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The abrupt halt to billions of dollars of US funding for foreign health programs is wreaking havoc.

Nowhere is that clearer than in South Africa, which has the world’s largest HIV-treatment program with 80% of 7.8 million infected people on medication.

The disbursement of antiretroviral drugs to so-called key groups — undocumented migrants, gay men, transgender people and sex workers — is falling apart, threatening to reignite what was a waning epidemic. 

Medication at the Witkoppen clinic in northern Johannesburg.  Photographer: Marc Shoul for Bloomberg Businessweek

Unlike many African countries that relied heavily on the US to shore up their health systems, South Africa has sufficient money to treat HIV patients. But it was heavily dependent on staff and expertise paid for by America to reach groups that government facilities are ill-equipped to cater for.

The termination of support without notice has made it hard to put alternatives in place.

Despite having a progressive constitution, South Africa wrestles with xenophobia and some parts of society are conservative. Members of the key groups are confronted with prejudice at already overburdened clinics and hospitals, resulting in them often either being turned away or not seeking treatment at all. 

Scientists and health nonprofits say people are already dropping out of medication programs and infection rates are expected to rise.

“This is irresponsible behavior,” Jean Bassett, the executive director at Witkoppen clinic in northern Johannesburg, said of the US funding withdrawal. The nonprofit treats HIV-positive migrants and others infected with the virus.

The number of AIDS-related deaths in South Africa fell to 68,000 last year, from 284,000 in 2005, thanks to the widespread provision of treatment. 

Now the fight to contain the scourge may have to begin all over again. — Antony Sguazzin and Janice Kew

Key stories and opinion:
Cuts to US Aid Imperil World’s Largest HIV-Treatment Program
AIDS Vaccine Work Imperiled by Trump’s Withdrawal of US Funding 
Trump Cuts See Main African Health Agency Turn to Local Funding 
USAID Is in Dire Need of Reform. But Not Like This: Mihir Sharma 
How Trump’s USAID Dismantling Will Affect Foreign Aid: QuickTake 

The 10th edition of the Africa Business Media Innovators will take place in Livingstone on June 8-10. If you are in the Zambian city and are keen to attend, please message gbell16@bloomberg.net.

Africa is set to be the largest beneficiary of the $200 billion the Gates Foundation plans to give away over the next two decades, co-founder Bill Gates said. The organization last month announced plans to disburse the money before shutting down in 2045. Gates — currently the world’s fifth-richest person — intends giving away 99% of his wealth. He’s worth about $175 billion, according to the Bloomberg Billionaires Index. The foundation he started with Melinda French Gates in 2000 has already distributed more than $100 billion.

Bill Gates. Photographer: David Ryder/Bloomberg

Islamist militants have ramped up an insurgency in northeastern Nigeria and attacked dozens of fortified army bases this year, setting back President Bola Tinubu’s efforts to restore security in Africa’s most populous nation. There were 45 verified incidents in May, the most since the same month in 2020, data collated by risk-analysis company Seerist shows. Most were linked to a group known as Islamic State West Africa Province, an IS affiliate that emerged in 2016. 

Madagascar is seeking to attract capital from the United Arab Emirates to spur economic growth, a partnership that’s become more urgent as it faces steep tariffs from the US. Talks are under way about potential investments in sugar- and vanilla-processing plants, luxury hotels and energy projects, David Ralambofiringa, the Indian Ocean island nation’s trade minister, said in an interview. Japan is meanwhile   supporting companies to grow their business in Africa and develop trade ties across a region where it’s mainly been seen as a key donor.

Workers process vanilla pods in Madagascar. Photographer: Rijasolo/Getty Images

A Berlin court ruled that Germany’s controversial move to refuse entry to some asylum seekers is unlawful, a setback to hancellor Friedrich Merz’s plans to clamp down on migration. The court upheld a challenge by three Somali nationals who were turned back at the Polish border last month, and said they should have been processed according to the European Union’s so-called Dublin rules for asylum cases. The tribunal rejected the government’s argument that the rules can be suspended due to an emergency situation.

Sudan’s army-appointed prime minister, Kamil Idris, dissolved the government in preparation to form a new cabinet, almost two weeks after becoming the war-torn country’s first premier in more than three years. He commissioned deputies and general secretaries to execute their ministries’ duties until the new administration takes shape, Sudan’s state-run news agency SUNA reported. His predecessor Abdalla Hamdok resigned in January 2022, about 16 months before the army and the rival Rapid Support Forces paramilitary group went to war.

Sudanese soldiers at the presidential palace in Khartoum, Sudan’s capital, on March 26. Photographer: Tariq Mohamed/Xinhua News Agency

Woodside Energy opened an arbitration case against Senegal to resolve a tax dispute related to its Sangomar oil project. The company started producing crude last year from the offshore field just as the government stepped up scrutiny of natural-resource contracts. The May 30 filing with the International Centre for Settlement of Investment Disputes provides no detail on the nature of the disagreement, but names Senegal’s oil ministry as a respondent. Woodside said it complied with all regulations and no outstanding taxes were owed.

Thank you for your responses to our weekly Next Africa Quiz and congratulations to Evans Munyoki who was first to identify Abidjan as the city where the African Development Bank is based.

South Africa’s economy expanded in the first quarter as increased output from the transport and farming industries helped offset a decline in manufacturing. Gross domestic product rose 0.1% from the previous three months. Most economists surveyed by Bloomberg expected a contraction. The latest reading is a minor boost for the governing coalition, after the National Treasury trimmed its growth forecasts for the year to 1.4% in a difficult global economic environment.

Thanks for reading. We’ll be back in your inbox with the next edition on Friday. Send any feedback to mcohen21@bloomberg.net