Researchers in South Africa are facing alarming uncertainty as funding from the United States National Institutes of Health (NIH) hangs in the balance, putting crucial medical research at risk. Reports suggest that the NIH is preparing to terminate grants for various clinical studies, which could deal a severe blow to ongoing research, including vital tuberculosis (TB) trials.
Professor Ntobeko Ntusi, the CEO of the South African Medical Research Council (SAMRC), disclosed to GroundUp that researchers were alerted on March 13, 2025, regarding the NIH's plans. "We were alerted on Thursday last week that the NIH is considering imminently terminating all grants to South Africa ... many of us believe these are likely to be announced in the coming days," said Ntusi. The implications of such a decision could be dire, especially as US grants account for 28% of SAMRC's funding.
On March 16, the University of Cape Town (UCT) sent an email warning health faculty of the imminent termination of US federal funding. This proactive communication reflects the severe nature of the situation, wherein the termination of the grants could derail extensive research already in progress.
One particularly concerning study, funded by the NIH, is experimenting with shortening the TB treatment regimen from the current six months to just three. Associate Professor Sean Wasserman, who leads this clinical trial in South Africa, noted that current patients are on a critical path towards improving treatment outcomes. He expressed fear that if funding is withdrawn, "there’s an immediate threat to patient wellbeing and care." He elaborated that transitioning patients back to routine care could be hazardous given the complexities of the experimental therapy they are on.
Conducted over the past three years, this NIH-funded trial has seen millions of rands allocated to monitoring 85 TB patients in South Africa, as well as parallel studies in Haiti. The current treatment strategy aims not just to accelerate the healing process but intends to reduce the chances of future illness by enhancing the likelihood of patients completing their course. If such funding is pulled prematurely, it threatens not just the trial's integrity but also the health of those being treated.
The context for these developments includes a broader deterioration in South Africa's relations with Washington, D.C. President Donald Trump's administration has already enacted measures to suspend aid to South Africa amidst claims of its alleged support for groups the US government challenges, which extends to claims about ties to Iran and questionable rhetoric over the African National Congress's governance.
Historically, grants from the NIH have been pivotal; 99% of drugs approved by the US Food and Drug Administration in the 2010s were developed with at least some level of NIH funding. That highlights how significant this situation is—not just for South Africa but for global health standards.
Just days before the UCT alert, a report from Science Magazine indicated that NIH officials were compiling lists of grants directed towards South Africa, echoing moves seen in other recent funding cuts related to different health topics. There are fears that this could be a precursor to wider funding cuts that would directly affect clinical trials linked to extremely pressing health issues.
This would not be the first time aid support has waned for South Africa; back in February, the United States Agency for International Development (USAID) ended most of its partnership agreements, further exacerbating the tension and financial constraints on health projects that directly support vulnerable populations.
These financial issues, examined in the stark environment of a potential loss of NIH funding, come as analysts are already voicing concerns over South Africa's fiscal outlook and the rising outflows of capital from foreign investors. Franklin Resources, along with JPMorgan Chase and Wells Fargo, has reduced its stakes in South African bonds significantly, triggering speculation that South Africa might lose its advantageous status under the African Growth and Opportunity Act (AGOA), which affects about $3.6 billion in exports to the US.
As of mid-March, foreign investors have expunged R16.1 billion in bonds, unveiling an unnerving trend taking place against the backdrop of domestic political discourse and economic turbulence. "Investors are sweating bullets, thinking Trump’s going to swing the AGOA axe over our rocky US ties," remarked Kristof Kruger, a fixed-income trader at Prescient Securities.
This turmoil is not purely transactional; it provides real implications for the lives and wellbeing of patients currently engaged in clinical trials. For the researchers betting their livelihoods on these studies, it is a grossly unfathomable prospect that their efforts could cease at a bureaucratic whim, undermining years of painstaking research.
In summary, should the NIH proceed with these cuts, it will mark a significant shift in American investment philosophy as it pertains to South Africa. The pullback not only stifles critical research in progress but could endanger patients and compromise future medical advancements that have global ramifications.
