đź”’ Trump freezes HIV aid, 5.6mn South Africans affected: John Matisonn

Key topics:

  • US halts PEPFAR funding, impacting HIV support in SA.
  • Funding freeze affects staff salaries, testing, and prevention.
  • US foreign aid may be tied to abortion-related concerns.

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By John Matisonn ___STEADY_PAYWALL___

The Trump Administration has suspended funding that supports HIV-AIDS programmes for 5.6million South Africans on anti-retroviral treatment under the PEPFAR programme, pending a review of all aid programmes.

Under that programme South Africa pays for the medications but the US government pays for some staff, prevention efforts, testing, user clubs and public messaging.

The action came in a State Department cable to all embassies on Friday suspending all aid globally for 90 days, except emergency humanitarian assistance and military financing for Israel and Egypt. The cable puts into effect an executive order signed by President Donald Trump on the day he took office.

A USAID memo on Saturday said that the foreign aid pause “means a complete halt” with limited exceptions. The freeze on spending could also “temporarily” halt the salaries of hundreds of contractors at the global health bureau of USAID, according to the USAID memo.

The State Department has not confirmed that this includes PEPFAR but CBS and NPR reported US government sources confirming that Pepfar is included in the ban. The US embassy in South Africa had not responded to a request for comment by the time of going to press.

Leading research done by South Africans into AIDS and TB, much of which is funded by the US National Institutes of Health, is expected to be affected by the suspension. Trump has also given one year’s notice the US will withdraw from the World Health Organisation.

Though much recent attention in the US-SA relationship focussed on whether Trump will remove South Africa’s trade benefits under the African Growth and Opportunity (AGOA) Act, his decision to suspend health assistance is the first action indicating that Trump’s return to the White House will affect South Africa directly. 

With its $6.5 billion annual budget, PEPFAR — the President’s Emergency Plan for AIDS Relief — provides HIV/AIDS medications for over 20.6 million people.

According to a State Department fact sheet, PEPFAR has saved the lives of an estimated 26 million people since its inception.

The programme, started under the George W. Bush administration, provides billions in funding to organizations to combat HIV and currently provides ARVs to more than 20 million people across 55 countries. 

While funding could be turned back on, there is also growing concern among advocates that congressional support for PEPFAR is in peril due to a revelation earlier this month that groups receiving aid performed abortions.

Reuters reported that four nurses in Mozambique had performed 21 abortions since 2021. Republican presidents have drawn a red line on funding entities that perform abortions.  

“We’re like a one-way street so we want other people to help us and we want other people to join us,” Trump told reporters this week. “We are spending billions and billions and billions of dollars and other countries that are wealthy are spending zero.  Why should we be the only ones?”

Democrats in the Congress have written to the administration arguing that foreign aid promotes stability in other countries to prevent crises expanding to the US.

“Foreign assistance is not a handout; it is a strategic investment in our future that is vital for U.S. global leadership and a more resilient world,” they added. “It directly serves our national interests and demonstrates our credibility to allies, partners, and vulnerable people who rely on American assistance for survival.” 

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