South Africa’s HIV patients face mounting barriers to life-saving treatment following former U.S. President Donald Trump’s suspension of PEPFAR funding. Programs supporting 5.5 million people on antiretroviral therapy are now in jeopardy, with NGOs shuttering and health workers left unpaid. Experts warn the PEPFAR funding freeze could reverse decades of progress against AIDS.
In rural Umzimkhulu, 19-year-old Nozuko Majola represents a growing crisis.
“Things will be tough,”she explains, detailing how the loss of home deliveries forces patients to choose between transportation costs and medication. KwaZulu-Natal—a province with 1.98 million HIV-positive residents—faces 1,300 new youth infections weekly according to 2024 data.
The U.S. initiative contributed $400 million annually (17% of South Africa’s HIV budget) before the freeze. Critical impacts include:
- 15,000 health workers at risk of losing incomes
- Mobile clinics and testing halted in remote areas
- Public hospitals overwhelmed by redirected patients
HIV treatment defaults are surging as NGOs close. Nozuko Ngcaweni, a 30-year survivor, reports neighbors missing doses:
“We wanted an HIV-free generation by 2030. Now we’ll see deaths instead.”
While a federal court recently ordered PEPFAR’s temporary reinstatement, NGOs report irreversible damage. Facilities like Umgungundlovu’s clinic—already South Africa’s hardest-hit HIV district—struggle with collapsed administrative support. Clinic staff warn:
“We cannot handle this workload alone.”
Mzamo Zondi of the Treatment Action Campaign stresses urgency:
“This is life and death. New infections will destroy our progress.”With stigma still deterring hospital visits, experts fear hidden outbreaks as community-based care vanishes.
The Associated Press’ health coverage in Africa receives Gates Foundation support. AP maintains full editorial control.
