HIV testing and monitoring decline in South Africa following US funding freeze
HIV testing and patient monitoring have significantly declined in South Africa following a freeze on US funding for healthcare workers and clinics. According to newly released government data, the reduction has disproportionately affected pregnant women, infants, and young people, leaving critical gaps in the fight against HIV.
South Africa bears the heaviest HIV burden in the world, with approximately 8 million people- or one in five adults- living with the virus.
US funding cuts impact:
- The United States previously funded 17% of South Africa’s HIV budget until President Donald Trump cut the aid earlier this year.
- Data from the National Health Service indicates that viral load testing dropped by up to 21% among key groups in the last two months.
- Four HIV experts attributed this decline directly to the suspension of US funding.
Viral load testing measures the amount of HIV in a patient’s blood who is undergoing antiretroviral therapy. It is conducted at least once a year to determine if the treatment is effective and if the virus is suppressed enough to prevent transmission.
Consequences of reduced testing:
- Fewer tests mean fewer people identified who might be transmitting the virus.
- Missing a test could also indicate that a patient has dropped out of the healthcare system and may not be receiving treatment.
- This is especially critical for pregnant women, who risk transmitting the virus during childbirth, and for infants, who need early diagnosis and treatment to survive.
Background on funding cuts:
- Trump suspended several international aid programs early in his presidency before restoring some life-saving initiatives, including the President’s Emergency Plan for AIDS Relief (PEPFAR).
- However, in February 2025, South Africa was specifically targeted with an executive order freezing all US funding to the country.
- South Africa does not rely on US aid for HIV medications, but 15,000 healthcare workers were funded through PEPFAR, which previously injected over $400 million annually into the country.
Most of this funding has been withdrawn, although the exact amount remains unclear.
These healthcare workers conducted HIV testing and counseling in high-risk areas and monitored patients who missed tests or discontinued treatment- a common occurrence.
PEPFAR funding also supported NGO-run clinics, many of which have now closed down.
The South African government has urged HIV patients who relied on these clinics to now seek care in public health facilities. However, public centers often have long waiting lines and staff that may not be welcoming to marginalized groups like sex workers and LGBTQ+ individuals.
Also read: HealthMin says HIV infections show annual decrease of 26%
