U.S. funding cuts to South Africa have significantly disrupted HIV prevention programmes at a critical time, just as the country begins rolling out the new long-acting prevention drug lenacapavir, according to a report released Tuesday by Physicians for Human Rights. South Africa, home to the world’s largest population of people living with HIV—around 8 million—previously relied on U.S. support for nearly 17% of its HIV budget. The aid reduction, implemented under former President Donald Trump as part of an “America First” policy, has weakened systems built over years of investment.
The report warns that the funding cuts have undermined both healthcare infrastructure and community-based programmes essential for HIV prevention. Lenacapavir, a twice-yearly injectable drug recently introduced in the country, could be a game changer in prevention—but experts say its impact may be limited without adequate outreach and education. Emily Bass, co-author of the report, noted that while the drug is highly effective, the absence of programmes to support awareness and access could hinder its success.
Researchers and advocacy groups report widespread disruptions in clinics and grassroots initiatives, particularly affecting vulnerable populations including LGBTQI communities, sex workers, and young people. Yvette Raphael of Advocates for the Prevention of HIV in South Africa highlighted reduced access to services, while also noting that the true scale of the impact remains unclear due to cuts in data collection funding. Although recent U.S. data suggests global HIV aid levels have been maintained, declines in testing and diagnoses indicate growing gaps in the response.
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