“The ‘golden age’ of global health funding has reached a definitive end. Funding accelerated in the early 2000s and spiked during the pandemic. However, it began falling sharply after 2021. Experts now warn that we are entering an era of deep uncertainty,” reported Bloomberg (15 March 2026)
SA has lost about R7.4bn in US federal funding for HIV prevention and treatment, reflecting a broader retreat of Western donors from African health programmes. Private philanthropy has also declined, with funding dropping 15% this year to roughly R50.46bn.
Nonprofit organisations are trying to cover major budget gap by accepting pharmaceutical company funding while others face months-long delays in receiving promised grants.
Administrative delays at the National Lottery and stricter US compliance checks have further disrupted cash flow, forcing some providers to turn away patients needing urgent care. Governments across Africa are exploring alternatives such as “vice taxes” on alcohol, tobacco and sugary drinks, while new donors and blended financing models are emerging, though these remain insufficient to replace lost international aid.