South Africa faces a health crisis as the U.S. government halts critical HIV funding, disrupting years of progress. President Donald Trump’s executive order suspends foreign aid, including the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), a key funding source for clinics and healthcare programs in low-income countries.
Since 2003, PEPFAR has provided more than R8 billion to South Africa’s fight against HIV/AIDS. The sudden stop has forced clinics to shut down, sparking fears of rising infections and treatment disruptions.
Healthcare System Under Pressure

The Treatment Action Campaign’s General Secretary, Anele Yawa, warned of severe consequences. “This will hurt our ability to fight HIV and AIDS,” he said.
Many South Africans get treatment from donor-funded facilities, some relying on external pickup points like mall pharmacies. With closures, more patients must turn to overcrowded public clinics, further straining the healthcare system.
South Africa has about 5.8 million people living with HIV on treatment. Adherence is already a challenge, and the country struggles to meet UNAIDS 95-95-95 targets. Losing PEPFAR funding makes this harder.
Mass Layoffs and Service Disruptions
Beyond the impact on patients, the funding freeze has led to mass layoffs. Yawa estimates at least 20,000 healthcare workers employed through donor-funded programs will lose their jobs, weakening the country’s healthcare capacity.
Several health facilities have already closed. The Wits Reproductive Health and HIV Institute’s Trans Health Centre has shut its doors. The Ivan Toms Centre for Men’s Health in Cape Town has also ceased operations, along with Engage Men’s Health clinics in Johannesburg, Buffalo City, and Nelson Mandela Bay.
Uncertain Future and Government Response
The U.S. decision is part of a broader freeze on foreign aid while officials review funding. South Africa relies on PEPFAR for 20% of its HIV budget, while some low-income countries depend entirely on the program.
Wits University Faculty of Health Sciences Dean, Professor Shabir Madhi, said the full impact remains unclear but urged the government to step in. “Many of these programs are integrated into public healthcare. The government must find a way to absorb affected staff and ensure continuity of care.”
The National Department of Health is assessing the impact. Spokesperson Foster Mohale said contingency plans are under discussion but noted that officials are still gathering information.
Key Populations at Risk
The funding freeze raises concerns for vulnerable groups, including sex workers. Yonela Sinqu, spokesperson for Sisonke, a national sex workers’ movement, warned of treatment setbacks. “Many of our members relied on these clinics. They preferred them over public health facilities, where they often face discrimination.”