South Africa Confronts Funding Gap as US Withdraws Support for World’s Largest HIV Program

Edited By: Safae Fathi

South Africa faces a significant challenge as the United States withdraws approximately $427 million in support for its HIV program, the largest in the world. The government has pledged to maintain the program despite the funding gap, yet clinics have already closed and patients are struggling to access essential medication. Individuals who relied on these services describe difficulties obtaining treatment, with some resorting to purchasing medication at higher costs on informal markets, while public hospitals report delays and shortages. The withdrawal has immediate implications for thousands who depend on regular care and preventive services.

Across the country, the impact of the funding cuts is evident. Over 63,000 people relied on 12 clinics that have since closed, and an estimated 220,000 individuals have faced disruptions to their daily HIV treatment. Even prior to the reduction in aid, only a fraction of South Africa’s roughly eight million people living with HIV were receiving antiretroviral therapy. Health advocates express concern that the current gap could reverse progress in controlling HIV transmission and compromise preventive care, particularly for vulnerable groups including infants and marginalized populations.

The broader context highlights the reliance of many African health systems on international support. US officials have justified the reduction in aid by emphasizing domestic budget constraints and the need for countries to assume greater responsibility for healthcare provision. While limited waivers have been issued to resume certain critical services, the sudden withdrawal has created uncertainty for patients and healthcare providers alike. Maintaining consistent treatment and access to services is essential to preventing an increase in new infections and ensuring the long-term effectiveness of HIV programs in South Africa.