South Africa’s once-lauded HIV response is under serious threat as critical funding from the United States is withdrawn, leading to sharp declines in vital HIV testing and treatment services. The cuts, particularly from the President’s Emergency Plan for AIDS Relief (Pepfar), have already begun to show devastating consequences for some of the most vulnerable populations.
In recent months, data from the National Health Laboratory Service revealed a significant drop in viral load testing—a key tool for monitoring the health of people living with HIV and preventing transmission.
Testing among young people aged 15-24 fell by 17.2% in April compared to the same period last year. Pregnant women and infants were similarly affected, with maternal testing dropping 21.3% and early infant diagnostics down by nearly 20%.
The abrupt withdrawal of US funding earlier this year, part of a 90-day suspension initiated during President Donald Trump’s administration, has left a substantial gap. President Cyril Ramaphosa noted in his State of the Nation Address that Pepfar represents roughly 17% of the country’s HIV spending.
Patrick Mdletshe, head of community programmes at Caprisa and deputy general secretary of the Treatment Action Campaign, said:
“The decline in viral load testing in South Africa can be attributed to funding cuts, particularly from Pepfar. These cuts have significantly impacted HIV testing and treatment programs, especially among vulnerable populations such as pregnant women, infants, and young adults.”
With fewer clinics operating and staffing budgets slashed, access to lifesaving services is dwindling. Health Department spokesperson Foster Mohale acknowledged that the country had already been grappling with patient retention issues but confirmed efforts are underway to secure alternative funding.
Without urgent action, experts warn of increased transmission risks and the possible rise of drug-resistant HIV strains—a setback the country cannot afford.
