The threat hanging over South African HIV/AIDS researchers for the past week has become a reality: President Donald Trump’s administration this afternoon began terminating or putting on hold their grants from the U.S. National Institutes of Health (NIH). The cuts appear in part linked to an escalation of NIH efforts to terminate grants, at least some of which the government has decided have components of diversity, equity, and inclusion (DEI).
“This is going to cut deep,” says HIV clinician Ian Sanne, a principal investigator of an immediately terminated $2.5 million grant to the University of the Witwatersrand (Wits) Research Group Clinical Unit, which participates in international human trials of HIV and tuberculosis (TB) medicines conducted by different NIH-supported networks. He notes that its termination puts volunteers who are in ongoing trials at risk. “Today is Human Rights Day in South Africa,” Sanne says. “Is this compliant with international standards of human ethics?”
A termination letter explaining that the grant “no longer effectuates agency priorities” gives no specific reason for the termination, but states that DEI “studies are often used to support unlawful discrimination on the basis of race and other protected characteristics, which harms the health of Americans.”
Trump has issued several executive orders—including some that mention DEI—that could be linked to the terminations. But a memo obtained by Science directed NIH program officers not to mention the executive orders, several of which have been temporarily blocked by judges, in communications with researchers. Instead, they should say the projects are no longer an “agency priority.” The memo added that grant officers must verify that each project aligns with NIH’s “goals.” These goals have not been publicly defined.
“Our work has nothing to do with DEI and everything to do with global health security,” Sanne says. “These are multicenter, cooperative agreements that target public health across the globe in diseases that know no boundaries and know no borders. If this is about efficiencies, they’re throwing decades of experience overboard.”
The memo suggests NIH’s parent agency, the U.S. Department of Health and Human Services (HHS), has directed NIH to quickly terminate 945 specific grants—only some of which are in South Africa. Multiple researchers have told Science their grants related to LGBTQ health inside the United States were also terminated today and 50 grants with termination dates of 20 March are on a list posted by an HHS website that tracks agency grants. The cuts follow previous terminations of grants involving diversity, transgender health, and vaccine hesitancy, among other topics.
Notifications of the latest grants the Trump administration has decided to cut are coming in batches to NIH institute and center directors. The memo also said all grants with money going to South Africa and China are on hold, meaning no new applications will receive awards and existing multiyear grants won’t be funded in the future.
“This is the Night of the Long Knives,” says Glenda Gray, an HIV/AIDS researcher at Wits, referring to a Nazi purge of perceived German enemies in 1934.
Gray, chief scientific officer and former head of South Africa’s Medical Research Council, notes that the country, which has more people living with HIV than any other, has played a pivotal role in clinical trials that have shaped international guidelines about the most effective ways to use anti-HIV and TB drugs. The trials have also helped lead to approvals of new drugs by the U.S. Food and Drug Administration. Landmark studies in South Africa have, for example, shown that anti-HIV drugs taken by breastfeeding mothers reduce the risk of transmission to their babies and demonstrated the power of long-acting pre-exposure prophylaxis for HIV that was Science’s Breakthrough of the Year in 2024.
Gray received notice today that her own $3.1 million grant for a clinical trial unit in Soweto has moved from an approved to a pending status.
These cuts come on top of an earlier decision by the Trump administration to terminate grants to South Africa, some for research, that came through the now-defunct U.S. Agency for International Development. According to a back-of-the-envelope calculation Gray did, South Africa receives about $250 million a year from NIH for medical research, three times what the government there invests. “If you take this away, you take away scientists, doctors, nurses, laboratories, fundamental science, basic science, clinical science, supervisors for Ph.D.s and masters, and postdocs. You basically abolish medical research in South Africa. That’s how serious this is.”
Trump issued an executive order on 7 February that said the U.S. government would no longer provide aid to South Africa because of supposed “unjust and immoral practices that harm our Nation.” But it’s unclear whether these specific concerns—which involved land owned by white farmers and South Africa’s stance on the Israel-Gaza war—are tied to the terminations.
Gray says the recent actions make her doubt, as many South African researchers earlier surmised, that the executive order is linked to the cuts. “It appears that no institution and no country is being spared,” Gray says. “This is an orchestrated assault on NIH-funded science.”
