JOHANNESBURG (AP) — The Trump administration's dismantling of USAID has put more than 8,000 health workers in South Africa's national HIV program out of work, the country's health minister said Thursday, as he outlined the impact of U.S. funding cuts on the biggest AIDS treatment project in the world.
The cuts have also closed down 12 specialized HIV clinics that were run by non-governmental organizations in South Africa and funded by the United States Agency for International Development through the U.S. President's Emergency Plan for AIDS Relief, Health Minister Aaron Motsoaledi told reporters.
He said health authorities are now registering the more than 60,000 patients who were served by those clinics at state health facilities to continue their life-saving treatment.
South Africa has nearly six million people on HIV medication, more than any other country in the world.
The clinics that were defunded by the U.S. were largely treating what are known as “key populations,” Motsoaledi said. They include gay men and sex workers who are considered at higher risk of HIV infection and who sometimes face stigma at public health facilities.
Motsoaledi said the Trump administration had terminated around $436 million annually in funding for HIV treatment and prevention in South Africa, which made up part of the $2.5 billion a year program. The South African government and other donors fund the rest.
Viral load testing — which measures how much the HIV virus is present in the blood of patients on treatment — had decreased by 21% since the aid cuts began to take effect in February, the health minister said. He didn’t give figures on how the testing program to find those who are HIV positive had been affected.
Dr. Linda-Gail Bekker, the CEO of the at Desmond Tutu Health Foundation. said medical professionals are deeply concerned about the possibility of undoing the progress gained in HIV treatment and the loss of healthcare worker jobs.
“We know these services have stopped and we are starting to see worrying signs that testing rates are down and other early warning signs that there are gaps," said Bekker. “It would be really helpful if the ministry acknowledged the gaps created and articulated a plan to ensure the gap will be filled at least partially."
HIV treatment and prevention is one of the areas that has been impacted most by the termination of U.S. foreign aid, especially in sub-Sahara Africa.
The head of the United Nations AIDS agency told The Associated Press in February that the number of new HIV infections globally could jump more than six times by 2029 because of the funding cuts.
Motsoaledi denied South Africa's national program was on the brink of collapse, but outlined significant problems like personnel shortages, funding shortfalls, and the difficulties in locating HIV positive persons that need to start treatment.
U.S. President Donald Trump’s move to terminate more than 90% of foreign aid through the USAID agency has undermined a near 20-year effort to stop HIV deaths in the country worst-hit by the disease. U.S. funding has been critical for South Africa's efforts to stop people dying of AIDS, largely through helping provide free antiretroviral medication that stops the virus replicating in the body.
“We must put it categorically clear that under no circumstances will we allow this massive work performed over a period of more than a decade and a half to collapse and go up in smoke because President Trump has decided to do what he has done,” Motsoaledi said.
South Africa has around 7.7 million people living with HIV, according to the U.N. AIDS agency. Not all of them are on treatment despite it being free. South Africa has recently embarked on a drive to get 1 million more people on treatment.
The 8,061 health workers who lost their jobs make up more than half of the health workers funded by USAID through PEPFAR, Motsoaledi said. He said South Africa still has more than 250,000 health workers in the HIV program paid by the government and other donors.
While South Africa still has donors like the Global Fund providing financial assistance for its HIV program, Motsoaledi said it was lobbying other governments and aid agencies for assistance, but no new funding had been secured.
Nozuko Majola sits in her Umzimkhulu home,, Nov. 11, 2025 in South Africa. Majola is one of millions of patients in South Africa affected by U.S. President Donald Trump's global foreign aid freeze, raising worries about HIV patients defaulting on treatment. (AP Photo/Jerome Delay, file)
