South African health organisations are warning that the gradual withdrawal of United States funding for HIV programmes could put millions of vulnerable people at risk, with adolescent girls, women and community health services already feeling the effects.

The funding reduction follows the United States' decision to phase out its support for the President's Emergency Plan for AIDS Relief (PEPFAR), ending more than two decades of financial assistance that has played a central role in South Africa's fight against HIV and AIDS.

Prevention Services Under Pressure

South Africa has the world's largest HIV population, with around eight million people living with the virus.

While the government funds most antiretroviral medication, PEPFAR previously accounted for roughly 17% of the country's HIV programme budget, supporting prevention initiatives, community outreach and frontline healthcare workers.

Health organisations say many prevention programmes have already been scaled back, with thousands of healthcare workers losing their jobs and several community support centres shutting down.

According to the Anova Health Institute, around 3,000 workers have been laid off following the withdrawal of PEPFAR-funded programmes, affecting access to HIV testing, prevention services and pre-exposure prophylaxis (PrEP), particularly among young people and other high-risk groups.



Why It Matters

The withdrawal comes as South Africa works to make its HIV response more financially independent while maintaining treatment for millions of patients.

Although the government has introduced emergency funding to help cushion the impact, health experts warn that prevention programmes are often the first to suffer when resources become limited. Reduced investment in testing, education and early intervention could eventually lead to higher infection rates and place greater pressure on public healthcare systems.

For countries such as Nigeria, where international partnerships continue to support parts of the healthcare sector, the development highlights the importance of building sustainable, locally funded health programmes that can withstand shifts in global aid priorities.