Health Minister
By Natalie Naidoo
Durban, KwaZulu-Natal – Health Minister Aaron Motsoaledi says the cancellation of the National Institutes of Health (NIH) funding is a major setback for South Africa, threatening years of progress in HIV and TB research. Speaking on Monday, 24 March 2025, at a World TB Day event in KwaZulu-Natal, Motsoaledi warned that the sudden termination of over R4.5 billion in US-funded research grants will hit healthcare and scientific breakthroughs hard, with ripple effects felt far beyond South Africa’s borders.
A Devastating Blow to Research Funding
South Africa woke up to grim news over the weekend as cancellation letters began landing, pulling the plug on billions of rands in NIH grants that fuelled vital HIV and TB research at universities and clinics nationwide. Experts reckon these funds made up about 70% of the country’s medical research budget—a lifeline now severed with little warning. The move comes on top of earlier cuts from other US programmes, like the United States Agency for International Development (USAID), the President’s Emergency Plan for AIDS Relief (PEPFAR), and the Centers for Disease Control and Prevention (CDC), leaving South Africa’s health sector reeling.
Motsoaledi didn’t mince words. “In the field of research, it’s definitely the area where the pipeline will start drying up. Research that has been done in South Africa is not only benefiting South Africa,” he said. Standing on the sidelines of the World TB Day event, he painted a stark picture: no research means no new drugs, no fresh solutions—not just for South Africa, but for the world, including the US itself. “It’s also going to affect the US. If there is no research, there will be no new pipeline about the production of original drugs,” he added.
Jobs and Trials on the Line
The fallout is already being felt. With the NIH cash tap turned off, thousands of jobs—think researchers, lab workers, and clinic staff—are at risk. Clinical trials, some in the thick of testing life-saving HIV and TB treatments, face being stopped dead in their tracks. South Africa’s battle against these diseases has leaned heavily on this funding, and experts warn the sudden halt could undo decades of hard work.
Take HIV, for example. South Africa has the world’s biggest antiretroviral (ARV) programme, with over 5.5 million people on treatment out of 8 million living with the virus. TB’s no small fight either—it’s the country’s top killer, claiming over 56,000 lives in 2023 alone, despite being preventable and treatable. Research funded by the NIH has been key to finding better drugs, cutting infection rates, and saving lives. Now, that’s all in jeopardy.
A Global Wake-Up Call
Motsoaledi’s warning isn’t just for South Africa. He hinted at a bigger problem: pulling funding doesn’t just hurt the country losing it—it’s a blow to global health. South African research has long punched above its weight, shaping international HIV and TB strategies. Think breakthroughs like early ARV treatment for babies or new ways to stop mother-to-child HIV transmission—ideas born here, shared worldwide. “If the pipeline dries up, everyone loses,” one health expert said, echoing the minister’s fears.
The timing couldn’t be worse. Monday’s World TB Day event in KwaZulu-Natal was meant to spotlight progress—like the End TB campaign aiming to slash deaths by 41% by 2035. Instead, Motsoaledi found himself fielding questions about this funding crisis, a bitter twist on a day meant for hope.
South Africa’s Health Burden
South Africa’s health challenges are no secret. With 7.8 million people living with HIV—the highest tally globally—and TB a constant threat, the country’s been a testing ground for solutions. NIH funding has bankrolled cutting-edge trials, like a promising TB vaccine set to report results in 2027. Now, those projects hang in the balance, with labs scrambling to find cash elsewhere.
The cuts pile onto an already tough situation. Earlier this year, PEPFAR’s funding freeze axed over 15,000 healthcare jobs—nurses, counsellors, pharmacists—leaving clinics stretched thin. Patients faced longer queues, fewer meds, and some were even turned away. Motsoaledi’s tried to reassure folks, saying 90% of ARVs come from South Africa’s own budget, with another 10% from the Global Fund, safe from US cuts. But research? That’s a different beast—70% of it relied on NIH dollars.
Voices from the Frontline
The human cost is real. “I’ve spent years studying TB strains—now what?” one Durban researcher asked, staring at a lab that might soon go dark. In Soweto, a nurse shared her worry: “We’re already short-staffed. If trials stop, patients lose hope—and we lose jobs.” Communities feel it too—grannies on ARVs, moms protecting their babies from HIV, all counting on research to keep them going.
Motsoaledi’s frustration was clear. He’s pushed for self-reliance, arguing South Africa’s 8.5% GDP spend on healthcare—higher than some BRICS peers—shows it can stand on its own. But losing R4.5 billion overnight? That’s a gap no one’s ready to fill.
What Led to This?
The cancellations stem from a US executive order in February 2025, halting aid to South Africa over political tensions. Some say it’s tied to claims of discrimination against certain groups—claims many South Africans call baseless, pointing to who still holds most of the country’s wealth. Whatever the reason, health experts argue punishing research funding is a low blow. “It’s unethical to stop trials midstream,” one scientist said. “People’s lives are at stake.”
South Africa’s not alone in feeling the pinch—US partners in these projects lose out too. Joint efforts with top universities and health bodies, built over decades, are crumbling, leaving global health poorer for it.
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