department of Health said the supply of life-saving antiretroviral medication is financed separately. The ministry said most of the funding for those medicines comes directly from the South African government.

In response to reports of the funding withdrawal, South Africa’s health ministry said it had not yet received official communication regarding the decision. However, the ministry added that it had already been implementing a long-term strategy aimed at increasing self-sufficiency in the country’s health sector.

Efforts to repair relations between the two countries have faced difficulties over the past year. A previous White House meeting between President Trump and South African President Cyril Ramaphosa failed to ease tensions, while the United States also boycotted the G20 meeting hosted by South Africa last November.

The withdrawal of Pepfar support marks another development in the changing relationship between the two nations and could have significant implications for the future funding structure of South Africa’s HIV response programme.