US aid cuts, initiated by President Donald Trump shortly after taking office, have severely disrupted health and development programs in South Africa, particularly those combating HIV/AIDS under PEPFAR and USAID initiatives.[1][2][5] These reductions, including the shuttering of USAID and cancellation of over 80% of its contracts by March 2025, ended funding for about 40 health projects on February 26, 2025, leading to the loss of services from 8,493 PEPFAR-funded staff.[2][6] This has caused clinic closures, reduced HIV testing, treatment, and prevention efforts like PrEP for key populations including adolescent girls and pregnant women, alongside disruptions in data management and mobile services.[2] Projections indicate dire consequences: cuts to South Africa's HIV/AIDS programs could result in 500,000 additional deaths over the next decade, per the Desmond Tutu HIV Center, while the Global Fund trimmed allocations by 16% for South Africa in its 2023-2025 cycle.[1] The South African Medical Research Council faces heavy exposure, with 28% of its budget from US sources now at risk, threatening health research.[3] Civil society coalitions have urged President Cyril Ramaphosa to coordinate a national response to avert mass disruptions, preventable deaths, and new infections.[3] In response, South Africa's Ministry of Health and SANAC launched a February 25, 2025, campaign with UNAIDS and WHO to close a 1.1 million HIV treatment gap by December 2025, targeting men for healthcare access.[2] The US approved a temporary $115 million PEPFAR Bridge Plan for South Africa from October 1, 2025, to March 31, 2026, amid ongoing political tensions that may exclude future grants.[7] These cuts, part of broader global reductions, exacerbate poverty and disease risks, with experts warning of precarious HIV advancements in sub-Saharan Africa.[1][5] Private sector involvement is sought to bridge gaps.[2] (298 words)