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“The United States has decided to initiate a phased drawdown of PEPFAR programming in South Africa following South Africa’s failure to make demonstrable progress on policy requests by the administration,” the State Department official told Semafor.
The aides said that State Department officials confirmed this week that the administration is aiming to close out PEPFAR, the US global initiative to fight HIV/AIDS, in South Africa by early next year. US Ambassador Leo Brent Bozell III is expected to meet with officials from South Africa’s Ministry of Health as soon as next week to deliver the news.
PEPFAR has provided over $8 billion to South Africa since its founding under President George W. Bush. South Africa has about 8 million people living with HIV, the most in the world. The Senate aide said PEPFAR funds to healthcare workers will continue into 2027 while program awards will wind down later this year.
A Senate aide said State Department officials, when pressed, cited unmet conditions placed on South Africa as justification for the decision — including demands that Pretoria reduce its partnership with Iran, end Black Economic Empowerment policies, and address the “Kill the Boer” anti-apartheid chant. “None of these asks have anything to do with health,” the aide argued. “They’re all political.”
When asked whether the administration had conducted or planned an impact assessment of ending the program, the aide said administration officials replied they would “consider it.”
The State Department official argued “PEPFAR was never intended to be permanent” and that “South Africa is a middle-income country and is more than capable of supporting its own health programs.”
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