US-South Africa Health Research Resumes After NIH Secures Funding Exemption

RESEARCH COLLABORATION RESUMES AFTER NIH EXEMPTION FROM TRUMP FOREIGN AID FREEZE

Scientists and public health researchers working across the US-South Africa partnership can now proceed with federally funded projects after a policy clarification from the National Institutes of Health. The agency announced this week that it has secured an exemption from an executive order issued by President Donald Trump in February 2025 that halted all foreign aid to South Africa, clearing the way for continued research collaboration on diseases including HIV and tuberculosis.

The decision came through an internal memo sent Wednesday by NIH Director Dr Jay Bhattacharya to staff, reported by the journal Science and reviewed by Health Policy Watch. The memo establishes that NIH grants operate under a different legal framework than traditional foreign assistance programs, allowing the agency to continue funding meritorious research projects in South Africa while remaining compliant with the broader administration policy.

Bhattacharya’s reasoning rests on a distinction between foreign aid and scientific collaboration. NIH grants are designed to “foster global scientific exchange” rather than serve as foreign assistance, the memo states. The director further notes that Congress has “explicitly authorised NIH to engage in international research collaborations” and that the agency’s funding mechanisms fall outside the scope of the Foreign Assistance Act that governs traditional aid programs.

The resumption of funding carries conditions. All research must demonstrate “a clear scientific rationale” for why it cannot be conducted in the United States and must have “direct potential to generate knowledge applicable to understanding, improving or protecting the health of Americans.” Projects also remain subject to standard NIH review processes, State Department review, and NIH policies governing foreign research structures.

What this means for ordinary Americans is not abstract. The US-South Africa research relationship spans decades, with particularly deep roots in HIV and tuberculosis research where both nations have contributed substantially to global scientific understanding. The freeze had created uncertainty about ongoing collaborations and threatened to disrupt projects mid-course, with potential knock-on effects for public health knowledge that benefits patients far beyond either country’s borders.

Trump’s February order targeted South Africa on two grounds, both characterized by the administration as “egregious acts.” The first involves land expropriation policy. The order claims the South African government has enacted legislation to “seize ethnic minority Afrikaners’ agricultural property without compensation.” This characterization differs from the actual 2024 law, which enables government expropriation of land without compensation only in exceptional circumstances following due process. The law does not specify ownership by any particular ethnic group and applies to unused municipal land as well as privately held property.

The second rationale centers on South Africa’s case against Israel at the International Court of Justice, in which South Africa alleges genocide. Trump’s order states this legal action undermines US foreign policy objectives.

The executive order itself contains language that allows agency heads discretion to permit aid when they determine it necessary or appropriate, a provision that gave the NIH director room to interpret the agency’s research funding as falling outside the aid freeze. The memo makes clear that while South Africa-based research can proceed, projects must still satisfy rigorous scientific standards and pass through established review channels before funding flows.

Meanwhile, the clarification resolves immediate questions about the status of active grants and allows researchers on both sides to plan future collaborations with greater certainty. The conditions attached to the exemption mean that not all proposed research will automatically qualify; each project must demonstrate its scientific merit and relevance to American health outcomes under the framework Bhattacharya outlined.

Whether that bar proves straightforward to clear in practice, or whether it introduces new delays for researchers whose work straddles both nations’ public health needs, remains to be seen as the first post-exemption grant applications move through review.