The Trump administration's abrupt withdrawal of funding has forced South African researchers to halt a promising HIV vaccine clinical trial just one week before it was scheduled to begin, dealing a significant blow to global HIV research efforts. The $46 million BRILLIANT program, led by researchers in a region with the world's highest HIV burden, was designed to leverage South Africa's genetic diversity and deep expertise to benefit people worldwide.
The funding cut is part of broader U.S. foreign aid reductions that have particularly impacted South Africa, which previously received approximately $400 million annually through USAID and the HIV-focused PEPFAR program. According to Glenda Grey, who heads the BRILLIANT program, the African continent has been vital to HIV medication development, and these cuts threaten future research capabilities.
Research Infrastructure Under Threat
The immediate impact on South Africa's research infrastructure has been severe. About 100 researchers working on the BRILLIANT program and other HIV-related projects have been laid off, according to the country's health department. The University of the Witwatersrand, which houses key research teams developing HIV vaccines, has seen its work come to an abrupt halt.
Professor Abdullah Ely, who leads the research team, reported that their work had shown promising results, with vaccines producing immune responses in early testing. "But now that momentum has all kind of had to come to a halt," Ely said, describing the devastating impact of the funding withdrawal.
Laboratory technician Nozipho Mlotshwa, whose grant-funded position supports both her family and her studies in a country with 46% youth unemployment, faces an uncertain future. "It's very sad and devastating, honestly," she said of the cuts. "We'll also miss out collaborating with other scientists across the continent."
Global Impact on HIV Research
South Africa's role in global HIV research extends far beyond its borders. The country has been instrumental in developing significant advances, including clinical trials for lenacapavir, the world's only twice-a-year shot to prevent HIV, recently approved by the U.S. Food and Drug Administration. One pivotal efficacy study involved young South Africans.
"We do the trials better, faster and cheaper than anywhere else in the world, and so without South Africa as part of these programs, the world, in my opinion, is much poorer," Grey emphasized. She noted that during the COVID-19 pandemic, South Africa played a crucial role by testing Johnson & Johnson and Novavax vaccines, while South African scientists' genomic surveillance led to the identification of important variants.
Broader Healthcare Consequences
The funding cuts extend beyond research, affecting direct patient care and disease surveillance. At least 8,000 health workers in South Africa's HIV program have been laid off, and data collectors who tracked patients and their care have been eliminated. HIV counselors who could reach vulnerable patients in rural communities are also gone, creating gaps in both treatment and prevention efforts.
The South African government estimates that universities and science councils could lose about $107 million in U.S. research funding over the next five years. These cuts affect not only HIV research but also tuberculosis programs, another critical area given the high disease burden in the country.
Limited Replacement Funding
South Africa's government has indicated it will be very difficult to find funding to replace the U.S. support. Universities South Africa, an umbrella organization, has applied to the national treasury for over $110 million for projects at major institutions, but this represents only a fraction of the lost funding.
UNAIDS executive director Winnie Byanyima, during a June visit to South Africa, acknowledged the stakes and lives at risk as research and healthcare struggle across the continent. While other heavily U.S.-dependent countries including Zambia, Nigeria, Burundi, and Ivory Coast are increasing their own resources, Byanyima was clear about the limitations: "What they are putting down will not be funding in the same way that the American resources were funding."
The BRILLIANT program continues to scramble for alternative funding sources, but the purchase of key equipment has stopped, and funding for postdoctoral students involved in experiments remains at risk. As HIV infections are expected to grow and medication becomes more difficult to obtain, the global implications of these research disruptions may be felt for years to come.
