Medical researchers in South Africa are in limbo as they wait to hear whether over R800 million in research grants from the United States National Institutes of Health will be terminated. South Africa's top universities, which receive the bulk of the funding, will be particularly hard hit if the cuts materialise.
In another major shock to medical research in South Africa, research groups around the country have been alerted that many millions of rands in funding from the United States National Institutes of Health (NIH) may be terminated within a matter of days. The potential cuts were first reported in Science Magazine and then by GroundUp.
According to GroundUp's reporting, the University of Cape Town sent an email to members of the health faculty on Sunday warning that "developments over the last two days indicate that the termination of US federal funding to South Africa appears to be imminent".
Science Magazine reported that an email sent on behalf of NIH acting Director Matthew Memoli asked researchers at the institute to compile lists of South Africa-related grants. Similar requests have preceded previous cuts at the NIH.
Spotlight understands from a well-placed source that all new applications for NIH funding will be put on hold and that some current grant recipients have been asked to justify why they should continue to be funded. In line with previous comments by US President Donald Trump, the fear that all NIH funding to South Africa will be cut is widespread, although there is no concrete evidence at the time of writing that this is indeed going to happen. The NIH did not respond to an e-mail from Spotlight seeking confirmation.
Treatment Action Group (TAG), a New York-based policy think tank, have also raised concern regarding the possible termination of NIH grants to South Africa and called on the US government to continue supporting research efforts in the country.
Unlike previous funding cuts under the Trump administration, NIH funding does not fall under foreign aid. Research funding from the NIH is awarded through competitive and rigorous grant proposal and review processes.
Over R800 million annually
Spotlight analysed the NIH's publicly available database, which details their funded research projects. Our analysis shows that the NIH awarded R803 million ($44 million) in grants to South African research groups in 2024. This amount was spread across 102 grants, ranging from R500 000 ($30 000) to R49 million ($2,7 million).
In total, the value of NIH grants awarded to South African research groups over the last five years add up to more than R4 billion.
The bulk of financing was directed to HIV and TB research - two areas in which South African scientists have provided outsized contributions to the development of science and health technologies that have benefitted the world.
At over R800 million annually, the amount of money South Africa receives from the NIH is similar to what government allocates to the South African Medical Research Council (SAMRC). In the 2024/25 financial year, the government earmarked R833 million for the SAMRC. For 2025/26, this allocation increased by 5% to R880 million. The SAMRC is South Africa's largest local funder of health research.
Spotlight's analysis of NIH awards to South Africa shows that, if NIH funding is terminated, it will be felt across South Africa's universities, but most acutely at the University of Cape Town, Wits University, and Stellenbosch University. These three universities jointly received 80% of NIH funding for South African research units in 2024.
The termination of NIH funding to South Africa would immediately slow down efforts to develop new tests, treatments, and vaccines for HIV and TB. The cuts would also require large-scale layoffs which could derail the development of the country's next generation of scientists.
South Africa has already been subject to broad funding cuts from the United States Agency for International Development, the President's Emergency Plan for AIDS Relief, and the Centers for Disease Control and Prevention. These cuts have led to the closure of critical HIV, TB, and sexual health services targeting at-risk populations, as well as the disruption of important research such as efforts to develop an HIV vaccine.
Impact on TB
According to a separate TAG analysis of NIH data, the NIH awarded R2.1 billion to South African research institutions for TB research between 2019 and 2023. This spending included R1.4 billion in core support for clinical trials sites across South Africa that are part of the NIH Division of AIDS HIV/AIDS network.
"Every major TB treatment and vaccine advance in the past two decades has relied on research carried out in South Africa," said TAG's TB Project co-director Lindsay McKenna in a statement. She added: "If NIH-funded TB trials are forced to discontinue work in South Africa, lifesaving research will take years longer and be far more expensive."
Turmoil at the NIH
The NIH is the world's preeminent science funder. The highly respected agency has an annual budget of around $47 billion. This funding supports critical health research efforts, including early-stage discovery research, and research to develop new drugs, vaccines and diagnostics.
While most of the NIH's funding goes towards research in the United States, it also plays a crucial role in financing research around the world.
But the NIH has been in turmoil over the last month as the Trump administration used executive orders to force the agency to terminate swaths of active grants that it perceives as being in conflict with its political agenda and ideology.
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Over the past month, the NIH terminated grants related to diversity, equity and inclusion, grants involving transgender participants, and grants supporting investigations of vaccine hesitancy. It also terminated grants to Columbia University as punishment for campus protests against Israel's war in Gaza and accusations by the Trump administration that the university has failed to police antisemitism on campus.
It is understood that the threat of termination of NIH grants to South Africa research institutes is linked to the Trump administration's 7 February executive order. This executive order called for the cancelation of aid and assistance to South Africa due to the administration's perception of racism within the country against white Afrikaners, concerns regarding the country's land law, and South Africa's court challenge against Israel for its actions in Gaza at the International Court of Justice.
