South African NGOs worry Trump’s aid freeze will cause HIV patients to default on treatment

AIDS RELIEF

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Unemployed 19-year-old Nozuko Majola, center, is one of millions of patients in South Africa affected by President Donald Trump’s global foreign aid freeze, raising worries about HIV patients defaulting on treatment. JEROME DELAY — THE ASSOCIATED PRESS

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By Mogomotsi Magome

The Associated Press

UMZIMKHULU, South Africa >> At a rural village in South Africa’s KwaZulu-Natal province, unemployed 19-year-old Nozuko Majola is trying to figure out if she has enough money for the one-hour ride to collect her much-needed HIV medication, usually delivered to her home that can’t be easily reached due to rough, untarred roads.

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, infection rates going up and eventually a rise in deaths.

In 2024, think tank Human Sciences Research Council released figures showing that Majola’s province recorded the second-highest HIV prevalence in the country, at 16%, with at least 1,300 young people estimated to contract the disease every week.

KwaZulu-Natal also had the highest number of people living with HIV in South Africa in 2022, about 1,980,000. The country counts more than 7.5 million people infected with the virus that causes AIDS — more than any other nation.

There are 5.5 million South Africans receiving antiretroviral treatment, whose funding is now in question after Trump suspended the President’s Emergency Plan for AIDS Relief, or PEPFAR. It contributes more than $400 million a year to South Africa’s HIV programs and nongovernmental organizations, about 17% of the total funding, according to the Health Ministry.

Globally, PEPFAR is credited with saving at least 26 million lives since its inception in 2003, according to the U.N. AIDS agency.

Last week, a federal judge ordered the Trump administration to temporarily lift the funding freeze, while the U.S. Embassy in South Africa said PEPFAR projects would resume under a limited waiver. However, aid groups dealing with HIV have already shuttered with closure notices hanging at the entrances and PEPFAR-branded vehicles standing idle, with patients diverted to struggling health facilities.

Most of the PEPFAR funding is channeled through non-governmental organizations, which run programs that compliment health care services provided by the government.

For Majola and other HIV patients in the Umzimkhulu region, where unemployment is rife and most people rely on subsistence farming and government welfare grants, the aid freeze has disrupted their lives.