Africa faces a looming health crisis as US President Donald Trump halts critical HIV/AIDS funding. Health experts warn that the cuts could lead to hundreds of thousands of preventable deaths. The decision, part of Trump’s broader foreign aid rollback, has already forced the closure of clinics and disrupted treatment for many.
South Africa, home to the highest number of HIV cases worldwide, is one of the worst-hit nations. The Desmond Tutu HIV Center warns that 500,000 people could die within the next decade due to treatment interruptions. Across the continent, many patients have already lost access to life-saving antiretroviral therapy (ART).
The Impact of the US Aid Freeze
In January, Trump signed an executive order pausing all foreign aid for 90 days. Last week, his administration escalated the policy, cutting 90% of USAID contracts and dismissing thousands of staff. The move has left health organizations scrambling to keep services running.
The US has also withdrawn funding from UNAIDS, the UN agency responsible for global HIV/AIDS programs. This decision further weakens international efforts to combat the epidemic, as UNAIDS relies heavily on American support.
HIV Programs Across Africa in Crisis
Seventeen of the 20 most aid-dependent HIV programs worldwide are in Africa. Countries like Mozambique, Tanzania, Zambia, and the Democratic Republic of Congo rely on US support for more than half of their HIV medicine supplies.
In South Africa, several HIV treatment clinics have shut down, particularly in rural KwaZulu-Natal. The closure of facilities such as Engage Men’s Health in Johannesburg has left thousands without care. Around 222,000 South Africans, including 7,445 children, now face major disruptions in ART access.
In Ivory Coast, the US funded HIV treatment for over 400,000 people before the cuts. Now, 85% of these patients are losing access to care as 516 health facilities shut down. Botswana has also lost a key orphanage that housed children living with HIV.
Mozambique has stopped providing free HIV testing in most regions. In Tanzania, community health workers and educators have lost their jobs, leaving patients without guidance. South Africa’s BRILLIANT Consortium has also paused a promising HIV vaccine trial due to lost US funding.
Confusion Over Emergency Waivers
After criticism, Trump’s administration issued a partial waiver allowing emergency humanitarian aid. However, this applies only to treatment programs and excludes prevention efforts. Clinics cannot use funds for HIV testing, education, or outreach, except for pregnant women.
Many organizations struggle to understand the waiver’s terms. The sudden shift disrupts integrated health services, making it difficult to keep treatment programs effective. Several US-funded groups have either shut down or are operating at reduced capacity.
Can Africa Fill the Funding Gap?
South Africa’s government has pledged to strengthen its healthcare system in response. President Cyril Ramaphosa announced a national HIV treatment campaign to enroll 1.1 million untreated individuals. Nigeria has allocated $3.3 million for HIV medication over the next four months.
UNAIDS has praised South Africa’s efforts but faces its own financial crisis due to US funding cuts. Experts suggest that European countries and private donors, like the Bill and Melinda Gates Foundation, might help. However, aid organizations warn that replacing USAID’s massive contributions will not be easy.
A Health Emergency in the Making
The US has spent $120 billion on HIV/AIDS relief through PEPFAR since 2003, saving millions of lives. The sudden withdrawal of this funding threatens decades of progress. Without urgent intervention, Africa could see a devastating surge in HIV-related deaths.
Health advocates urge global leaders to act quickly. Without alternative funding, millions could lose access to life-saving treatment, and the epidemic could spiral out of control.
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