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South Africa’s HIV/Aids patients worry about treatment

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Mayeni Jones

BBC News, Johannesburg

Reuters A glove-wearing nurse takes a blood sample from a child for an HIV test while the child's mother looks on at a clinic in Diepsloot, north of Johannesburg, South Africa, 12 March2025Reuters

Gugu used to collect her antiretrovirals from a USAID-funded clinic in downtown Johannesburg.

But when President Trump’s cuts to aid funding were announced earlier this year, she and thousands of other HIV-positive patients across South Africa suddenly faced an uncertain future.

Gugu was lucky, the clinic where she got the medication that helps suppress her symptoms contacted her before it closed down.

“I was one of the people who was able to get their medication in bulk. I usually collect a three-month prescription. But before my clinic closed, they gave me nine months’ worth of medication.”

She will run out of antiretrovirals (ARVs) in September, and then plans on going to her local public hospital for more.

A former sex worker, the 54-year-old found out she was HIV-positive after she’d quit the industry.

Ten years ago she got a chesty cough, and initially thought it was tuberculosis. She went to a doctor who told her she had a chest infection and treated her for it.

But when the treatment failed, she went to a clinic to get an HIV test.

“By then I already assumed that I was HIV-positive, and I told the nurse this.”

She was right, and she has been on ARVs ever since. We’re not using her real name at her request.

She currently works as a project coordinator for an NGO.

“We help pregnant sex workers get their ARVs, to ensure their children are born HIV-negative. We also do home visits to make sure that the mothers take their medication on time, and to look after their babies when they go for their monthly check-ups.”

Many HIV-positive sex workers in South Africa relied on private clinics funded by the US government’s now-defunct aid agency, USAID, to get their prescriptions and treatments.

But most of the facilities closed after US President Donald Trump cut most foreign aid earlier this year.

In a report due to be released on Thursday, the UN body in charge of fighting HIV/Aids does not single out the US, but says that drastic cuts from a number of donors have sent shockwaves around the world, and the “phenomenal progress” in tackling the illness risks being reversed.

“New HIV infections have been reduced by 40% since 2010, and 4.4 million children have been protected from acquiring HIV since 2000. More than 26 million lives have been saved,” UNAIDS says, warning that if the world does not act, there could be an extra six million new HIV infections and four million Aids-related deaths by 2029.

Gugu believes that many sex workers could be discouraged from going to public hospitals for their HRVs..

“The problem with going to public hospitals is the time factor. In order to get serviced at these facilities, you have to arrive at 4 or 5am, and they may spend the whole day waiting for their medication. For sex workers, time is money,” Gugu says.

She adds that she recently went to her local clinic with some friends to register her details and build a relationship with staff.

“The nurse who attended to us was very rude. She told us there was nothing special about sex workers.”

She thinks this could lead to many sex workers defaulting on their medication, “especially because their hospital files contain a lot of personal information, and the concern is that sometimes the nurses at these local clinics aren’t always the most sensitive in dealing with this kind of information.”

According to the UN, the US cuts to HIV funding could reverse some of the gains made by what has been called one of the most successful public health interventions in history.

Scientists in the UK-based Lancet medical journal last month estimated that USAID funding directly reduced Aids deaths by 65%, or 25.5 million, over the past two decades.

Getty Images Standing at a podium, George W. Bush, in a suit, turns his head as South Africa's Thandazile Darby and Dr Helga Holst, both seated with children, applaud on 1 December 2005 as World Aids Day is commemorated in the Eisenhower Executive Office Building in Washington, DC.Getty Images

Former US President George W Bush is widely acknowledged for his commitment to tackling HIV/Aids

Then-US President George W Bush launched an ambitious programme to combat HIV/Aids in 2003, saying it would serve the “strategic and moral interests” of the US.

Known as the President’s Emergency Plan for Aids Relief (Pepfar), it led to the investment of more than $100bn (£74bn) in the global HIV/Aids response – the largest commitment by any nation to address a single disease in the world.

