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    • Global Health

    After US aid cuts, South Africa’s HIV response strains to hold the line

    The withdrawal of U.S. support has shuttered community clinics, strained public hospitals, and forced South Africa to rethink how it funds HIV care. But one year after USAID's collapse, South Africa is beginning to pick up the pieces.

    By Elissa Miolene // 16 February 2026

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    US retreat stalls Botswana’s HIV prevention outreach
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    JOHANNESBURG — It’s mid-morning, and Lungani Sithole has already made dozens of phone calls.

    Some numbers don’t ring, and others go straight to voicemail. A few connect, briefly, before the line drops. But when someone does answer, the peer educator moves carefully, trying to figure out whether the person whose number he called is still in treatment — and in some cases, whether they’re still alive.

    “Any wrong move I do now, or any wrong attitude that I portray, could unleash the mental thread that’s keeping that person together,” said Sithole, who has been a peer educator at the South African HIV clinic OUT LGBT Well-Being since 2019. “These people are coming from a lot within their communities, within their houses, within themselves.”

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    More reading:

    ► HIV prevention services hit hardest by funding cuts, UNAIDS warns

    ► US aid cuts overshadow HIV research advances

    ► How economic resilience projects are helping HIV patients survive aid cuts

    • Funding
    • Global Health
    • Trade & Policy
    • Humanitarian Aid
    • Democracy, Human Rights & Governance
    • South Africa
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    About the author

    • Elissa Miolene

      Elissa Miolene

      Elissa Miolene reports on USAID and the U.S. government at Devex. She previously covered education at The San Jose Mercury News, and has written for outlets like The Wall Street Journal, San Francisco Chronicle, Washingtonian magazine, among others. Before shifting to journalism, Elissa led communications for humanitarian agencies in the United States, East Africa, and South Asia.

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