1. A Personal Battle Against the Virus
Gugu’s story isn’t rare, but it’s powerful. A former sex worker and now an NGO coordinator, the 54-year-old has lived with HIV for a decade. Until recently, she relied on a USAID-funded clinic in Johannesburg to access antiretrovirals (ARVs) that kept her symptoms at bay.
When US President Donald Trump slashed global health aid earlier this year, clinics like the one Gugu depended on began shutting down. Fortunately, hers gave her a nine-month supply before closing. But after September, she’ll have to rely on an overstretched public hospital system.
2. A Dangerous Shift from Clinics to Hospitals
For many sex workers and vulnerable individuals, USAID-supported clinics weren’t just places to pick up meds — they were safe, stigma-free spaces. Now, they’re being forced into public hospitals where they face long lines, early morning queues, and judgment.
Gugu explains: “To get medication, sex workers have to reach hospitals by 4 or 5 a.m. and spend the whole day there. For them, time is money. And stigma is real. Nurses have told us we’re nothing special.”
This loss of dignity and time may push many to stop treatment altogether.
3. A Global Setback in HIV Progress
The fallout goes beyond individuals. According to a new UNAids report, global progress in the fight against HIV is at risk. Since 2010, new infections dropped by 40% and 26 million lives were saved — thanks, in part, to US-led efforts.
But now? If funding isn’t restored, we could see 6 million new infections and 4 million AIDS-related deaths by 2029.
Sub-Saharan Africa had been leading the fight — with new infections down 56% and countries like Lesotho and Zimbabwe on track for 90% reductions by 2030. But that momentum is slipping.
4. South Africa’s Fragile Gains at Risk
South Africa has 7.7 million people living with HIV — the highest number globally. With Pepfar (the US President’s Emergency Plan for AIDS Relief) contributing 17% to its national programme, the recent cuts have hit hard.
That money funded mobile clinics, outreach, and treatment efforts that helped reduce AIDS-related deaths by 66% since 2010.
Now, scientists like Prof Lynn Morris fear a resurgence in HIV, TB, and other infectious diseases. “We were getting on top of it. Now we risk losing everything.”
5. Research Halted, Hopes Delayed
Beyond treatment, the cuts have crippled research. Labs in South Africa, once leading trials for vaccines and new drugs, have been forced to pause or cancel clinical trials.
Wits University’s Prof Abdullah Ely says his team had to stop work mid-project: “We’ve lost months. Maybe even a year.”
Despite emergency support from the Gates Foundation, Wellcome Trust, and local government, funding falls far short of what’s needed.
6. A Future in Limbo
For Gugu, it’s not just about her health — it’s about survival, caregiving, and hope. “I’m raising a nine-year-old. I want to live long enough to take care of him.”
Her fear is echoed across communities: What happens to the next generation when treatment becomes inaccessible and research dries up?
As Dr Phethiwe Matutu put it: “South Africa is leading in HIV research — but it’s not leading for itself.”
