What's happened
South Africa secures R753-million from national and international sources to offset US funding withdrawal for HIV programs. UNAIDS warns that the US funding loss could cause over 4 million AIDS-related deaths and 6 million new infections by 2029, reversing decades of progress.
What's behind the headline?
The US funding withdrawal exposes the fragility of global HIV efforts, revealing heavy dependence on a single donor. The abruptness of the cut, ordered by the US government, has caused systemic shocks—clinics closing, health workers losing jobs, and prevention programs stalling. This demonstrates the risks of over-reliance on external aid, especially when geopolitical shifts or policy changes occur. Countries like Nigeria and South Africa are responding with increased local funding and community-driven initiatives, but these efforts are insufficient to fill the gap left by US support. The UNAIDS report underscores that without sustained funding, the progress made over the past decades will be reversed, leading to millions of preventable deaths and new infections. The situation highlights the importance of diversified funding streams and resilient health systems. The potential for a resurgence of HIV infections and AIDS-related deaths by 2029 is a stark warning that global health security depends on stable, predictable funding and international cooperation. The upcoming availability of new prevention tools, like Gilead’s injectable drug, offers hope, but high costs and limited access threaten to undermine these advances. Overall, this crisis underscores the urgent need for countries to develop sustainable, locally owned HIV responses to withstand future shocks.
What the papers say
The articles from All Africa, The Independent, AP News, and Bloomberg collectively paint a comprehensive picture of the current crisis. All emphasize the destabilizing impact of the US funding withdrawal, with UNAIDS warning of a potential reversal of decades of progress. The Independent and AP News highlight the systemic shocks—clinic closures, staff layoffs, and disrupted testing—while Bloomberg underscores the urgency, describing the situation as a 'ticking time bomb.' There are nuanced differences: The Independent and AP focus on the immediate effects and local responses in Nigeria and South Africa, whereas Bloomberg emphasizes the global implications and the risk of losing hard-won gains. All sources agree that without replacement funding and resilient health systems, the future of HIV control is at serious risk.
How we got here
US funding through PEPFAR has historically been a cornerstone of global HIV response, supporting testing, treatment, and research in many countries, including South Africa and Nigeria. The recent abrupt US withdrawal in early 2025 has caused significant disruptions, destabilizing supply chains, closing clinics, and reducing community outreach efforts. Countries are now seeking alternative funding sources and local solutions to sustain their HIV programs amid shifting global priorities and reduced donor support.
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Donald John Trump is an American politician, media personality, and businessman who served as the 45th president of the United States from 2017 to 2021.
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Gilead Sciences, Inc., is an American biopharmaceutical company headquartered in Foster City, California that researches, develops and commercializes drugs.