Just a week remained before pioneering trials for an HIV vaccine were set to commence in South Africa. Optimism was palpable; perhaps another stride in mitigating one of the deadliest pandemics was within reach. Then, like a thunderclap in clear skies, an email arrived.
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It instructed cessation of all activities. The United States, guided by the Trump administration, was pulling its funding. This news hit like a sledgehammer in a region grappling with the highest concentration of HIV cases globally. Their research initiative, aptly named BRILLIANT, was designed to leverage the area’s genetic variability and profound expertise to benefit the world over.
The $46 million earmarked by the U.S. was vanishing, amid a broader dismantling of foreign aid by the world’s largest donor. Earlier that year, President Donald Trump vowed to prioritize domestic concerns.
South Africa, already stung by Trump’s unfounded allegations regarding the country’s white Afrikaner minority, was profoundly affected. The country had been benefiting from approximately $400 million annually via USAID and the HIV-focused PEPFAR. Now, it was gone.
Glenda Gray, head of the BRILLIANT program, succinctly remarked, “The African continent has been pivotal in developing HIV medication, and the U.S. cuts jeopardize our ability to continue this work in the future.”
Significant leaps had been made, including clinical trials for lenacapavir, the world’s only twice-a-year HIV preventive shot, recently sanctioned by the U.S. Food and Drug Administration. A key study validating its efficacy involved young participants from South Africa.
“We excel in conducting trials—better, faster, and at a lower cost than anywhere else. Without South Africa’s involvement, the world is considerably impoverished,” Gray asserted.
Recollecting the urgency during the COVID-19 pandemic, South Africa was instrumental in testing the Johnson & Johnson and Novavax vaccines. Moreover, the genomic surveillance spearheaded by South African scientists led to the discovery of a significant variant.
At the University of the Witwatersrand, dedicated researchers were at the forefront of developing HIV vaccines for upcoming trials. Technician Nozipho Mlotshwa, clad in a white lab coat, diligently worked on samples but now faces the unsettling prospect of unemployment.
“It’s heartbreaking and devastating,” she reflected on the U.S. funding cuts and the ensuing instability. “We’ll also miss collaborating with other scientists across the continent.”
Professor Abdullah Ely, leading the research team, noted the promising results, signifying that the vaccines were eliciting an immune response. Yet, momentum has now come to an abrupt stop.
The BRILLIANT program is making fervent efforts to secure alternate funding. Procurement of essential equipment has halted. South Africa’s health department reports that about 100 researchers associated with HIV-related projects have been laid off. Postdoctoral students involved in these endeavors face precarious futures as their funding evaporates.
It’s estimated that universities and scientific councils in South Africa could forfeit around $107 million in U.S. research funding over the next five years, affecting not just HIV, but also tuberculosis projects—another prevalent disease in the country.
Faced with these challenges, the South African government concedes the difficulty in replacing U.S. support. The consequences are grim. HIV infections are likely to rise, making medication harder to access. At least 8,000 health workers within the HIV program have already been let go. Similarly, data collectors and HIV counselors, vital in rural areas, are no longer available.
Universities South Africa, an umbrella organization, has petitioned the national treasury for over $110 million to support projects at major institutions.
During a June visit to South Africa, UNAIDS executive director Winnie Byanyima acknowledged the stakes involved. Countries heavily reliant on U.S. funding, such as Zambia, Nigeria, Burundi, and Ivory Coast, are already bolstering their own resources.
“But let’s be clear,” Byanyima emphasized, “what they are allocating won’t match the financial depth of American resources.”
