As World Aids Day 2025 was acknowledged this week, CAPRISA director Professor Salim Abdool Karim reflects, in Spotlight, on the frantic days following the unprecedented cuts to health aid and research funding from the US this year, saying that the deliberate disruptiveness was designed to be cruel. Nonetheless, he argues, our HIV response must now forge ahead on a path that is more affordable, sustainable and independent.
The Centre for the Aids Programme of Research in South Africa (CAPRISA) received its first US Government “STOP WORK” order from the US Agency for International Development (USAID) on 27 January 2025, imposing a 90-day suspension on a major HIV prevention research project.
A week earlier, incoming US President Donald Trump signed an Executive Order imposing a 90-day freeze on USAID funding. Shortly thereafter, Elon Musk and his Department of Government Efficiency arrived at the USAID headquarters to systematically dismantle it and terminate most of its projects.
Within seven days, the full effect of Trump’s decision was reverberating across the world.
The acute US funding cuts disrupted its foreign aid programmes that had, for years, worked to improve the lives of the most vulnerable communities across the globe.
The impact was instantaneous. Several US-funded projects ground to a halt. Feeding programmes for the hungry, shelter projects for those displaced by war and conflict, daycare for abandoned children and many other programmes in dozens of countries around the world were stopped. The swiftness of the implementation of the USAID dismantling caught the world off-guard.
On 3 February, Secretary of State Marco Rubio declared himself to be the new head of USAID, giving Musk carte blanche to destroy it. That day, I was contacted by journalists from The New York Times and from the prestigious magazine Science for information on the impact of US funding cuts on our HIV research.
On 7 February, The New York Times front page headline, Clinical Trials Left in Lurch By Aid Freeze informed the world of the impact of the funding cuts on Aids research in Africa. It described in graphic detail the impact on research being done by Dr Leila Mansoor and Dr Disebo Potloane of CAPRISA in partnership with world-leading US scientist Dr Sharon Hillier, in developing new HIV prevention technologies for women.
Exactly a month after the initial 90-day “STOP WORK” order, we were notified that this US government funded project had been officially terminated for good. Several other large US-funded projects in South Africa, like an HIV-vaccine development project led by
Professor Glenda Gray, also received termination notices.
While the US Government is perfectly entitled – as it sees fit – to stop funding for any of its projects, the deliberate disruptiveness of its implementation was sadly designed to be cruel.
Musk relished his destruction of USAID with a chainsaw performance on stage at the Conservative Political Action Conference on 21 February. Ironically, the chainsaw, which he had just received as a gift from Argentine President Javier Milei, was engraved with the phrase “Viva la libertad, carajo”, which is Spanish for “Long live liberty, damn it”.
‘Disownment of science’
The Trump administration effectively dislocated the highly effective partnerships forged by the US and South African scientific communities over the past three decades. It was not simply a withdrawal of funding, but the disownment of science that rocked these research collaborations.
A devaluing of science and an era of disinformation set in.
False information from the Trump administration is now rife, from debunked theories regarding autism from vaccines and the supposed dangers of paracetamol during pregnancy to the fictitious “white genocide” in South Africa or “Christian genocide” in Nigeria.
This is a threat to democracy and to the decades of progress made in the Aids pandemic.
Science, in its search for the truth, is under attack as disinformation-based policies become official.
No time to wallow
After the initial shock, we realised that we had zero time to wallow in this grief of sorts. At CAPRISA, we went to work mobilising our own resources, contacting participants in terminated studies to offer them medical and emotional support. In March and April, our scientists routinely worked late into the night on new grant applications to research funders besides the US Government.
That hard work is now beginning to bear fruit as new grants start to fill the gaps in our research funding.
These unprecedented disruptive funding cuts have been a stark reminder to never take donor funding for granted. And certainly, never to be as heavily reliant on a single donor again. While overseas development aid is intended to be altruistic, it has often come with strings attached.
Those strings were a rude awakening in 2025 and have left several governments and NGOs, who were dependent on US foreign aid, in the lurch.
Scientific breakthroughs in HIV, including those by South Africa’s many highly accomplished Aids researchers, have had widespread global impact benefitting vulnerable groups from all walks of life.
Ironically, the funding cuts comes at a time when even greater resources are needed for research to successfully navigate the “last mile” on the way to the Sustainable Development Goal of ending Aids by 2030.
As this year’s World Aids Day theme, “Overcoming disruption, transforming the Aids response” reminds us, this is the time to forge ahead on a path that transforms the response to one that is more affordable, sustainable and independent.
As African scientists, we have already begun to take bold steps on the path to greater independence, thereby shifting our focus away from the disruption towards charting a determined path to a world without Aids.
Professor Salim Abdool Karim is the Director of CAPRISA and Pro Vice-Chancellor (Research) at the University of KwaZulu-Natal in Durban.
See more from MedicalBrief archives:
US stands to lose from funding cuts for top-notch SA research
Trump’s aid cuts halt crucial SA-led HIV vaccine trials
Global healthcare on shaky ground as Trump’s moves take effect