South Africa says years of planning for funding uncertainty have positioned the country to maintain its HIV/AIDS response despite reports that the United States may have withdrawn support through the President’s Emergency Plan for AIDS Relief (PEPFAR).
The Department of Health has moved to reassure millions of South Africans who rely on public healthcare services, emphasizing that the country’s HIV treatment programme remains largely funded through domestic resources.
The response follows media reports suggesting that the administration of US President Donald Trump has ended PEPFAR funding to South Africa. While officials have not received formal confirmation from Washington, the department said it has long anticipated the possibility of reduced foreign assistance.
According to the department, preparations began after the suspension of USAID grants and foreign aid in January 2025, prompting the development of a self-reliance strategy aimed at protecting critical health services from external funding shocks.
Health authorities stressed that South Africa’s antiretroviral treatment programme—the largest in the world—is primarily financed through the national budget. Government funding covers approximately 90% of ARV procurement, while the remaining 10% is supported by the Global Fund.
Officials said this financial structure has enabled the country to reduce its dependence on international donors and ensure continuity of treatment for millions of patients.
The department also noted that PEPFAR support was concentrated in 27 of South Africa’s 52 HIV/AIDS high-burden districts across eight provinces. Most public healthcare facilities nationwide have operated without direct PEPFAR funding and will continue providing services as normal.
Patients who previously received care through PEPFAR-supported clinics have been encouraged to continue accessing treatment through existing public health facilities.
As global concerns grow over the future of HIV/AIDS funding, South Africa is expected to contribute to discussions at the United Nations High-Level Meeting on HIV/AIDS in New York on 22 and 23 June 2026. Health Minister Dr Aaron Motsoaledi will participate in debates focused on sustainable financing and the long-term future of the global HIV response.
The developments highlight South Africa’s increasing focus on healthcare self-sufficiency as governments worldwide adapt to shifting international aid priorities.