Additional Context: This quote was collected in September 2025 by a global health expert associated with Physicians for Human Rights, or PHR, documenting the lived experiences of individuals impacted by the transitions in foreign aid, particularly U.S. government funding for HIV and AIDS services. All narrators were recontacted in March 2026 to validate quotes and provide updates. The quote was anonymized by the source.

While the U.S. only accounted for 17% of HIV response funds prior to 2025, PHR highlights the important role of the U.S. government in supporting community-based outreach, awareness, and targeted actions for key populations in tandem with the government response. The South African government has, as of April 2026, not replaced many of the community-based prevention services that PEPFAR, the U.S. flagship HIV program, almost uniquely funded.

Devex Researcher Note: According to the South African health news outlet Bhekisia, this type of PEPFAR funding largely went to local NGOs, which have since ceased operating in the country. At facilities, where treatment is still available, users report facing long queues, overburdened nurses, and an increased insensitivity to patient-specific needs. PEPFAR supported the salaries for 15,374 or about 5.5% of the total payroll across 27 priority districts, with the estimated human resource cost of $250 million. As of January 2025, staffing losses have been acknowledged to have a disproportionate effect on last-mile community outreach systems.

Source: Physicians for Human Rights