This downsizing is part of a broader initiative led by Elon Musk's Department of Government Efficiency (DOGE) to streamline government operations.

The reduction has led to the recall of USAID personnel stationed abroad and the suspension of numerous projects, including those focused on anti-human trafficking and HIV/Aids prevention. Additionally, hundreds of contractors have been laid off, with some terminated immediately without severance pay.

These actions have raised concerns among former officials and politicians, who argue that such measures undermine US foreign policy efforts and harm vulnerable populations worldwide.

The rapid dismantling of the agency is expected to have significant and immediate global repercussions. Already the African continent is experiencing disruptions in health services due to the US government's halt of funding for HIV and TB programmes. In Uganda, the suspension has forced organisations like the Africa Queer Network to cease operations, causing concerns about a potential resurgence of sexually transmitted diseases due to the interruption of essential health services.

The stop in funding is set for a 90-day period as per President Donald Trump's executive order issued on 20 January, 2025.

HIV funding uncertainty

At his State of the Nation address on Thursday 6 February 2025, South African President Cyril Ramaphosa voiced apprehension over the suspension of USAID funding: "We are concerned about the potential impact of the decision by the United States government to suspend some of its funding for HIV and TB programmes in African countries for 90 days.

"This funding accounts for about 17 percent of our country’s HIV spend. We have been able to provide funding from our fiscus for our HIV and TB programmes over the years, however we are looking at various interventions to address the immediate needs and ensure the continuity of essential services," he said.

Ramaphosa did not detail these specific strategies publicly. He did, however, announce the SA government would be launching a campaign this year to ensure 1.1 million South Africans not currently on antiretroviral medication would receive treatment.

"We are encouraged by the great progress the country has made towards ending HIV and Aids as a public health threat. By the end of March 2024, 96 percent of people living with HIV knew their status, 79 percent of these were on antiretroviral treatment and 94 percent of those on treatment were virally suppressed."

The new campaign will ensure SA reaches its target of 95-95-95 - a global HIV strategy set by UNAIDS to help end the AIDS epidemic.

The goal is that by 2030: 95% of people living with HIV should know their status; 95% of those diagnosed should be on antiretroviral treatment (ART), and 95% of those on treatment should have viral suppression, meaning the virus is undetectable and cannot be transmitted.