Overview
- U.S. officials have confirmed the start of a phased wind-down of the President’s Emergency Plan for AIDS Relief in South Africa, a move that U.S. sources say responds to unmet policy requests and that is expected to end U.S. programming by early 2027.
- South African health officials say they have not received formal written notice of a final decision and stress the government already pays about 90% of antiretroviral drug costs and is implementing a transition plan, according to Health Department spokesperson Foster Mohale.
- The first phase of the drawdown has already hit frontline services, with reports of more than 8,000 job losses and sharp staff cuts at NGOs that have reduced outreach and clinic support in provinces such as KwaZulu-Natal and Limpopo.
- Global health leaders and researchers have warned the withdrawal could reverse progress, with modelling cited by experts projecting hundreds of thousands of additional infections and tens of thousands of excess deaths by 2028 if care is disrupted.
- South Africa will press the issue at the U.N. High-Level Meeting on HIV this week and is seeking coordinated support from partners such as UNAIDS, the Global Fund, and the World Bank to preserve tracing teams, data capturers, and community health workers that PEPFAR has funded for two decades.