NIH research funding is open to South African scientists again after an 18-month freeze that helped strip roughly $450 million out of local health research.
The United States National Institutes of Health has told staff that its grants are exempt from the executive order signed by President Donald Trump in February 2025 halting foreign aid and assistance to South Africa. Local researchers can apply for and receive NIH awards once more.
The decision matters well beyond the laboratory. South African units run much of the world’s frontline HIV and tuberculosis research, and the trials they conduct shape the treatment protocols used in local clinics.
It also comes with a loss attached. From 5 December 2026, the NIH’s Fogarty International Centre will no longer process applications from South Africa or fund the training of South African scientists, because the country is classified as upper middle-income and sits in the G20.
What the NIH research funding memo says
The reversal came in an internal memo sent to NIH staff on Wednesday by director Dr Jay Bhattacharya, first reported by the journal Science and since seen by Health Policy Watch and Business Day.
Bhattacharya’s reasoning is technical rather than political. He argues that NIH grants are distinct from foreign aid or assistance, that Congress has explicitly authorised the NIH to conduct international research collaboration, and that the Foreign Assistance Act does not govern NIH funding mechanisms.
On that basis, the memo states that “meritorious research projects located in South Africa are permitted to proceed”.
The permission is conditional. Projects remain subject to NIH review processes, State Department review, and NIH policies on foreign award structures.
The memo also sets a substantive test. Research must carry a clear scientific rationale for being conducted outside the United States, and it must have direct potential to generate knowledge that helps understand, improve or protect the health of Americans.
What 18 months without US money cost local science
South African researchers have historically been the largest recipients of NIH grants awarded outside the United States.
When the NIH initially read the executive order as covering its own grants, that position collapsed. Research units dropped projects and retrenched staff whose salaries were paid from grant funding.
Ntobeko Ntusi, president and chief executive of the South African Medical Research Council, has put the combined loss from NIH and other terminated grants, including those administered by USAID, at almost $450 million. At roughly R16.20 to the dollar, that is about R7.3 billion.
The replacement money never came close. Ntusi led a fundraising effort last year that secured R400 million from the Gates Foundation and the Wellcome Trust, matched by an equal amount from the National Treasury. That R800 million covers roughly a tenth of what was lost.
Ntusi called the reversal “a major opportunity for South African science”.
Linda-Gail Bekker, director of the Desmond Tutu HIV Centre at the University of Cape Town, was more measured, describing the change as “a lifeline to rebuild, but it’s a long and unpredictable road”. She noted that it has come too late for some projects.
The Fogarty exclusion that starts on 5 December
The Fogarty International Centre funds research training and career development. It is where many South African scientists received their first independent grants.
Salim Abdool Karim, director of the Centre for the Aids Programme of Research in South Africa at the University of KwaZulu-Natal, called the termination extremely disappointing. He argued that the centre’s entire purpose is international research, which makes barring it from any association with South Africa unusual and difficult to justify.
Karim pointed out that Fogarty early-career grants went to scientists who went on to lead HIV and TB studies that shaped the global response to both diseases.
Ntusi said the effect reaches past South Africa’s borders. Many of the postgraduate students and early-career scientists trained on Fogarty programmes hosted in South Africa came from elsewhere on the continent, which he described as a loss for Africa rather than for one country.
The practical consequence is a split outcome. Established researchers with track records regain access to project funding, while the pipeline that produced the next generation of those researchers closes.
Why the ban existed in the first place
| Date | Development |
|---|---|
| February 2025 | Trump signs executive order 14204 halting foreign aid and assistance to South Africa |
| 2025 | NIH interprets the order as covering its own grants, freezing South African projects |
| 2025 | SAMRC secures R400m from the Gates Foundation and Wellcome Trust, matched by National Treasury |
| June 2026 | US State Department announces a phased drawdown of PEPFAR |
| 19 August 2026 | Bhattacharya memo declares NIH grants exempt from the order |
| 5 December 2026 | Fogarty International Centre stops processing South African applications |
The executive order cited two grievances. The first was legislation the order described as enabling the seizure of Afrikaner agricultural property without compensation. The second was South Africa’s genocide case against Israel at the International Court of Justice, which the order said undermined US foreign policy.
The legislation referred to is the Expropriation Act 13 of 2024. The Act permits expropriation without compensation only in specified circumstances and after a due process is followed, does not identify any racial or ethnic group, and covers categories such as unused municipal land. Health Policy Watch has described the order’s characterisation of it as a distortion.
The order also contained a discretionary clause allowing agency heads to permit aid they consider necessary or appropriate. That clause is the mechanism the NIH has now used.
The freeze sat inside a broader deterioration. South Africa received one of the highest tariff rates announced by Washington in April 2025 and was among the countries hit by follow-up Section 301 tariffs this year. Southafriworld has previously reported on the five policy demands the US ambassador set out as conditions for better terms, covering rural safety, political rhetoric, expropriation compensation, black economic empowerment and non-alignment. The South African government has not moved from its position on any of them.
What has not been resolved
Several important questions remain open.
The reversal is contained in an internal staff memo rather than a published NIH policy statement, and no public NIH announcement has been issued. The government has not responded publicly, and the executive order itself remains in force.
The memo does not indicate that terminated grants will be reinstated. It permits new and continuing meritorious projects to proceed, which is not the same as restoring what was cancelled.
Individual awards can still be stopped. The requirement for State Department review means a project can clear NIH scientific review and still be blocked on foreign policy grounds, and no timeline has been given for how quickly awards will start flowing.
Wider US health assistance is still contracting. Some life-saving support was reinstated after the initial freeze, including parts of the President’s Emergency Plan for AIDS Relief, but the State Department announced a phased drawdown of PEPFAR in June this year.
The next fixed date is 5 December, when the Fogarty exclusion takes effect.
