The NIH has lifted its ban on funding research projects in South Africa, reversing a policy introduced after US President Donald Trump ordered agencies in February 2025 to halt foreign aid and assistance to the country.
The decision follows an internal memo from NIH director Jay Bhattacharya, reported by Science, which concluded that NIH research grants do not constitute foreign aid and are therefore outside the scope of the executive order.
Bhattacharya argued that Congress has explicitly authorised the NIH to participate in international research collaborations and that the agency’s funding mechanisms are not governed by the Foreign Assistance Act.
The restoration does not mean the US is committing $450 million in new funding to South Africa. Instead, the figure represents the scale of funding the country is estimated to have lost following the broader US funding cuts, which affected NIH programmes alongside other US-backed research and health initiatives.
Why the NIH decision matters beyond South Africa
The funding disruption had put at risk a research ecosystem built over decades of US-South African collaboration, particularly in HIV and TB.
South Africa has become a major international centre for clinical research because of its large HIV and TB burden, established research institutions and ability to conduct large-scale clinical trials.
The country’s researchers and patients also play an important role in international studies, meaning interruptions to South African sites can affect research programmes well beyond its borders.
Health Policy Watch previously reported that the funding crisis threatened dozens of HIV and TB research sites and studies, including trials investigating new treatments and interventions. The disruption also forced institutions to consider staff cuts and the closure or scaling back of research programmes.
Researchers warned that the greatest danger was not simply the loss of individual grants, but the erosion of research infrastructure and expertise that took decades to build.
That concern is particularly significant for HIV and tuberculosis, where South African researchers have contributed to studies that have shaped treatment and prevention strategies internationally.
The NIH’s latest decision could therefore allow some of those collaborations to resume and give institutions an opportunity to rebuild capacity lost during the funding freeze.
Funding restoration comes with conditions
Bhattacharya said research conducted in South Africa must have a clear scientific rationale for being carried out outside the US and must have the potential to generate knowledge relevant to understanding, improving or protecting the health of Americans.
Projects will also remain subject to NIH review procedures, State Department review and US rules governing foreign awards.
South African researchers will also remain excluded from certain training and career-development programmes run by the NIH’s Fogarty International Center.
That restriction could have consequences beyond South Africa because Fogarty-supported programmes have historically helped develop researchers and research capacity across Africa.
The NIH reversal therefore represents a significant opening for South Africa’s scientific community, but not a full restoration of the relationship that existed before the funding disruption.
For universities, research institutes and scientists that lost grants, staff and research momentum, the challenge now is to rebuild an ecosystem that took decades to establish.
