NEW YORK — A new report from Physicians for Human Rights says cuts to U.S. global health aid are disrupting HIV prevention and treatment programs in South Africa, potentially placing decades of progress against the epidemic at risk.
According to PHR research, reductions in U.S. support for HIV services have led to the deterioration of prevention programs, weakened research infrastructure and undermined disease surveillance systems — all of which were essential components in efforts to limit the spread of HIV.
As one of the nations hardest hit by the virus, an estimated 8 million South Africans are living with HIV, making ongoing programs vital to international efforts to control the disease and prevent further transmission.
Researchers involved in the report expressed concern that the cuts threaten to undermine billions of dollars in American investment made over the past several decades to build clinical capacity for HIV prevention and treatment in South Africa.
According to interviews with doctors, researchers and people living with HIV in South Africa, the report identified three major areas of concern weakened by the funding cuts. These included the dismantling of community-level prevention programs, the breakdown of collaborations between research institutions in the United States and South Africa, and the erosion of diplomatic relationships needed to sustain a robust HIV prevention and treatment campaign.
According to Emily Bass, a co-author of the report, the funding cuts come at a critical moment as South Africa begins implementing new prevention strategies, including the use of novel injectable treatments designed to lower the risk of HIV transmission.
“We have a product that’s really powerful,” said Bass. “But we don’t have a program to fit it into anymore.”
Public health experts also noted that the U.S.-based prevention program provided outreach efforts and peer education programs that were important in helping people understand their HIV prevention options and access testing.
Without these programs, researchers fear vulnerable communities, including young people, LGBTQ+ individuals and sex workers, will no longer have access to the information and resources they need.
Researchers also said disease-tracking systems have deteriorated because of the cuts, making it increasingly difficult to measure the impact of changes in prevention efforts.
Worldwide, foreign aid programs administered by the United States, such as PEPFAR, have played a critical role in delivering HIV testing, treatment and prevention services to tens of millions of people. Public health experts warn that disruptions tied to reductions in foreign assistance have affected HIV testing, access to treatment and clinic operations.
Experts said those disruptions can increase the risk of delayed diagnoses and reduced access to treatment, resulting in higher transmission rates.
Reductions in prevention funding may also slow the rollout of innovative biomedical prevention tools, including long-acting injectable treatments that experts view as a major advancement in HIV prevention.
PHR further warned that the cuts may deepen existing global health disparities, as reduced prevention funding means fewer services for people who already face barriers to care.
Public health experts said prevention programs supported by past U.S. funding created crucial opportunities to improve health education and access to HIV screening and treatment for rural and underserved communities in South Africa.
According to researchers, renewed investment in HIV prevention efforts and international partnerships could help stabilize existing health infrastructure and continue progress toward reducing HIV transmission worldwide.
In particular, PHR called on the U.S. government to protect funding for HIV prevention programs and restore collaborations that have previously reduced HIV rates.
PHR also urged the South African government to prioritize funding for prevention, treatment and primary health care in its next budget cycle in order to preserve current progress against the epidemic amid shifting global health funding.
Advocates said the future success of current anti-HIV strategies depends on sustained collaboration among governments, researchers and communities in South Africa and around the world.
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