Termination of US funding in South Africa threatens lives

Johannesburg, 25 June 2026 – The Treatment Action Campaign (TAC) strongly condemns the decision by the United States government to phase out health funding to South Africa through the President’s Emergency Plan for AIDS Relief (PEPFAR), as reported this past week.

For more than two decades, PEPFAR has played a critical role in supporting South Africa’s response to HIV and TB, investing over $8 billion dollars since 2003. Through partnerships with civil society organisations, community health programmes, clinics, researchers, and government institutions, PEPFAR funding has helped save millions of lives, strengthen health systems, and expand access to HIV and TB prevention, treatment, care, and support services. Importantly, this relationship has been bi-directional, as in turn, South Africa has and continues to be a critical partner on new technologies and strategies necessary in combatting the response globally. 

The withdrawal of this funding at this critical juncture, without an adequate transition plan threatens to reverse hard-won gains in the fight against HIV and TB. South Africa remains home to the world’s largest HIV treatment programme, yet millions of people continue to rely on services that have been directly or indirectly supported by PEPFAR. Community healthcare workers, lay counsellors, data capturers, peer educators, key population programmes, and community-led monitoring initiatives have already begun experiencing devastating impacts from funding cuts since 2025.

Through our community-led monitoring efforts at Ritshidze, TAC showed the inimical effects that the 2025 cuts had already caused. For example:

–   82% of facility managers reported staffing shortages after PEPFAR withdrawal.

–   15% of public healthcare users surveyed said waiting times were longer than usual

–   30% of public healthcare users surveyed reported not being offered HIV testing when attending a health facility.

–   28% of people said it took longer to collect ART after PEPFAR disruptions.

These cuts are not abstract budget decisions. They have real consequences for people living with HIV, particularly adolescent girls and young women, sex workers, people who use drugs, the LGBTQIA+ community, migrants, and people living in poverty. Reduced access to testing, prevention, treatment adherence support, and community outreach will inevitably lead to increased HIV transmission, treatment interruptions, preventable illness, and avoidable deaths.

TAC wholly rejects any suggestion that the lives and health of people living with HIV and members of key populations should be subjected to shifting political priorities or geopolitical disputes! Access to healthcare is a human right. International solidarity in addressing global health challenges is not charity – it is a shared responsibility grounded in principles of human rights and justice.

We also note the reduction of funding across the region at this critical juncture in the response to HIV and TB. We stand in solidarity with comrades in Zimbabwe, Zambia and other countries in these trying times.

We call on the Trump administration to urgently reconsider their decisions and engage with affected governments, communities, and civil society organisations to mitigate the devastating consequences of the funding withdrawal.

At the same time, TAC calls on the South African government to act decisively to protect essential HIV and TB services. The government must immediately assess the impact of funding losses, mobilise domestic resources where necessary, and ensure that no person is denied access to lifesaving healthcare because of donor withdrawal. This moment also highlights the urgent need for greater investment in a resilient, publicly funded health system capable of sustaining critical services regardless of changes in international funding. We look forward to engagement with government on these issues.

We further call on other duty bearers to support efforts to protect community-based programmes and prevent disruptions in treatment and care.

The HIV epidemic has taught us a painful lesson: when political decisions undermine access to healthcare, people die. South Africa cannot afford a return to the devastating losses of the past, where we buried comrades every weekend. The gains achieved through decades of activism, scientific progress, and public investment must not be sacrificed.

TAC stands in solidarity with all affected communities and organisations and will continue to mobilise, organise, and advocate to ensure that the rights, health, and lives of people living with HIV and members of key populations remain protected.

For media interviews, please contact:

Ngqabutho Nceku Mpofu: ngqabutho.mpofu@tac.org.za | +27 72 225 9675

Ndivhuwo Rambau: ndivhuwo.rambau@tac.org.za | +27 66 161 1048