South Africa Faces HIV Crisis as US Aid Cuts Deepen

As funding cuts from the US threaten to dismantle vital HIV treatment services, local voices express concerns that the progress made in combating the epidemic may regress, particularly among sex workers and other marginalized groups.

Gugu used to rely on a USAID-funded clinic in central Johannesburg for her antiretroviral medications. However, the recent cuts to foreign aid announced by the Trump administration have left her and thousands of other HIV-positive individuals facing an alarming uncertainty. Although Gugu managed to secure a nine-month supply of her medication before her clinic closed, she now anticipates running out by September and will have to navigate the public hospital system for more.

Previously a sex worker, Gugu learned of her HIV-positive status after experiencing persistent health issues. For almost a decade, she has been taking antiretrovirals (ARVs), essential for managing her condition. Now, as a project coordinator for an NGO, she assists fellow pregnant sex workers in securing their necessary medications so their children can be born HIV-negative.

However, the drastic cuts have precipitated the closure of numerous clinics previously funded by the US, creating barriers for many who depended on these services. Gugu notes that public hospitals may deter sex workers from seeking necessary care due to long wait times and potentially discriminatory attitudes from staff.

A UN report warns that cuts from multiple donors, including those from the US, threaten the remarkable advances made in reducing new HIV infections globally. UNAids communicates that the epidemic, which has seen a significant decline in new infections—by 40% since 2010—might see a resurgence without adequate support, predicting as many as six million new infections and four million AIDS-related deaths by 2029 if action is not taken.

Progress in HIV treatment has historically been supported by US initiatives, including the President's Emergency Plan for Aids Relief (Pepfar), which allocated over $100 billion to combat the infection. South Africa alone has around 7.7 million individuals living with HIV, but the country has made strides in treatment access, leading to a 66% decrease in AIDS-related deaths since 2010.

Researchers in South Africa are also alarmed, as funding cuts jeopardize advancements in HIV vaccine trials and treatment innovations. Professor Abdullah Ely from Wits University confirms that US funding halts have pushed critical trials to a standstill, thereby slowing down the global fight against HIV.

Dr. Phethiwe Matutu from Universities South Africa has called for essential funding, projecting that a supportive financial package is required to mitigate the impacts of the US cuts and allow researchers to continue their work.

Fortunately, the South African government has secured some alternative funding from international organizations, but these amounts fall short of the financial needs laid out by researchers facing a steep decline in operational capabilities due to aid withdrawal.

Ultimately, for individuals like Gugu, the stakes are much higher than funding figures. She fears for the health and future of the next generation, worried that the progress made in battle against HIV may be unraveling just when so much has been accomplished. "This isn't just a problem for right now," she warns, "we need to consider how it will affect the next generation of women and young people."