US Boosts South Africa’s HIV Fight with $115 Million PEPFAR Funding Amid ARV Smuggling Concerns
South Africa’s battle against HIV/AIDS has got a big lift with the United States government’s approval of $115 million through the President’s Emergency Plan for AIDS Relief (PEPFAR) Bridge Plan. This funding comes after earlier worries when the US froze global aid, hitting South Africa’s programmes hard. Minister in the Presidency Khumbudzo Ntshavheni shared the news at a post-Cabinet briefing on Thursday, 16 October 2025.
The money will help keep HIV services running without breaks, focusing on what the country needs most to save lives. Cabinet thanked the US for sticking with the partnership to fight HIV/AIDS.
Ntshavheni stressed that everyone must work to not lose ground and aim for an HIV-free society by cutting new cases to below 0.1% by 2032.
This boost ties in with plans to roll out Lenacapavir, a new long-acting drug to prevent HIV, starting next year. But worries grew after a bus crash in Limpopo where stolen ARV drugs were found, showing risks to the supply chain.
PEPFAR Bridge Plan: A Lifeline for HIV Services
Cabinet welcomed the PEPFAR Bridge Plan worth $115 million for six months, from 1 October 2025 to 31 March 2026. “The PBP is meant to ensure uninterrupted HIV service delivery in South Africa by supporting HIV/AIDS service continuity and prioritising country-specific needs and life-saving impact,” Ntshavheni said.
“Cabinet expressed its appreciation to the government of the United States of America on its commitment to supporting and sustaining progress in the fight against HIV/AIDS.”
This funding fills a gap after the US froze aid earlier this year. It will help keep testing, treatment, and prevention going strong. South Africa has over 7.8 million people living with HIV, and PEPFAR has been key since 2003, giving billions to cut new cases and deaths.
The Treasury also stepped in with R750 million in emergency funds for HIV and TB after the US cuts, showing local efforts to bridge shortfalls.
Lenacapavir Rollout: A Game-Changer for HIV Prevention
Ntshavheni gave updates on Lenacapavir, a new HIV prevention drug set for rollout in March or April 2026. “Lenacapavir is a revolutionary long-acting HIV prevention drug that offers protection for six months with just two annual doses. The initial rollout will focus on 23 high-incident districts across six provinces, targeting approximately 360 high-performing public clinics within these areas.”
“The rollout will further bolster government’s fight against HIV and AIDS and our goal to of reducing new HIV infections to below 0.1% by 2032,” she added.
The first phase, from 2026 to 2028, will use the branded version from Gilead Sciences, funded by a $29.2 million Global Fund grant plus $5 million more. It will start at 300 public clinics in high-risk areas, aiming to reach key groups like young women and girls, who face high infection rates.
Lenacapavir, given as a shot every six months, has shown 100% effectiveness in trials like PURPOSE 1 in South Africa and Uganda. It’s a big step from daily pills, making prevention easier and cutting stigma.
ARV Smuggling Concerns from Limpopo Bus Crash
The good news on funding comes with worries after a bus crash near Makhado in Limpopo on Sunday, 12 October 2025. The accident killed 43 people, mostly from Zimbabwe and Malawi, heading home from Gqeberha in the Eastern Cape.
No papers for medical cargo were found at the scene, but boxes of ARV drugs and other medicines were scattered around. “A full-scale investigation has been launched, and law enforcement agencies are also treating this accident as a potential case of pharmaceutical smuggling. The theft of prescription medicines – in particular ARVs – also undermines the fight [for] an HIV free region,” Ntshavheni said.
She warned about the dangers: “People who are using this [stolen] medication, because they are not continuous, they are going to develop a resistance and thus create a problem for the fight against HIV.”
Cabinet sent condolences to Zimbabwe and Malawi. “Cabinet further extended well wishes to the 48 injured people who remain in hospitals across the Vhembe District of Limpopo.
“Cabinet is saddened to note that this accident was unnecessary and preventable if road traffic regulations were adhered to and enforced. [Cabinet] has called on all road users, in particular public transport users, to obey the law by using only roadworthy vehicles, avoiding overloading of both passengers and luggage, and driving safely,” Ntshavheni said.
President Cyril Ramaphosa also shared condolences, calling for safe roads and a full probe.
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