The United States has lifted an NIH ban that shut down major HIV and TB work in South Africa, reopening the possibility of US-funded projects but leaving researchers cautious about what comes next. An internal NIH memo dated 17 August, signed by director Jay Bhattacharya and marked "Not for distribution outside government", says funding for "meritorious research projects" in South Africa may proceed and that NIH grants are "distinct from the objectives traditionally associated with foreign aid or assistance".
The funding pause began in January 2025, when the United States started halting NIH grants and USAID aid to South African projects, an action that followed an earlier February order that had already disrupted work. The interruption forced many clinical trials to stop and led to staff retrenchments across institutions that depended on US support.
A brief from May 2025 by Médecins Sans Frontières, Treatment Action Group, and the South African Medical Research Council documented the damage, saying critical research initiatives and decades of investment in infrastructure were affected. Ntobeko Ntusi, president and CEO of the SAMRC, said the decision to lift the ban follows 12 months of negotiations with the NIH "to reverse their position on South Africa". He argued that South Africa had been a partner that co-funded biomedical research with the NIH, rather than merely a recipient. "I welcome this apt decision of the NIH because no country can ever solve the challenges of global health alone ... We need scientific collaboration to drive scientific progress," Ntusi said.
Institutions that relied heavily on NIH networks felt the impact directly. Linda-Gail Bekker, director of the Desmond Tutu HIV Centre, said the centre had to retrench staff when funding stopped and that long-running partnerships with networks such as ACTG and HVTN had gone quiet. She noted that the centre's clinical trials units are nearing the ends of seven-year trials, and while "We haven't had confirmation that South Africa will be included. But we feel more optimistic than we did before," Bekker said, she added SAMRC support has only partially filled the gap.
In August 2025 the SAMRC announced it had raised around R600-million in rescue funds to support affected projects. The package included about R400-million from National Treasury, R100-million from the Gates Foundation, R100-million from the Wellcome Trust, and R14.4-million from the ELMA Foundation. These sums provide immediate relief for groups that scrambled to keep trials and labs afloat.
Still, experts warn the reprieve is incomplete. Landon Myer of UCT's School of Public Health described a cautious outlook, saying South Africans should be "cautiously optimistic" and that "Time will tell" what the memo means in practice. He pointed to layoffs and resignations inside the NIH and constrained budgets that may have reduced bureaucratic capacity. The memo also specifies that the Fogarty International Center will "no longer supporting research training and career development applications from South Africa", a move that threatens the long-term training pipeline that helped build the country's research base.
The immediate consequence is clear: meritorious NIH-funded projects can seek to restart, but science groups face a complex rebuild. Restoring paused trials, rehiring staff, and re-establishing longstanding US partnerships will depend on how quickly the NIH operationalises the memo, and whether other funders sustain the short-term rescue funding that kept many programmes alive.