South Africa has about 7.7 million people living with HIV, the highest number in the world, according to UNAIDS.

About 5.9 million of them receive antiretroviral treatment, resulting in a 66% decrease in Aids-related deaths since 2010, the UN agency adds.

South Africa’s government says Pepfar funding contributed about 17% to its HIV/Aids programme. The money was used for various projects, including running mobile clinics to make it easier for patients to get treatment.

The Trump administration’s cuts have raised concern that infection rates could spike again.

“I think we’re going to start seeing an increase in the number of HIV infections, the number of TB cases, the number of other infectious diseases,” Prof Lynn Morris, Deputy Vice-Chancellor of Johannesburg’s Wits University, tells the BBC.

“And we’re going to start seeing a reversal of what was essentially a real success story. We were getting on top of some of these things.”

Gugu points out that treatment is a matter of life and death, especially for vulnerable populations like sex workers.

“People don’t want to default on their ARVs. They’re scared that they’re going to die if they don’t get access to them.

The cuts have also affected research aimed at finding an HIV vaccine and a cure for Aids.

“There’s the long-term impact, which is that we’re not going to be getting new vaccines for HIV,” Prof Morris adds.

“We’re not going to be keeping on top of viruses that are circulating. Even with new viruses that might appear, we’re not going to have the surveillance infrastructure that we once had.”

South Africa has been one of the global leaders in HIV research. Many of the medications that help prevent the virus, and which have benefitted people around the world, were trialled in South Africa.

This includes Prep (pre-exposure prophylaxis), a medication which stops HIV-negative people from catching the virus.

Another breakthrough preventive drug released this year, Lenacapavir, an injection taken twice a year and that offers total protection from HIV, was also tried in South Africa.

Prof Abdullah Ely is in his lab, in a white coat and blue gloves

South African academic Prof Abdullah Ely is concerned that research will be affected by the US funding cut

In a lab at Wits University’s Health Sciences campus, a small group of scientists are still working on a vaccine for HIV.

They are part of the Brilliant Consortium, a group of labs working across eight African countries to develop a vaccine for the virus.

“We were developing a vaccine test to see how well that works, and then we would trial it on humans,” Abdullah Ely, an Associate Professor at Wits University, tells the BBC in his lab.

“The plan was to run the trials in Africa based on research carried out by Africans because we want that research to actually benefit our community as well as all mankind.”

But the US funding cuts threw their work into doubt.

“When the stop order came, it meant we had to stop everything. Only some of us have been able to get additional funding so we could continue our work. It’s set us back months, probably could even be a year,” Prof Ely says.

The lab lacks funding to carry out clinical trials scheduled for later this year.

“That is a very big loss to South Africa and the continent. It means that any potential research that comes out of Africa will have to be tested in Europe, or the US,” Prof Ely says.

In June, universities asked the government for a bailout of 4.6bn South African rand ($260m; £190m) over the next three years to cover some of the funding lost from the US.

“We are pleading for support because South Africa is leading in HIV research, but it’s not leading for itself. This has ramifications on the practice and policies of the entire globe,” says Dr Phethiwe Matutu, head of Universities South Africa.

South Africa’s Health Minister Aaron Motsoaledi announced on Wednesday that some alternative funding for research had been secured.

The Bill and Melinda Gates Foundation and the Wellcome Trust have agreed to donate 1m rand each with immediate effect, while the government would make available 400m rand over the next three years, he said.

This would bring the total to 600m rand, way below the 4.6bn rand requested by researchers.

As for Gugu, she had hoped that by the time she was elderly, a cure for HIV/Aids would have been found, but she is less optimistic now.

“I look after a nine-year-old. I want to live as long as I can to keep taking care of him,” she tells the BBC.

“This isn’t just a problem for right now, we have to think about how it’s going to affect the next generation of women and young people.”

