One of the most horrific and apocalyptic documents I’ve ever come across

The U.S. aid freeze shows how easily dependency can be weaponised. Programmes addressing HIV, maternal health, SRH and TB could grind to a halt, leaving millions at risk. This dependency mirrors colonial-era resource exploitation.

Global health funding reflects hierarchies of power. South Africa is positioned as a recipient of aid, not an equal partner. This reinforces global inequalities, keeping countries in the Majority World dependent.

This is imperialism in action. Decisions about our health systems are made Washington, undermining our sovereignty. Meanwhile, local needs, like strengthening the entire health system, can take a backseat to donor priorities.

Aid isn’t just charity, it’s a tool of soft power. The U.S. uses foreign assistance to advance its own political and economic goals. Conditions like the Global Gag Rule show how aid often imposes Western agendas on countries like ours.

Enter foreign aid. Programmes like PEPFAR & USAID stepped in to address crises like HIV but instead of building long-term local capacity, these initiatives entrenched dependency. The U.S. controls priorities, creating a neo-colonial dynamic of giver vs. receiver.

But why is South Africa so dependent on U.S. aid for health? It starts with our history: colonialism and apartheid created deep inequalities, leaving our public health system underfunded and ill-equipped to meet the needs of the majority population.