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US Funding Freeze Shuts Down Key HIV Clinics in South Africa

A funding freeze imposed by the United States government has forced several South African HIV/AIDS clinics to suspend services, leaving thousands of patients without access to treatment and prevention programs. Among the hardest hit is OUT, a Johannesburg-based LGBTQ clinic that has closed its doors, affecting 6,000 clients.
Similarly, the University of the Witwatersrand’s HIV project—one of the country’s leading service providers for sex workers—has also halted operations. The closures are part of the fallout from former US President Donald Trump’s recent 90-day freeze on foreign aid, a decision that has sent shockwaves through South Africa’s public health sector.
PEPFAR Freeze Jeopardizes HIV Treatment
South Africa is one of the largest beneficiaries of the President’s Emergency Plan for AIDS Relief (PEPFAR), a US-led initiative that has funded HIV/AIDS treatment globally since 2003. The program covers 17% of South Africa’s HIV budget and ensures that approximately 5.5 million people receive life-saving antiretroviral (ARV) treatment.
With the sudden suspension of funding, organizations reliant on PEPFAR support are now scrambling for alternative solutions. OUT, which had expected $2 million in US funding to sustain operations until September, is now at risk of failing its 2,000 HIV-positive patients and 4,000 individuals relying on PrEP, a crucial preventative treatment.
“The US is a totally unreliable partner,” said Dawie Nel, director of OUT. “The system is very volatile and chaotic.”
South Africa Faces Backlash from Funding Cuts
The consequences of this funding freeze extend far beyond individual clinics. According to the Treatment Action Campaign’s Anele Yawa, the decision could reverse decades of progress in HIV treatment and prevention.
“The PEPFAR-fund freeze will take South Africa and the world back in terms of the gains we have made in our response to HIV,” Yawa said. “People are going to be left behind in terms of prevention, treatment, and care.”
Despite a recently issued waiver for humanitarian aid—including life-saving treatments—many healthcare providers remain unsure whether it applies to them. The Wits Reproductive Health and HIV Institute, which serves sex workers and transgender individuals, has announced the indefinite closure of its Key Population Programme clinics.
Government Scrambles for Alternatives Amid Uncertainty
The South African government has vowed to reallocate resources to fill the funding gap, prioritizing key HIV treatment programs. However, experts argue that without clarity from the US, determining those priorities remains a challenge.
“There is no clear guidance from the Americans, making it difficult to decide how to redirect funds,” said Munya Saruchera, director of the African Centre for Inclusive Health Management at Stellenbosch University.
As South Africa prepares to lead the G20 this year, officials may use the platform to rally other African nations for collective negotiations with Western donors. Meanwhile, global health advocates warn that prolonged funding delays could cripple HIV programs and lead to devastating consequences.
“The longer they last, the more difficult it will be to rebuild the programs,” said Craig Lasher of Population Action International. “The suffering will be immediate and profound.”
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Sourced: AFP