The United States government has announced plans to gradually end funding for HIV and AIDS programmes in South Africa, marking a significant shift in health cooperation between the two countries amid growing diplomatic tensions.
South Africa is home to more than eight million people living with HIV, the highest number in any country worldwide. For years, the United States has played a major role in supporting the country’s fight against the epidemic through the President’s Emergency Plan for AIDS Relief (PEPFAR), contributing an estimated $400 million annually until 2025.
A US State Department official confirmed that a phased withdrawal of PEPFAR funding will begin, citing South Africa’s failure to meet certain policy expectations set by the Trump administration. The official said the move is intended to encourage greater self-reliance and reduce dependence on American financial support, noting that South Africa, as a middle-income nation, has the capacity to fund its own health programmes.
The decision comes against the backdrop of increasingly strained relations between Washington and Pretoria. Since returning to office, President Donald Trump has criticized several South African policies, including the country’s Black Economic Empowerment programme, claiming they undermine equal opportunities and contribute to discrimination against white Afrikaners.
The South African government has strongly rejected these allegations, maintaining that its policies are designed to address economic inequalities rooted in the apartheid era. Pretoria has also dismissed claims of a so-called “white genocide” in the country, a narrative that has been widely discredited by experts and human rights groups.
South Africa’s Health Ministry said it had not received formal notification of the funding withdrawal but emphasized that the government has been preparing for greater financial independence in managing HIV programmes. Officials stressed that life-saving antiretroviral medicines are primarily funded by the South African government and would not be directly affected by the US decision.
The White House has also expressed concerns over South Africa’s foreign policy positions, including its case against Israel at the International Court of Justice and its diplomatic ties with Iran. US officials cited these issues among the reasons for reconsidering aid commitments.
Efforts to repair relations between the two nations have yielded limited results. A high-profile meeting between President Trump and South African President Cyril Ramaphosa reportedly failed to ease tensions, while the United States also declined to participate in a recent G20 meeting hosted by South Africa.
Analysts warn that the reduction in US funding could place additional pressure on South Africa’s public health system, although government officials insist that critical HIV treatment services will continue without interruption.