Contact: Dorrit Walsh, dorrit.walsh@treatmentactiongroup.org

New York City, March 18, 2025 — Treatment Action Group (TAG) opposes in the strongest possible terms the termination of National Institutes of Health (NIH) research awards and contracts to South Africa, feared following reporting by Science. This attack against South African scientists is an attack on science at large and particularly jeopardizes research against tuberculosis (TB), the world’s leading cause of death due to an infectious disease.

Millions of people with TB and comorbidities around the world – and in the United States – benefit from scientific advances made possible by South Africa’s vibrant research community. South Africa is home to around 270,000 people living with TB and 7.7 million people living with HIV — one of the highest TB burdens per capita and the largest HIV epidemic in any single country. The country desperately needs this research and, contrary to the shortsighted “America First” policy touted by the current U.S. administration, so do the American people.

With a wealth of talented scientific investigators and decades of research experience, South Africa hosts some of the world’s most important sites for TB and HIV research, including the quest to discover efficacious vaccines and cures for TB and HIV.

“Every major TB treatment and vaccine advance in the past two decades has relied on research carried out in South Africa,” said TAG TB Project Co-Director Lindsay McKenna. “It’s because of the country’s health system, academic and lab infrastructure, clinical and scientific expertise, transparent regulatory processes, and TB and TB/HIV disease burden. That combination of factors makes rigorous medical research possible — if NIH-funded TB trials are forced to discontinue work in South Africa, lifesaving research will take years longer and be far more expensive.”

According to the NIH RePORTER database, between 2019 and 2023, South African research institutions received $117.6 million in NIH grants that funded work on TB, including $78.7 million in core support distributed to the NIH Division of AIDS HIV/AIDS clinical trials network sites across South Africa. Examples of current research imperiled by U.S. funding cuts include trials involving new treatment regimens for TB meningitis, dosing and safety assessment for new drug pretomanid to cure drug-resistant TB in children, and the safety and immunogenicity of a TB vaccine candidate for people living with HIV.

This racist and destructive move dishonors the decades of mutually beneficial collaboration between the South African and American people on science and innovation. These cuts will have disastrous consequences for research institutions across the United States and their South African collaborators already grappling with fallout from USAID contract terminations earlier this year. USAID is the third largest funder of TB R&D globally and has supported cutting-edge studies in South Africa that have changed approaches to preventing, diagnosing, and treating TB in the United States and around the world.

Importantly, NIH investments in South African TB research are matched by domestic funding sources, because South Africa spends more on TB research relative to overall GDP and research expenditures than practically any other country on Earth. “If the administration’s goal is to transition to country-led research programs, then cutting off South Africa entirely at this juncture is the worst possible strategy,” said TAG U.S. and Global Health Policy Director Lizzy Lovinger. “The infrastructure it has built and could continue to expand in partnership with U.S. researchers is a working model for many other low- and middle-income countries, but that model will be damaged by ending those partnerships.”

“TAG has fought for decades to expand the funding and scientific capacity necessary to develop better tools to diagnose, prevent, and cure TB,” said TAG Co-founder and Executive Director Mark Harrington. “We’re outraged to see such hard-won progress toward ending the TB pandemic so pointlessly and impulsively obstructed. We demand the administration continue to support TB research in South Africa, and end these hostile attacks on health and science.”

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