U.S.-funded health projects around the world, including those providing lifesaving care, received termination notices from Washington on Thursday as President Donald Trump's administration neared completion of a review to ensure grants are aligned with its "America First" policy.
Trump ordered a 90-day pause on all foreign aid in January pending assessments of how projects were consistent with this foreign policy.
U.S. Secretary of State Marco Rubio has dismissed concerns that Washington is ending foreign aid, saying waivers had been provided to life-saving aid.
Only weeks later, the administration decided to terminate more than 90% of the programs globally, according to a February 25 court document, including many that were initially covered by waivers such as work tackling HIV as well as wider health programs.
Several of the largest U.S.-funded HIV/AIDS programmes in South Africa were told that their funding would not resume, according to three senior leaders at health organizations, while a global non-profit that works on malaria and maternal and newborn health had the majority of its contracts cancelled.
UNAIDS, the United Nations agency tackling HIV and AIDS, had its contract with the United States Agency for International Development (USAID) cancelled, documents reviewed by Reuters showed.
Khana in Cambodia, an HIV and TB organisation, also got a termination notice, according to a source familiar with its work.
There was no immediate response to a request for comment from the U.S. State Department.
Reuters was not immediately able to determine how many organisations worldwide were affected, or exactly what the criteria were for termination.
"Secretary Rubio and (USAID) Deputy Administrator (Peter) Marocco have determined your award is not aligned with Agency priorities and made a determination that continuing this program is not in the national interest," said the notice received by organisations, which was seen by Reuters.
International AIDS Society President Beatriz Grinsztejn, referring to cuts worldwide, said: "The U.S. funding cuts are dismantling the system. HIV treatment is crumbling. TB services are collapsing... Lives are on the line." Her organisation is not affected directly.
Some of the programmes that were cut in South Africa provided HIV/AIDS services to vulnerable groups such as LGBT+ people and sex workers.
Others provided HIV testing and services to the general population, said Francois Venter, executive director of the Ezintsha Research Centre in Johannesburg, which is not funded by USAID.
South Africa has the world's largest number of people living with HIV, at around 8 million.
"The programmes who received their termination letters this morning were among the most efficient, effective health delivery programmes in the country," said Venter, calling it a "devastating blow" for South Africa's HIV response.
