The United States will begin phasing out financial support for Namibia's HIV response programs, making Namibia the latest southern African country affected by the Trump administration's withdrawal of foreign aid.

Under a joint statement, the U.S. will provide Namibia with $45 million for its HIV response in the 2027 fiscal year, after which the country will fund its own HIV programs while the U.S. provides only "technical cooperation."

Namibia has received roughly $45 million annually in recent years through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR). The United States says it has contributed more than $1.1 billion to Namibia's HIV response since 2003. Namibia has one of the highest adult HIV prevalence rates in the world, meaning the shift places a significant share of a longstanding national health effort onto domestic financing for the first time in two decades.

The funding withdrawal had been anticipated since the Trump administration announced its "America First" approach to foreign aid, but it follows Namibia's rejection of proposed provisions requiring the sharing of health data and biological specimens with the United States. Namibia cited privacy, sovereignty, and legal concerns for its decision.

The Trump administration has pursued country-by-country agreements that Washington says will reduce donor dependency, increase domestic financing, and safeguard American interests. Since late last year, the U.S. has signed agreements with about 30 countries, many of them in Africa.

However, Ghana rejected a proposed agreement over access to sensitive health data, Zimbabwe withdrew from a $367 million package over similar concerns, and a court challenge has put Kenya's $2.5 billion agreement on hold. Zambia has also objected to data-sharing demands.

Namibian officials previously said the proposed provisions in their original form were "not in compliance with Namibia's national laws" and infringed constitutional privacy protections and national sovereignty over biological resources.

Both governments are reported to be negotiating a new bilateral health agreement. What remains to be settled is how "technical cooperation" will be defined in practice, and how Namibia will absorb the cost of treatment and testing programs currently supported by U.S. funding.

According to the joint statement, Namibia has surpassed UNAIDS targets, with 96% of people living with HIV knowing their status, 98% of those diagnosed receiving treatment, and 98% of those treated achieving viral suppression.

"Over the next year, this support will transition into a technical cooperation model as the HIV response is fully integrated into Namibia's sustainable national health system, in line with Namibia's national laws," the governments said.

The U.S. recently announced the phasing out of more than $400 million in annual support for South Africa's HIV programs. It has also begun a "phased drawdown" of PEPFAR, a program that has supported South Africa's fight against HIV and AIDS for the past 20 years and is widely credited with saving more than 20 million lives over that period.

Source: Fortune