South Africa on Thursday welcomed a new $115 million US ‘bridge’ funding package designed to sustain HIV treatment and prevention services through March 2026, describing the move as a sign of goodwill after months of diplomatic and financial strain.
The temporary relief comes through the US President’s Emergency Plan for AIDS Relief (PEPFAR), a landmark initiative credited with saving more than 25 million lives since its launch two decades ago, most of them in Africa. South Africa remains the country with the world’s largest number of people living with HIV.
The relief follows a turbulent start to the year when US President Donald Trump issued an executive order in January suspending all foreign aid to South Africa, including PEPFAR funding. Although a temporary 90-day waiver was granted, the US began terminating grants in late February, halting most HIV-related financial support.
Before the freeze, Washington had contributed more than $400 million annually, about 17 percent of South Africa’s total HIV funding, according to the health department. The sudden cuts triggered widespread disruption — over 8,000 health workers lost their jobs, and 12 specialised HIV clinics run by non-governmental organisations funded through USAID were forced to close.
Minister in the Presidency Khumbudzo Ntshavheni said on Thursday that the South African cabinet had welcomed the approval of the PEPFAR Bridge Plan, seeing it as proof of enduring cooperation between the two nations.
‘It’s confirmation of good bilateral relations between South Africa and the US, so that when we have complaints, they intervene and we find an amicable solution,’ she told reporters. Ntshavheni added that one of Pretoria’s main grievances had been the lack of notice to prepare alternative budget provisions when the funding was abruptly suspended.
Despite the conciliatory tone, relations between the two countries remain uneasy. Trump has accused South Africa’s Black-majority government of overseeing what he termed a ‘genocide’ against white Afrikaners, even fast-tracking refugee applications for Afrikaners seeking to resettle in the United States.
In addition to suspending financial aid, Washington imposed 30 percent tariffs on South African exports and criticised Pretoria’s stance on the Israel-Hamas conflict. In 2023, South Africa filed a case at the International Court of Justice accusing Israel of genocide in Gaza — a move that further soured relations. The US later expelled South African ambassador Ebrahim Rasool over his criticism of the Trump administration.
Health Minister Aaron Motsoaledi said during a roundtable earlier this week that an American delegation had briefed him on changes in Washington’s approach to PEPFAR. Countries would now be given varied transition periods, in some cases up to five years, before the programme is phased out entirely.
‘That plan is still being hatched and it is not ready,’ Motsoaledi said. ‘We ought to be happy about this because it could have been worse.’
