US halts $400m HIV aid to South Africa

The United States has announced a phased drawdown of its $400m a year pledge for South Africa’s HIV programmes, ending decades of support through the President’s Emergency Fund for AIDS Relief (Pepfar).

South Africa has the highest number of people living with HIV worldwide, over eight million, and the U.S. has historically funded a substantial share of its antiretroviral treatment programmes. The decision follows President Trump’s 2025 executive order labeled South Africa as a “rogue state” for alleged policies that allegedly undermine “racial equality” and are linked to violent crime.

The nation’s health ministry said it has not been formally notified of the U.S. move but has launched a self‑reliance plan to reduce dependency on foreign aid. It added that life‑saving HIV drugs are largely funded by the South African government, which has a separate budget for medication.

The U.S. cited repeated “failure to make demonstrable progress” on policy requests, citing the South African government’s stance on Black Economic Empowerment as a counter‑measure to post‑apartheid inequality.

Statements from a U.S. State Department official emphasised a push for “self‑reliance” and highlighted that South Africa is a middle‑income country capable of supporting its own health programme.

Attempts to mend relations have largely floundered: a 2027 White House meeting between President Trump and South African President Cyril Ramaphosa, a boycott of the G20 meeting hosted by South Africa, and ongoing accusations of a “white genocide.” These allegations have been widely discredited, and only a small number of European‑descendants have been granted refugee status.

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