The Trump administration plans to stop funding HIV programs in South Africa under the President’s Emergency Plan for AIDS Relief over policy differences.
The U.S. State Department is winding down the funds South Africa receives from PEPFAR to care for the roughly 8 million people there who are living with HIV, Semafor, Politico and The BBC reported.
PEPFAR was launched in 2003 by former President George W. Bush and, over the last two decades, has partnered with health authorities in more than 50 nations to save 25 million lives and prevent millions of new HIV infections, State Department figures show.
President Donald Trump in a February 2025 executive order accused South Africa of permitting discrimination against white Afrikaners and has slowly pulled back U.S. funding for its HIV programs over the last year.
“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 told Semafor.
Upon retaking office in 2025, President Donald Trump took aim at the program as part of his administrations efforts to slash federal government spending, with specific attention paid to South Africa, which has the largest number of people living with HIV in the world.
Since 2003, more than $8 billion has been sent to South Africa to both care for people living with HIV and distribute medications that can prevent spread of the virus, though funds sent there have been halved in each of the last two years.
South African President Cyril Ramaphosa earlier this month announced that the country was working Gilead to launch the company’s twice-yearly HIV prevention drug Lenacapavir, generic versions of which are set to be manufactured and sold there.
Experts have raised concerns that ending support for PEPFAR programs could lead to millions more HIV infections globally, potentially canceling out 20 years of progress against the virus.
The Trump administration and some of its Republican allies in Congress have said, however, that the program was never meant to be permanent and should be wound down.