Trump Administration Ends PEPFAR Funding for South Africa’s HIV Programs Over Policy Requests

The Trump administration plans to end funding for South Africa’s HIV programmes under the President’s Emergency Plan for AIDS Relief, with a State Department official telling Semafor that the U.S. will “initiate a phased drawdown of PEPFAR programming in South Africa following South Africa’s failure to make demonstrable progress on policy requests by the administration.”

“The United States announced on Tuesday, April 14, the funding, through a public-private partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria, for doses of a highly promising preventive HIV treatment”

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Semafor reported that State Department officials are aiming to close out PEPFAR in South Africa by early next year, while a Senate aide said PEPFAR funds to healthcare workers will continue into 2027 and program awards will wind down later this year.

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The BBC said the U.S. decision links to alleged failure to protect the white-minority Afrikaner community, and it noted that until 2025 the U.S. supported South Africa’s HIV efforts with an estimated $400m (£300m) a year through PEPFAR.

The UPI report said the Trump administration plans to stop funding HIV programmes in South Africa over policy differences and described PEPFAR as launched in 2003 by former President George W. Bush, partnering with health authorities in more than 50 nations to save 25 million lives.

UPI also said South African President Cyril Ramaphosa announced earlier this month that the country was working with Gilead to launch the company’s twice-yearly HIV prevention drug Lenacapavir, with generic versions set to be manufactured and sold there.

The BBC said the U.S. linked the funding decision to alleged failure to protect the white-minority Afrikaner community, while it reported South Africa’s health ministry responded that it had not been informed and that it had “long been working on a self-reliance plan.”

Semafor reported that a Senate aide argued the administration’s conditions were political, saying, “None of these asks have anything to do with health,” and “They’re all political.”

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UPI reported that a February 2025 executive order accused South Africa of permitting discrimination against white Afrikaners and said the U.S. has slowly pulled back funding for its HIV programmes over the last year.

The Semafor report said an expert familiar with the issue told Semafor that ending PEPFAR funding to South Africa “could be catastrophic” without replacement, and it described a “cascading effect” leading to “a resurgence of HIV.”

BBC also said the executive order alleged “countless” South African policies dismantled equal opportunities and fuelled violence “against racially disfavored landowners,” a claim the South African government disputed.

While the U.S. move targets PEPFAR funding, africaradio reported that the United States announced on Tuesday, April 14, a public-private partnership with the Global Fund to Fight AIDS, Tuberculosis and Malaria to fund doses of lenacapavir, also known as Yeztugo.

africaradio said the lenacapavir treatment consists of two annual injections and reduces the risk of HIV transmission by 99.9%, and it reported that the agreement raises to three million the number of people in various low-income countries who will receive the treatment through this initiative by 2028.

The same report said the Global Fund counts nine African countries that have started receiving doses since 2025—Eswatini, Zambia, Kenya, Lesotho, Mozambique, Nigeria, South Africa, Uganda, and Zimbabwe—and it listed twelve additional countries it hopes to extend deliveries to, including Benin, Haiti, Indonesia, Morocco, and Thailand.

Semafor said the State Department official argued “PEPFAR was never intended to be permanent” and that “South Africa is a middle-income country and is more than capable of supporting its own health programs.”

UPI added that experts have raised concerns that ending support for PEPFAR programmes could lead to millions more HIV infections globally, potentially canceling out 20 years of progress against the virus.