South Africa, home to the world’s largest HIV program, is grappling with the fallout of a $427 million cut in US support, raising fears of rising infections and preventable deaths.
The government has pledged to sustain the program, but experts warn the shortfall could reverse years of progress.
More than 63,000 people lost access to care after 12 clinics shut down, while up to 220,000 patients have seen disruptions to their daily medication.
Some have turned to the black market, where drug prices have nearly doubled.
“This is frightening,” said Yvette Raphael, co-founder of Advocacy for Prevention of HIV and AIDS.
“We are scared we’ll see people dying again, and more infants born with HIV. The funds from USAID covered a gap our government couldn’t fix.”
South Africa has an estimated 8 million people living with HIV, but only about 2 million are on treatment.
Patients report being turned away from hospitals and say community-based services they once relied on have collapsed.
The Trump administration defended the cuts, arguing Africa must shoulder more responsibility for healthcare spending.
But activists say the decision has already caused irreversible damage to vulnerable communities.
Although Washington has since granted a limited waiver to restore some vital services, campaigners warn the crisis has exposed deep vulnerabilities in South Africa’s fight against HIV.
