South African Legislator Proposes Denying Foreigners Access to ARVs After PEPFAR Funding Halt
Controversial South African Member of Parliament Gayton McKenzie has proposed an immediate halt to all medical assistance, including Antiretroviral Treatment (ART), in response to the gap left by the cessation of aid from the United States government.
In the final week of February, PEPFAR-funded HIV organizations in South Africa, which receive funding through the United States Agency for International Development (USAID), were notified that their PEPFAR grants had been permanently ended.
PEPFAR, the President’s Emergency Plan for AIDS Relief, was launched in 2003 to help combat AIDS in countries with high HIV infection rates, such as South Africa. Since its inception, South Africa has received approximately $8 billion (about R145 billion), with $439,537,828 (about R8.1 billion) allocated for the current US financial year, which runs from October 1, 2024, to September 30, 2025.
Speaking in Parliament, McKenzie declared, “Foreigners must go now!”
Because PEPFAR has been removed, 17% of the money is gone. I want to ask the president of this country: can we stop giving any medical help to foreigners? They should be banned from all our hospitals. They must go to their own countries that have a good relationship with America,” McKenzie said.
Out of South Africa’s 63 million people, 7.8 million are HIV-positive, with 5.5 million on ARVs. Zimbabwe has the largest number of foreign nationals in South Africa. However, the exact number of foreigners receiving ARVs in the country remains unknown.
Meanwhile, a study comparing ART outcomes between South African citizens and foreigners at a Johannesburg clinic found that foreigners had better retention rates and lower mortality. However, the study did not specify the total number of foreigners receiving ART.
As of 2024, approximately 8.0 million people are living with HIV in South Africa, representing an overall prevalence rate of 12.7%. Among adults aged 15–49 years, the prevalence is estimated at 16.7%. The country has implemented one of the largest HIV treatment programs globally, with 5.7 million people receiving antiretroviral therapy (ART) as of 2022.
In 2022, there were 160,000 new HIV infections and 45,000 AIDS-related deaths. In February 2025, the U.S. government announced the termination of over 90% of USAID’s foreign aid contracts, including those supporting HIV programs in South Africa. This abrupt funding cut has raised concerns about potential increases in mortality and instability within the healthcare system.
South Africa is considering adopting the World Health Organization’s recommended first-line HIV treatment regimen. This would involve transitioning most patients to a combination of tenofovir, dolutegravir, and lamivudine, aiming to simplify and enhance treatment efficacy. HealthTimes
