🇿🇦 South Africa Faces HIV Crisis After U.S. Aid Cuts: Clinics Close, Patients Left in Limbo
Gugu, a 54-year-old former sex worker from Johannesburg, used to collect her life-saving antiretrovirals (ARVs) from a USAID-funded clinic. That changed earlier this year when President Donald Trump slashed U.S. foreign aid, forcing numerous HIV clinics in South Africa to shut down.
While Gugu managed to secure a nine-month supply before her clinic closed, her story is far from unique. Thousands of HIV-positive South Africans—many from vulnerable groups like sex workers—now face a devastating treatment gap.
🔻 Clinics Closed, Treatment Halted
For patients like Gugu, the closures represent a life-threatening disruption. “I will run out of ARVs in September,” she says. Her backup plan is to register at a public hospital, but the transition is riddled with obstacles—long queues, rude staff, and concerns about privacy.
“The nurse who attended to us was very rude. She told us there was nothing special about sex workers,” Gugu recalls.
Without sensitive care, many fear defaulting on their treatment—risking not only their lives but also increasing the risk of transmission.
🌍 Funding Cuts Threaten Global Progress
According to a new report by UNAIDS, progress in tackling HIV is on the brink of reversal.
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40% drop in new infections since 2010
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26 million lives saved
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4.4 million children protected from HIV since 2000
But the momentum is faltering. UNAIDS warns that without urgent action, the world could face 6 million new infections and 4 million AIDS-related deaths by 2029.
South Africa, with the highest number of people living with HIV globally (7.7 million), is particularly vulnerable. About 5.9 million receive ARVs, largely supported by PEPFAR, the U.S. President’s Emergency Plan for AIDS Relief, launched in 2003.
PEPFAR has invested over $100 billion, including 17% of South Africa’s HIV/AIDS programme, funding mobile clinics, outreach services, and research.
🧪 Medical Innovation Stalled
The cuts not only impact treatment but also jeopardize groundbreaking research:
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PrEP, a prevention drug, was first trialled in South Africa
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Lenacapavir, a new biannual injection offering full HIV protection, also underwent local trials
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Surveillance systems for emerging viruses may collapse
“We’re not going to be getting new vaccines for HIV,” warns Prof Lynn Morris of Wits University. “We’re going to start seeing a reversal of what was essentially a real success story.”
🧑🤝🧑 At-Risk Communities Face the Brunt
Sex workers, pregnant women, and HIV-positive youth now face delays, stigma, and dangerous health risks without community clinics.
“For sex workers, time is money,” says Gugu. “Now they’ll spend the whole day in line, maybe for nothing.”
Without sensitive handling of personal health information, many are too afraid to seek care—threatening both individual health and public safety.
⚠️ A Global Setback?
While UNAIDS doesn't name the U.S. directly, the timing and impact of donor withdrawals are clear. The world’s fight against HIV may be facing its most serious threat in decades.