Gugu, a 54-year-old project coordinator for an NGO in Johannesburg, used to collect her antiretrovirals (ARVs) from a USAID-funded clinic, now closed due to funding cuts imposed by the Trump administration. Ensuring she had a nine-month supply before the closure, Gugu's future now rests on acquiring treatment from overwhelmed public hospitals, where she fears stigma and long wait times could deter many, especially vulnerable populations such as sex workers.

The loss of private treatment facilities, like those funded by USAID, poses a significant threat as a UN report indicates that global HIV advancements could reverse. The report revealed a 40% reduction in new infections since 2010 but warns that funding deficits—coupled with pandemic-induced health vulnerabilities—could lead to an estimated six million additional HIV cases by 2029.

Though the south African government previously benefited from 17% of its HIV budget from the PEPFAR program initiated by George W. Bush, recent reductions have sparked concerns from health officials like Prof. Lynn Morris of Wits University. "We're going to see an increase in HIV infections and other diseases if action isn't taken,” Morris stated, highlighting a potentially catastrophic turnaround for a region that has made incredible strides in healthcare access.

Currently, around 5.9 million of the 7.7 million individuals living with HIV in South Africa receive ARVs, with substantial improvements in life expectancy directly attributed to such treatments. Nonetheless, with the research into HIV vaccines and cures also suffering, institutions like the Brilliant Consortium, led by Prof. Abdullah Ely, face devastating delays, threatening future breakthroughs that could benefit patients worldwide.

As pressure mounts on the South African government to secure alternative funding, efforts from organizations like the Bill and Melinda Gates Foundation are stepping in—but experts from the academic community warn that these funds fall short of the total needed to sustain vital research efforts.

Despite her challenges, Gugu remains determined to support others in need. "We have to think about the next generation," she shares, advocating for ongoing awareness and treatment accessibility to safeguard the health of South Africans facing an uncertain future.