South Africa’s government says it will not allow the withdrawal of about $427 million in US support to collapse its HIV programme, but experts warn the shortfall could lead to hundreds of thousands of new infections in the coming years.
The country, which has the highest number of people living with HIV globally, was hit hard after President Donald Trump’s aid cuts forced the closure of free clinics, leaving thousands without access to treatment.
Advocacy groups caution that the lack of services risks reversing hard-won progress, with more infants at risk of being born HIV-positive and patients turning to the black market for overpriced drugs.
According to local organisations, more than 63,000 people were affected by the closure of 12 clinics nationwide, while up to 220,000 have faced disruptions in daily treatment.
Authorities insist hospitals should still provide care, but patients say many are being turned away.
Civil society leaders argue that US aid had been filling gaps the government could not cover, and worry that deaths could rise again if the funding is not replaced.
Washington has defended the cuts as a budgetary necessity, saying African countries must take on more responsibility for healthcare.
Although a limited waiver has allowed some services to resume, campaigners say the damage has already been severe.