FW de Klerk Foundation Appeals to Trump Over PEPFAR Funding Cuts

The FW de Klerk Foundation has urged US President Donald Trump to spare South Africa from further cuts to PEPFAR HIV funding, warning that using life-saving health aid as leverage in diplomatic disputes could endanger millions of vulnerable people and undermine two decades of progress against the country’s HIV epidemic.

In a letter sent on Sunday to the White House, with copies to the US State Department and Ambassador Leo Brent Bozell III, the foundation described the planned withdrawal of American support as a move that would harm ordinary South Africans rather than target any specific political actors. Executive Director Christo van der Rheede argued that health infrastructure should not become a bargaining chip in tensions over land reform, crime, and racial policies.

South Africa carries the world’s largest HIV burden, with roughly eight million people living with the virus. Since its launch in 2003 under President George W. Bush, PEPFAR has delivered around $400 million a year to the country (roughly one-fifth of its total HIV response) funding treatment, prevention programmes, laboratories, data systems, and thousands of healthcare workers. The programme has played a central role in helping South Africa scale up antiretroviral therapy and move closer to global targets for controlling the epidemic.

The US decision to phase out funding stems from broader strains in bilateral relations. Since President Trump’s return to office in 2025, Washington has expressed frustration over issues including farm attacks on white Afrikaner communities, land expropriation policies, Black Economic Empowerment laws, and South Africa’s foreign policy positions, such as its case at the International Court of Justice against Israel.

A temporary $115 million bridge plan had provided some continuity into 2026, but the State Department confirmed a gradual drawdown in mid-June, citing insufficient progress on American concerns and the need for South Africa, as a middle-income nation, to achieve greater self-reliance.

The FW de Klerk Foundation, established to promote the values of reconciliation and constitutional democracy associated with the late former president, rejected framing South Africa’s challenges as a racially targeted campaign against white farmers. It described violent crime as a national problem affecting all citizens and cautioned that cutting health funding could hand propaganda victories to extremists on all sides. The organisation called instead for constructive bilateral engagement focused on shared interests such as trade and critical minerals.

South Africa’s government has sought to reassure the public, as Health Department spokesman Foster Mohale said domestic funding now covers the bulk of antiretroviral procurement and that a long-term transition plan is in place.

However, experts and NGOs have warned that PEPFAR’s departure could still create serious gaps in prevention services, outreach to key populations, and support for frontline health workers. Modelling suggests that without full replacement funding, the country could see hundreds of thousands of additional infections and deaths in the coming decade.

The appeal arrives as the United Nations prepares to hold a high-level meeting on HIV/AIDS, where the future of global funding is expected to feature prominently. It also underscores a deeper policy tension: the longstanding bipartisan American commitment to PEPFAR, credited with saving an estimated 25 million lives worldwide, versus the current administration’s “America First” emphasis on accountability and reduced foreign aid to nations perceived as unwilling to address US priorities.