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Live updates: Trump’s UK state visit

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Welcome to our live coverage of US President Donald Trump’s administration, including his state visit to the UK.

As we’ve previously reported, this is the president’s second visit to the UK.

Last night, Trump and first lady Melania Trump were greeted at London Stansted Airport by members of the Royal Air Force and British officials, including Foreign Secretary Yvette Cooper. The Trumps then spent the evening at Winfield House, the residence of the US ambassador to the UK, Warren A. Stephens.

Guests traveling with the president included his daughter Tiffany Trump and her husband, chief of staff Susie Wiles, deputy chief of staff Stephen Miller, and press secretary Karoline Leavitt.

Later today, the president and first lady will travel to Windsor for a ceremonial welcome, lunch with the royal family, an air force flypast, and a lavish state banquet.

Tomorrow, Trump will head to Chequers, the UK prime minister’s country retreat, for a bilateral meeting with Keir Starmer. Initially, the first lady will remain at Windsor, where she will carry out two engagements with Queen Camilla and Catherine, Princess of Wales.

She will later reunite with her husband at Chequers before they fly back to the US.

We’ll keep you up to date with all of the movements today, as they happen.



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American independent cinema owes much to Sundance king Robert Redford | Robert Redford

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Robert Redford, who died at the age of 89 on Tuesday, will rightly be remembered as one of Hollywood’s finest leading men, a true-blue movie star and assured actor who was, to quote my mother and surely many others, “very, very handsome”. His many iconic performances – in Butch Cassidy and the Sundance Kid, All the President’s Men, The Way We Were, The Sting and more – certainly left an indelible mark on American movies. But he should perhaps be remembered more for his work behind the camera, as the country’s greatest benefactor of independent cinema.

Through his Sundance film festival and non-profit institute, Redford lent his considerable star power and funds to American independent film, and created what is still its most secure and enduring pillar of support. He provided maverick, cutting-edge film-making with a freewheeling marketplace and crucial buzz, helping to launch the careers of a true who’s who of critically acclaimed directors across generations. With Sundance, Redford played the role of mentor, patron, champion of the small and scrappy, benevolent godfather of independent cinema. It’s through Sundance, rather than his films, that Redford became, as the Black List founder Franklin Leonard put it on X, “arguably the film industry’s most consequential American over the last fifty years”.

Redford founded the Sundance Institute, named after his character in the 1969 film, in 1981, as a means to support risk-taking voices outside the Hollywood studio system. The mission was loose, but grounded in the then 44-year-old actor’s real frustration with the movie business. “We started this with no rigid expectations,” Redford told the critic Roger Ebert at an early iteration of the film festival in 1981. “I have no idea what this will turn out to be. I know that it’s getting increasingly hard to get a movie well distributed in this country unless it has the potential to make millions of dollars.” As an alternative experiment, Redford invited 10 screenwriters to develop their low-budget scripts at a cabin in Utah’s Wasatch mountains, where the reclusive star had purchased land and made his home.

Reservoir Dogs. Photograph: Rank/Sportsphoto/Allstar

The tiny Sundance Institute grew into a small festival after Redford purchased the struggling Utah/US film festival in 1984. By 1989, when Steven Soderbergh’s Sex, Lies and Videotape premiered at what had become an annual January gathering in Park City, the Sundance film festival (as it was renamed in 1991) represented the creative vanguard. Some of the most influential and enduring films of the 1990s came out of the festival – Reservoir Dogs, Before Sunrise and The Blair Witch Project, as well as the documentaries Hoop Dreams and Paris Is Burning.

