The US National Institutes of Health (NIH) has done an about-turn on its funding ban on South African research projects, opening the door for local scientists to apply for its grants once more – but with the lifeline being accompanied by the news that another source of financial support will unexpectedly dry up, reports Business Day.
South African researchers, historically the biggest recipients of NIH grants awarded outside the US, were devastated last year when President Donald Trump signed an order halting all foreign aid and assistance to this country. Research units had to dump some projects and retrench staff whose salaries were covered by grant funding.
At the time, the NIH interpreted Trump’s directive to include its grants, but NIH director Jay Bhattacharya has now reversed the decision, much to South African researchers’ relief.
The scientific journal, Science, reported that an internal memo dated 17 August, signed by Bhattacharya, had lifted the ban. GroundUp has since obtained the memo, which is marked “Not for distribution outside government”.
According to Medical Research Council president Ntobeko Ntusi, the loss of NIH funding, with the termination of other grants – like those administered by the US Agency for International Development – had cost South Africa almost $450m.
In a memo to staff, Bhattacharya justified the policy change on the basis that NIH grants are distinct from foreign aid and assistance.
Not only has US Congress explicitly authorised the NIH to conduct international research collaboration, but foreign aid laws such as the Foreign Assistance Act do not govern the NIH, he said.
“Because NIH grants are distinguished from ‘foreign aid or assistance … meritorious research projects in South Africa are permitted to proceed …’,” he added.
While the change is too late for some projects, it will help restore some of the loss capacity, said Linda Gail Bekker, director of the Desmond Tutu HIV Research Centre at UCT. “I see this as a lifeline to rebuild, but it’s a long and unpredictable road.”
She said the centre had to retrench people when the funding stopped, since it was largely NIH funded. It had enjoyed a partnership with the NIH for decades, she told GroundUp.
She added that there has been a long hiatus from receiving research protocols from their networks in the US, like the Advancing Clinical Therapeutics Globally (ACTG), HIV Vaccine Trials Network (HVTN), and others.
She said their networks are coming to the end of seven-year trials for their clinical trials units. “We haven’t had confirmation that South Africa will be included. But we feel more optimistic than we did before.”
Although they have received some funding from the SAMRC to make up some of the lost NIH money, it was nowhere close to the same volume.
There is a catch, however. Bhattacharya said scientists from South Africa will no longer be eligible for research training and career development grants from the NIH’s Fogarty International Centre (FIC). That’s because SA is an upper middle-income country and a member of the G20, he said in the memo.
The restoration of NIH grant funding to South Africa was “great news”, but terminating Fogarty support for South African researchers was disappointing, said Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa at the University of KwaZulu-Natal.
“The FIC’s goal is international research, so to tie its hands and say it cannot have any association with South Africa is very unusual and frankly does not make sense,” said Karim.
The FIC had provided early career grants to SA scientists who led ground-breaking HIV and TB studies that helped shape the global response to these diseases, he said.
Ntusi said excluding South Africa from the Fogarty programme would have far-reaching implications. “Many of the postgraduate students and early career scientists trained on Fogarty training programmes in South Africa were from the rest of the continent. This is a major loss for Africa and not [just] South Africa,” he said.
Ntusi, who led a fund-raising exercise last year that secured R400m from the Gates Foundation and the Wellcome Trust, matched by an equal amount from the National Treasury, told GroundUp that the decision comes after 12 months of negotiating with the NIH “to reverse its position on South Africa”.
In August 2025, the SAMRC had announced that it had raised around R600m in rescue funds to support research projects and groups affected by the cuts. Apart from the Gates and Wellcome support, it had also secured R14.4m from the ELMA Foundation.
“Part of the mandate of the NIH to engage in international research collaborations should be viewed in light of the fact that South Africa is one of only few countries that co-funded biomedical research with the NIH, rather than merely being a recipient,” he said.
“I welcome this apt decision of the NIH because no country can ever solve the challenges of global health alone … We need scientific collaboration to drive scientific progress.”
Critical decision
A brief from May 2025 by Médecins Sans Frontières (Doctors Without Borders), US advocacy organisation Treatment Action Group, and the SAMRC, found that critical research initiatives and decades of investments in research infrastructure had been affected by the NIH stop-work order.
The brief noted that research in South Africa, mostly led by South African scientists with NIH funding, had, in the past two decades, “shaped global health policies that have revolutionised TB and HIV prevention, diagnosis, treatment and care, benefiting both the local population and communities worldwide, including people who live in the United States”.
Landon Myer, at UCT’s School of Public Health, warned that South Africans should be “cautiously optimistic”. He did not think things were going back to the way they were before NIH funding halted.
Myer said it was difficult to know what the memo means in practice. “Time will tell,” he said.
Within the NIH there have been numerous layoffs and resignations, and budgets have been limited, possibly undermining their bureaucratic capacity, he added.
Myer confirmed Bekker’s view that many of the world’s major advances over the past two decades in understanding the science of HIV arose from South African scientists and from studies conducted here, the vast majority of them funded by NIH.
On the news that Fogarty will no longer support research training and career development applications from South Africa, Myer said that over decades, the centre had invested heavily in South African scientists, which in turn led to so many “scientific accomplishments” here.
See more from MedicalBrief archives:
How the SAMRC weathered the funding storm
How Trump derailed crucial HIV research
UCT-Swedish study calls for collaborative HIV, mental health care
HIV-associated TB training programme established at UCT
US stands to lose from funding cuts for top-notch SA research