BY: Saneliso Mlambo
On February 27, 2025, President Donald Trump issued an executive order mandating an immediate cessation of USAID funding to HIV organizations in South Africa. This directive is part of a broader policy review aimed at aligning foreign aid with the administration’s “America First” principles, resulting in the termination of over 90% of U.S.-funded health projects globally.
South Africa, home to the world’s largest HIV-positive population, heavily relies on support from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) to provide life-saving antiretroviral treatment to approximately 5.5 million individuals daily. The abrupt funding halt has led to the closure of numerous clinics and the suspension of critical services, leaving millions without essential medications and support.
Organizations received termination notices instructing them to “immediately cease all activities, terminate all subawards and contracts, and avoid incurring any additional obligations chargeable to the award beyond those unavoidable costs associated with this Termination Notice.”
The executive order’s reach extends beyond South Africa, affecting health initiatives worldwide. In Cambodia, contracts with organizations like UNAIDS and Khana have been terminated, disrupting HIV/AIDS programs. Critics, including International AIDS Society President Beatriz Grinsztejn, warn that the collapse of HIV and tuberculosis services could jeopardize millions of lives.
The suspension has also led to the closure of clinics across Africa, with non-governmental organizations dependent on U.S. funding ceasing operations. This disruption affects a range of services, including HIV testing, treatment, and prevention efforts, particularly in regions with high prevalence rates.
In response to legal challenges, Chief Justice John Roberts issued a stay halting an order that required the release of nearly $2 billion in USAID funding. This decision allows the administration to continue freezing foreign aid allocations, further complicating the operational capacities of affected health programs.
Despite assertions from U.S. Secretary of State Marco Rubio that life-saving aid would receive waivers, the reality on the ground indicates that many critical services have been discontinued, leading to widespread uncertainty and fear among affected populations.
The immediate termination of USAID funding for HIV organizations in South Africa and beyond has precipitated a global health crisis, disrupting essential services for millions. The long-term consequences of this policy shift remain uncertain, but the immediate impact underscores the vital role of sustained international support in combating global health challenges.