The Trump administration will begin phasing South Africa out of a signature American program that has supported the prevention and treatment of H.I.V. in Africa for more than two decades, according to a statement issued by the State Department on Friday.
In an emailed statement described as “attributable to a State Department official,” the department said South Africa was being removed from the President’s Emergency Plan for AIDS Relief, known as PEPFAR, because it had failed “to make demonstrable progress on policy requests by the administration.”
While the official did not specify the policy requests, the administration has in the past called on South Africa to repeal a law allowing for the expropriation of land without compensation, to exempt American companies from Black empowerment laws and to not align with U.S. enemies such as Iran.
The United States has repeatedly told the South African government “that PEPFAR funding would to be terminated if they failed to address President Trump’s concerns,” the official said.
The administration’s demands have nothing to do with how the program operates or with public health.
Most of South Africa’s funding for the program was cut last year after President Trump dismantled the U.S. Agency for International Development. The planned cut in PEPFAR for South Africa was first reported by Semafor.
South Africa has the highest H.I.V. prevalence globally, with approximately eight million people living with the virus, according to World Health Organization data.
South Africa received about $456 million in funding from the United States for H.I.V. and AIDS in 2024, according to U.S. government data. The South African government reported a significant drop in 2025, to $213 million.
As of last year, the program supported more than 15,000 health care workers, including nurses, counselors and pharmacists, according to the South African government. It supported South Africa’s health department in more than half of the 52 districts in the country with high H.I.V. prevalence rates, according to Foster Mohale, a spokesman for the department.
The end of PEPFAR does not come as a surprise, Mr. Mohale said. South Africa has been working on plan to pay for its H.I.V. program with its own money since the cancellation of U.S.A.I.D. grants last year, he said. While PEPFAR was a big contributor to South Africa’s H.I.V. program, the country did not rely on it for lifesaving drugs, Mr. Mohale said.
The end of the program is the latest blow to relations between the United States and South Africa, which has endured withering attacks from Mr. Trump since he took office last year. Mr. Trump has accused the South African government of discriminating against Afrikaners, a white ethnic minority, and has said falsely that they were victims of a genocide.
In an executive order last year, Mr. Trump created a special pathway for Afrikaners to enter the United States as refugees, even though he stopped the admission of refugees from virtually all other countries. In the executive order, the president also said he was cutting all U.S. government aid to South Africa.
The State Department official said the end of PEPFAR funding was in line with the 2025 executive order.
“South Africa is a middle-income country and is more than capable of supporting its own health programs,” the official said, adding that the decision was in line with the administration’s philosophy of encouraging self-reliance among countries that receive aid.
