A global health emergency unfolds
In a move that sent shockwaves across the globe, the Trump administration’s abrupt freeze on foreign aid funding — including the U.S. President’s Emergency Plan for HIV/AIDS Relief (PEPFAR) — has placed millions of lives in jeopardy.
On January 24, 2025, clinic staff were sent home, antiretroviral (ARV) distributions halted, and HIV treatment for 20.6 million people suspended overnight. While a temporary waiver was issued days later by U.S. Secretary of State Marco Rubio, experts warn the damage could be irreversible without urgent action.
South Africa’s HIV programme hangs in the balance
South Africa, home to the world’s largest HIV burden with 7.8 million people living with the virus, faces catastrophic fallout. Over 5.9 million South Africans rely on PEPFAR-funded ARVs, a lifeline threatened by the freeze. “This is a matter of life or death,” warns International AIDS Society (IAS) President Beatriz Grinsztejn. “Stopping PEPFAR’s funding essentially stops HIV treatment. If that happens, people are going to die, and HIV will resurge.”
The halt also jeopardises PEPFAR’s 20-year legacy in South Africa, where it supports 1,250+ community organisations providing HIV/TB care. Health department spokesperson Foster Mohale confirmed no formal communication from PEPFAR but acknowledged the potential crisis: “We will communicate implications once we receive official correspondence.”
A dangerous precedent for global health
The freeze reflects a broader policy shift under Trump’s January 2025 executive order, suspending foreign aid for 90 days and withdrawing from the World Health Organization (WHO). Professor Hassan Mahomed, a public health specialist at Stellenbosch University, warns of cascading consequences: “Job losses in the health sector will deepen South Africa’s unemployment crisis. The ripple effects on research, treatment, and pandemic preparedness are unthinkable.”
NIH funding suspensions have already paralyzed biomedical research, including HIV/TB studies, while the U.S. exit from WHO undermines global health collaboration. “Pandemics don’t respect borders,” Mahomed stresses. “If the U.S. abandons multilateral efforts, everyone loses.”
A wake-up call for the global South
While the crisis exposes vulnerabilities in aid-dependent systems, Mahomed sees an opportunity: “This is a chance for Africa to amplify its voice and leverage partnerships with Brazil, Russia, and China.” Yet, immediate solutions are urgent. IAS urges PEPFAR implementers to resume work swiftly to prevent further treatment interruptions.
Join the call to action
The IAS’s full statement demands the immediate restoration of PEPFAR services. Read their appeal and add your voice here.
