Faith Nyasuguta
Organizations combating HIV/AIDS across Africa have received sweeping termination notices, following the US government’s decision to permanently cut funding for HIV projects. Experts warn the cuts will have catastrophic consequences, including a surge in HIV-related deaths, the closure of critical healthcare services, and widespread job losses.
The funding shutdown could result in 500,000 deaths in South Africa over the next decade, according to modeling projections. Thousands of workers in HIV-related programs are also set to lose their jobs in the coming days as projects grind to a halt.
The US government has announced a dramatic reduction in foreign aid spending, slashing $60 billion from overseas aid budgets. More than 90% of contracts under the US Agency for International Development (USAID) are being cut, affecting health programs across multiple African nations, including Malawi, Zambia, Tanzania, and Zimbabwe. Even the United Nations’ Joint Programme on HIV/AIDS (UNAIDS) has been impacted.
The Elizabeth Glaser Pediatric AIDS Foundation, which provides HIV treatment to more than 350,000 people in Lesotho, Eswatini, and Tanzania, has received termination notices for three of its major projects. Among those affected are over 10,000 HIV-positive pregnant women, who need antiretroviral drugs to prevent transmission of the virus to their babies.
Dr. Lynne Mofenson, a senior advisor at the foundation, condemned the move, calling it “a death sentence for mothers and children.”
Critical HIV Programs Forced to Shut Down
Many affected projects had already been forced to halt operations in January 2025, when the Trump administration launched a 90-day review of foreign aid. While some programs received temporary waivers, new termination orders issued last week have instructed them to shut down permanently.
The cuts have hit programs funded by the President’s Emergency Plan for AIDS Relief (PEPFAR), which was established by George W. Bush in 2003. PEPFAR supports 17% of South Africa’s HIV response and contributes an even higher percentage in other African countries.
Professor Linda-Gail Bekker, director of the Desmond Tutu HIV Centre at the University of Cape Town, warned of dire consequences. “It is not hyperbole to say that I predict a huge disaster,” she said.
Bekker’s modeling suggests that a complete loss of PEPFAR funding in South Africa could result in over 500,000 additional HIV-related deaths over the next ten years. The decision comes at a time when new scientific advancements, such as long-acting injectable prevention drugs, had given hope for ending the epidemic.
Instead, Bekker warns, HIV rates could start rising again, reversing years of progress. South Africa currently has the world’s highest number of people living with HIV, around 8 million.
Cuts Affect Vulnerable Communities & Halt HIV Research
Bekker initially expected the US to cut funding for groups serving the LGBT+ community, given the Trump administration’s anti-diversity stance. However, she said, “this has been across the board”, impacting programs for children, orphans, vulnerable women, and young girls.
The cuts also halt crucial HIV research, including vaccine trials and the development of new prevention drugs. US funding had previously helped bridge gaps in healthcare, supporting safe clinics for transgender people and sex workers, where stigma and legal risks often prevent access to care.
Kholi Buthelezi, national coordinator of Sisonke, a sex workers’ organization, expressed deep concern. “I’ve been having sleepless nights. This blow reminded us of the time when there was no cure for HIV,” she said.
At a recent press briefing, HIV advocates urged the South African government to step up and fill the funding gap left by the US withdrawal.
Thousands of Jobs Lost
PEPFAR funding has historically been channeled through USAID and the US Centers for Disease Control and Prevention (CDC). While programs funded by the CDC have not yet been shut down, Dr. Kate Rees, a public health medicine specialist at the Anova Health Institute, warned that it was too soon to assume they were safe.
Rees noted that plans had been in place to gradually transition donor-funded programs to government funding over five years. However, the sudden US withdrawal has turned this transition into a crisis.
“Instead of a careful handover, we’re being pushed over a cliff edge,” she said. US funding was deeply embedded in the healthcare system, meaning everyone who uses or works in health services will feel the impact.
Anova Health has already received a termination notice. “Tomorrow, we are letting go more than 2,800 people,” Rees said. “That’s counselors, data capturers, healthcare workers, and these people are not going to find other jobs very easily.”
A Devastating Setback
The US decision to cut HIV/AIDS funding marks a devastating setback for global public health efforts. While countries like South Africa have made significant strides in HIV prevention and treatment, the loss of funding threatens to undo years of progress.
With half a million lives at risk, experts are urging governments, international donors, and health organizations to act swiftly to prevent a public health catastrophe.
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