The US decision to cut all HIV and AIDS funding to South Africa could cost lives, the head of the UN’s HIV agency has warned.
UNAIDS Executive Director Winnie Byanyima urged Washington not to abruptly withdraw support, warning that the decision could undermine years of progress in South Africa’s HIV response.
“Please do not take money away because you are taking lives away,” Byanyima told reporters ahead of a UN meeting on HIV, calling instead for a planned and responsible transition.
South Africa has the highest number of people living with HIV in the world, with more than eight million people affected.
Although the country does not rely on US funding for HIV medication, Washington has played a major role in supporting prevention programmes and wider HIV response efforts through the President’s Emergency Plan for AIDS Relief, known as PEPFAR.
Until 2025, the US was contributing an estimated $400 million a year to South Africa’s HIV programmes through PEPFAR. According to Byanyima, the funding accounted for around 17% of the country’s HIV response.
She warned that removing this support would hit some of the most vulnerable communities and risk reversing gains made in tackling the virus.
“Taking it away is taking life-saving support from the most vulnerable people,” she said, adding that she wanted the US to reconsider its position.
US officials said the funding cut was partly linked to South Africa’s alleged failure to protect the white Afrikaner minority, an accusation strongly rejected by Pretoria.
South Africa’s health ministry said it had not been formally informed of the decision, but added that the government had “long been working on a self-reliance plan”.
The move comes amid worsening relations between Washington and Pretoria since President Donald Trump returned to office.
Trump previously issued an executive order accusing South Africa of pursuing policies that dismantle equal opportunities and fuel violence against “racially disfavoured landowners”.
The South African government disputes the claim, arguing that policies such as Black Economic Empowerment are necessary to address economic inequality rooted in the apartheid era.
Trump has also repeated the widely discredited claim that a “white genocide” is taking place in South Africa.
Pretoria has consistently rejected the allegation, insisting that crime affects all communities and that the claim is being used to distort South Africa’s political and social realities.
Byanyima said cuts to international HIV assistance were not limited to one country, but described the US withdrawal as especially damaging because America has historically been the largest contributor to global HIV programmes.
“I call on member states to protect the rights of people living with HIV,” she said.
