Trump Ends Major HIV Programme in South Africa, Citing Government Failures

The administration of U.S. President Donald Trump has announced the termination of the President’s Emergency Plan for AIDS Relief (PEPFAR) in South Africa, a move that could have significant implications for the country’s fight against HIV/AIDS.

The decision follows growing diplomatic tensions between Washington and Pretoria, with the U.S. government citing a range of concerns relating to South Africa’s domestic policies and its treatment of the white minority population.

According to reports, the U.S. State Department said South Africa had failed to adequately address issues repeatedly raised by Washington. Among them were the country’s Black Economic Empowerment (BEE) policies, which American officials argued do not provide sufficient exemptions for U.S. companies operating in the country.

The State Department also criticised what it described as Pretoria’s inadequate response to racially charged rhetoric, including the controversial “Kill the Boer” chant, which has long been a source of debate both within South Africa and internationally.

Another major point of contention was South Africa’s Expropriation Act of 2024. U.S. officials expressed concerns that the legislation could pave the way for land seizures without fair compensation or due process protections for property owners.

Washington further urged South African authorities to place greater emphasis on combating rural crime and increasing resources to tackle attacks on farming communities. Concerns were also raised over refugee-related policies, with the U.S. warning against measures that could undermine refugee programmes operating under South African law.

Defending the decision, a spokesperson for the State Department said South Africa possesses the economic capacity to sustain its own public health initiatives.

“South Africa is a middle-income country and is more than capable of supporting its own health programmes,” the spokesperson said.

The withdrawal of PEPFAR funding is likely to spark concern among healthcare workers, advocacy groups and patients who have benefited from the programme over the years. Since its launch in 2003, PEPFAR has played a critical role in supporting HIV prevention, treatment and care efforts across Africa, including in South Africa, which has one of the world’s largest populations of people living with HIV.

President Trump has repeatedly accused South African authorities of failing to adequately protect white farmers. During a meeting with South African President Cyril Ramaphosa at the White House in May 2025, Trump reportedly presented videos showing politicians chanting slogans directed at Boers and alleged that more than 1,000 burial sites belonging to white farmers existed across the country.

The latest move marks a further deterioration in relations between Washington and Pretoria, with analysts warning that the fallout could extend beyond healthcare cooperation to broader diplomatic and economic ties.