MSF, Doctors Without Borders, US funding cuts threatens research sites in South Africa, putting hard-won progress against TB and HIV at risk
South Africa

US funding cuts threaten 39 research sites in South Africa

Press Release15 May 2025

TAG and MSF urge donors to act now to protect ongoing research and ensure continuity of care for people with TB and HIV

Lifesaving scientific research on prevention, testing, treatment and care for people living with HIV and tuberculosis (TB) in South Africa is under serious threat due to US funding cuts, suspensions and grant terminations from the United States (US) government. A recent joint analysis by Treatment Action Group (TAG) and Doctors Without Borders (MSF) revealed that 39 TB and HIV clinical research sites in South Africa are under threat due to potential funding cuts by the National Institutes of Health (NIH), placing at least 27 HIV trials and 20 TB trials at risk. This is the first time an analysis has been done to map specific trials and clinical research sites related to HIV and TB that are at risk due to the US funding cuts. TAG and MSF call on donor agencies, governments, and philanthropic organisations to urgently intervene to:

  • Ensure continuity of care and follow-up for research participants in South Africa already enrolled in impacted HIV and TB clinical research sites by providing emergency support.
  • Address urgent research gaps by funding vital HIV and TB trials that were planned or paused just before launch.
  • Make sustained investments to secure South Africa’s unique and internationally recognised research infrastructure.
Dr. Tom Ellman, director of the Southern Africa Medical Unit (SAMU) For years, South Africa has spearheaded the research and development of critical innovative medical tools for the prevention, diagnosis, treatment and care of HIV and TB which have saved lives not just within South Africa’s borders, but also in communities worldwide, If the research work of tackling these two infectious diseases – including for the most vulnerable, is stalled, we risk losing hard-won progress.
Tom Ellman

"Public funding from the US government to South Africa is the scaffold on which pharmaceutical companies, philanthropies, and other governments invest in transformative TB and HIV science,” said Lindsay McKenna, TB project co-director of Treatment Action Group. “These ongoing funding disruptions by the US government don't just affect US-funded research projects, they put in peril a much wider ecosystem of global research. Donors must act swiftly to preserve scientific advances, prevent the collapse of medical research infrastructure in South Africa, and ensure continuity of care for people living with HIV and TB that have volunteered to participate in research.”

As per TAG and MSF’s analysis, TB trials that are at risk include new drugs and shorter, safer regimens for treatment and prevention, an optimised regimen for TB meningitis, and therapeutic and preventive vaccines. Cutting support to sites in South Africa that are part of international clinical trial networks, including ACTG, HVTN and IMPAACT[i], could derail up to 30 per cent of global TB trial enrollment and between 50-90 per cent for studies focused on pediatric and pregnant populations.

MSF, Doctors Without Borders, US funding cuts threaten research sites in South Africa, putting hard-won progress against TB and HIV at risk
Zhiketile Mtetwa holds a sputum sample collection bag at a Luyanda site in the rural town of Vuma outside Eshowe. Image from 2020
Tadeu Andre/MSF

For HIV, trials at risk include cure-related protocols involving broadly neutralising antibodies (bNAbs) and analytical interruptions of antiretroviral therapy in both adults and infants, studies to promote treatment adherence for youth, and trials of innovative preventive vaccine modalities designed to induce bNab production.

The analysis was primarily focused on NIH-funded DAIDS[ii] HIV Clinical Trials Network studies and research infrastructure, but this is just the tip of the iceberg. The US funding cuts impacting critical research being funded through other NIH mechanisms, US university grants, US Centres for Disease Control and Prevention (CDC) and the US President’s Emergency Plan for AIDS Relief (PEPFAR) are expected to disrupt a much wider array of TB and HIV research projects.

MSF, Doctors Without Borders, US funding cuts threaten research sites in South Africa, putting hard-won progress against TB and HIV at risk
Every three minutes, a child dies of tuberculosis (TB), even though treatment is available. In children, under-diagnosis is a major obstacle to effective treatment. New WHO recommendations, including treatment decision algorithms, could change all that. As part of the TACTiC project, launched in 2023, Doctors Without Borders (MSF) implemented these recommendations in 12 countries in Africa and Asia.
Stuart Tibaweswa

"Future breakthroughs in HIV and TB research, particularly in the areas of vaccine development and long-acting treatments, is likely to rely on settings with high incidence rates and vulnerable populations, such as those in South Africa. Importantly, these advances will benefit people globally, including in high-income countries like the United States," said Ellman.

Read the briefing document, South Africa’s TB and HIV Research At Risk: A Call to Catalyse Urgent Action by Funders, for more details on the HIV and TB trials that are impacted by US funding cuts and their ripple effects. The annexe provides a detailed overview of trials and South African research sites in the DAIDS HIV/AIDS Clinical Trials Networks and the extent of disruptions caused by actual and potential US government funding terminations.

[i] ACTG = Advancing Clinical Therapeutics Globally for HIV/AIDS and Other Infections; HVTN = HIV Vaccine Trials Network; and IMPAACT = International Maternal, Pediatric, Adolescent AIDS Clinical Trials Network.

[ii] DAIDS stands for the Division of AIDS within the National Institute of Allergy and Infectious Diseases (NIAID), which is part of the U.S. National Institutes of Health (NIH).