The United States has announced a significant reduction in its HIV assistance to South Africa, ending a two-decade programme that provided antiretroviral drugs to millions. The decision, confirmed by the State Department late on Tuesday, will see funding fall from $400 million to $150 million annually by the end of the fiscal year. The move is expected to shift the balance of international health diplomacy in the region, with Britain poised to assume a lead role.
The US President's Emergency Plan for AIDS Relief (PEPFAR) has been the cornerstone of South Africa’s HIV response since 2003, covering nearly 5.1 million patients. The cuts will affect the supply of generic drugs and technical support to rural clinics, raising fears of treatment interruptions.
British officials have signalled readiness to expand the Department for International Development’s existing HIV programmes, which focus on prevention and mother-to-child transmission. A DFID spokesperson said the UK would 'work with partners to ensure continuity of care'. South Africa, which accounts for one-fifth of the global HIV burden, now faces a funding gap of $250 million per year.
The decision comes as Washington reassesses its overseas aid priorities, with a focus on domestic spending. Critics argue the cuts undermine progress in a nation where 7.8 million people live with HIV. The African National Congress has called the move 'regrettable', but analysts note the government has increased its own health budget in recent years.