Limpopo NGO Adjusts to Trump's Reductions in Financial Assistance
In 2025, Sindy Nkuna awoke to a chilling email, announcing that the US was momentarily halting all foreign aid. This stark news left the data captor feeling jittery, unsure about her and her children's future.
"I felt devastated," she admits. "Days of racing heartbeats, contemplating the unknown. Unbelievable, I have two boys."
Nkuna was stationed at the Hlokomela Clinic, a 200km-distant facility serving the HIV-affected fruit and game farming communities of Mopani district, Limpopo. As a data tracker, she monitored fresh HIV diagnoses, tests administered, and individuals on treatment. Her job's financial support originated from Anova Health Institute—the largest recipient of the President's Emergency Plan for Aids (PEPFAR) funding in South Africa.
PEPFRAR is the U.S. government's extensive aid program dedicated to AIDS initiatives. It primarily funds HIV projects, like Hlokomela's, mostly managed by non-profit organizations, in nations such as South Africa.
Anxiously, Nkuna awaited confirmation of her employment status at the end of February. The news emerged: most United States Agency for International Development (USAID) funding—encompassing many PEPFAR projects — would be irrevocably slashed.
Consequently, Hlokomela found itself without its HIV testing team, responsible for fieldwork, and financial strains for essential equipment, like cooler bags, and mobile testing clinic transportation—all previously covered by Anova.
HIV field services across Hoedspruit farms and communities, which assisted about 1,000 HIV tests every month, shut down. Christine Du Preez, Hlokomela's founder, described the situation as worse than the COVID-19 pandemic.
To adapt, Hlokomela had to innovate. The team focused on retaining essential staff, including 25,000 farmers, workers, and family members who depended on them for basic healthcare services.
Despite the challenges, Hlokomela's resilience stemmed from its past experiences. They realized they could lean on their existing resources.
With three clinics and 9 mobile clinics operating in 72 sites, Hlokomela employed doctors, nurses, data capturers, lay counselors, community health workers, and paid volunteers. Anova funding accounted for merely 2% of their overall budget, covering mobile testing clinics and the staff that ran them.
Before the funding halt, in 2008, some 28.5% of Hoedspruit's farmworkers were HIV-positive, which was over 10 percentage points above the national average of 17.64% that year. Fast forward to this year, Hlokomela's data indicates the HIV-infected farmworkers have dropped to 6.5%.
However, when funding ceased, Hlokomela was caught off guard. Subsequently, HIV tests dropped by nearly 90%, according to Nkuna.
To overcome this setback, Hlokomela has relied on community health workers known as nompilos, meaning "mother of life" in isiZulu. They've trained around 75 of these farm workers, who receive a monthly stipend, in health education, including monitoring blood pressure and heart rates, and screening for chronic conditions like HIV and TB.
- Sindy Nkuna, initially supported by Anova Health Institute and PEPFAR funding, was working on HIV-related health-and-wellness projects at Hlokomela Clinic.
- The US government's decision to halt foreign aid led to a significant reduction in PEPFAR funding for Hlokomela, causing a near elimination of HIV tests and financial strains for essential equipment.
- In response to the funding cut, Hlokomela has been relying on community health workers, known as nompilos, for health education and screening, including HIV and TB, and offering them a monthly stipend as a form of support.
