Since January 2025, a series of United States (U.S.) executive orders, funding suspensions, and grant terminations have thrown South Africa’s tuberculosis (TB) and HIV programs into crisis, threatening lifesaving research, prevention, and treatment programs.

Developed by TAG, Médecins Sans Frontières, and the South African Medical Research Council, this issue brief provides information about TB and HIV clinical trials and research programs impacted by U.S. government funding disruptions, and proposes urgent actions that donor agencies, governments, and philanthropies can take to preserve scientific advances underway and prevent the collapse of TB and HIV medical research in South Africa.

The issue brief identifies 39 clinical research sites and at least 20 TB trials and 24 HIV trials at risk, and includes a mapping of: priority innovations at risk (Table 1); TB and HIV studies sponsored by the National Institutes of Health-funded Division of HIV/AIDS Clinical Trials Networks that will be affected should the U.S. government terminate research awards to South African institutions (Tables 2 and 3); NIH-funded clinical trials units and clinical research sites in South Africa (Table 4); and other U.S. government-proposed or -funded TB studies with sites in South Africa (Table 5).