The State Department is winding down the funds South Africa receives from the President’s Emergency Plan for AIDS Relief, officials told Semafor. The decision follows a period of escalating tensions between the two countries over South Africa’s domestic policies. “The United States has decided to initiate a phased drawdown of PEPFAR programming in South Africa following South Africa’s failure to make demonstrable progress on policy requests by the administration,” State Department officials said in a statement reported by Semafor and confirmed by UPI.
PEPFAR was launched in 2003 under former President George W. Bush and has since partnered with health authorities in more than 50 nations. According to State Department figures, the program has saved approximately 25 million lives and prevented millions of new HIV infections worldwide. South Africa, the country with the largest HIV-positive population on the globe, has been a major recipient.
President Trump signed an executive order in February 2025 accusing the South African government of allowing discrimination against white Afrikaners. Since then, U.S. funding for South African HIV programs has been steadily reduced. Funds sent to the country have been cut by half in each of the last two fiscal years, UPI reported.
South African President Cyril Ramaphosa earlier this month announced that his government is working with pharmaceutical company Gilead to introduce a twice-yearly HIV prevention drug, Lenacapavir. Generic versions are expected to be manufactured and sold in South Africa, potentially providing an alternative to treatments funded through PEPFAR.
Experts have expressed alarm at the withdrawal. Ending support for PEPFAR programs, they say, could lead to millions of additional HIV infections around the world, potentially offsetting two decades of gains in combating the virus. The Trump administration and Republican allies in Congress have argued that the program was never intended to be permanent. “The program was never meant to be permanent and should be wound down,” administration officials have said, according to UPI.