US NIH Cuts Billions in South African Medical Research Funding
New Policy Bans Foreign Sub-Awards, Disrupting Critical Health Studies
The US National Institutes of Health (NIH), the world’s largest public biomedical research funder, has implemented a new policy prohibiting foreign sub-awards, effectively cutting billions in research funding for South African clinical trials. The move threatens critical HIV and TB research projects nearing completion.
Video credit to: Elles van Gelder – Africa Correspondent NOS
How Sub-Awards Work and Why They Matter
Sub-awards occur when primary NIH grant recipients distribute portions of funding to international collaborators. For example, a US university testing an experimental HIV drug might partner with South African researchers to conduct trials in high-prevalence areas.
Under the new rules, these collaborative funding arrangements are no longer permitted. While direct NIH grants to foreign institutions remain valid, most South African research relies on sub-awards – meaning the majority of NIH funding to the country will effectively end.
“Recipients due for sub-grant renewal on 1 May lost funding immediately, while others will see funding dry up later this year,” explained one researcher.
Clinical Trials Grinding to a Halt
The policy change has already forced several long-running clinical trials to stop abruptly, including:
- A promising 3-month TB treatment regimen trial (versus standard 6-month treatment)
- Multiple HIV drug efficacy studies nearing completion
- Vaccine development programs
Professor Sean Wasserman of UCT described the ethical dilemma: “We have patients on experimental treatments who now must transition back to standard care without proper support staff, as we can no longer pay them.”
Wider Impact on South African Research
South Africa receives between R3-R6.65 billion annually from NIH, with estimates suggesting:
| Funding Type | Amount |
|---|---|
| Direct Grants | Under R1 billion |
| Sub-Awards | Majority of funding |
Even direct NIH grants appear frozen, with researchers reporting unexplained delays in routine renewals since March.
Broader Context of US Funding Cuts
This follows other recent US funding reductions:
- February 2025: USAID terminated global HIV programs
- March 2025: Columbia University sub-grants canceled
- March 2025: NIH cut grants allegedly promoting DEI initiatives
The South African Medical Research Council is attempting to secure alternative funding, having obtained R400 million in conditional donor commitments.
Looking Ahead
While NIH claims to be developing new direct funding mechanisms, researchers remain skeptical about South Africa’s inclusion. The abrupt termination of ongoing trials raises serious ethical concerns about patient care and scientific integrity.
For more details, read the original report on GroundUp.