The festival has built a reputation as a pipeline of diverse talent; top directors such as Quentin Tarantino, Richard Linklater, Chloé Zhao, Ava DuVernay, Ryan Coogler, Nicole Holofcener, David O Russell, Darren Aronofsky, the Daniels and Celine Song have all been nurtured at some point in their early career by Sundance. In 2022, Coda, directed by Sian Heder with a $10m budget, became the first festival premiere to win the best picture Oscar. “Coda came to the attention of everyone because of Sundance,” its star Marlee Matlin posted on X. “And Sundance happened because of Robert Redford.”

Alongside its renegade narrative features, the festival has also become the go-to destination for hot-button documentaries, particularly those grappling with tough, timely subjects. The documentary streaming boom arguably began at the festival in 2017, when Netflix purchased Icarus, a film on the Russian doping scandal that went on to win the Oscar – Netflix’s first – for a then staggering sum of $5m. For several years after, the festival was a hot marketplace for documentaries large and small. Celebrities such as Taylor Swift, Brooke Shields and Michael J Fox debuted films about them in Utah; documentaries on such figures as Christopher Reeves, the Russian opposition leader Alexei Navalny and Hillary Clinton generated international headlines and commanded ever-larger sums. Though the market has cooled, the festival remains an incubator for pressing documentaries – this year saw films on Florida’s stand-your-ground laws, abysmal Alabama prisons and US book bans in schools – as well as awards. Institute-supported documentaries have won a total of 20 Oscars; all but one of last year’s best documentary nominees premiered at the festival.

With mainstream acclaim come major celebrities, and with celebrities come crowds, sponsors and influencers. Starting in the 2010s, the festival has been as synonymous with celebrities in trendy winter wear, long lines and pop-up brand houses as independent film. After years of logistical issues – what once drew a few hundred cinephiles to the mountains now courts upwards of 85,000 visitors every January – the festival announced earlier this year that it would relocate in 2027 to Boulder, Colorado.

Robert Redford at the 2003 Sundance film festival. Photograph: Douglas C Pizac/AP

But the institute has remained true to Redford’s founding mission. According to Sundance, more than 11,000 early career artists have received support since its founding, in the form of grants, labs, intensive programs, mentorship and fellowships. I personally know film-makers and writers who have applied to the lab, considered the pinnacle of early-stage mentorship, an imprimatur of taste and trust. And since the establishment of its Native American and Indigenous program in 1994, the non-profit remains one of the pre-eminent supporters of Indigenous film talent too-long ignored by institutional Hollywood. The program’s grants, labs and community have helped launch the careers of Chris Eyre (whose film Smoke Signals premiered in 1998), Reservation Dogs’ Sterlin Harjo and Taika Waititi.

In his later years, Redford often groused about the mainstreaming of the festival to which he devoted nearly half his life; “I want the ambush marketers – the vodka brands and the gift-bag people and the Paris Hiltons – to go away forever,” he told a reporter during the 2012 festival. It is true that the festival is not the iconoclastic upstart it once was, and that the festival produces a few imitative “Sundance movies” – spare, underwritten dramas with beautiful vistas and natural light – every year. But the impact of Sundance – in time, in space, in mentorship, money and community – is incalculable to the landscape of American cinema. Redford’s goal, as he said in his 2002 honorary Oscar speech, was to “make sure the freedom of artistic expression is nurtured and kept alive”. With 40 years of stewardship at Sundance, Robert Redford has done more than most to ensure that it will.



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Main suspect in Madeleine McCann case due to be released from German prison | Germany

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The main suspect in the disappearance of Madeleine McCann is expected to be freed on Wednesday as German authorities admit they no longer have legal justification to hold him in jail.

Christian Brückner, 49, is due to be released from prison in Sehnde, northern Germany, after serving a sentence for the rape of an American woman, then 72 years old, in Portugal in 2005.

The rape took place in Praia da Luz, the holiday resort on the southern Portuguese coast where the three-year-old British toddler disappeared 18 months later.

German prosecutors say that Brückner, a German national, remains their prime suspect in the disappearance, which they are treating as a murder inquiry. British police call him a suspect in their investigation, which they continue to treat as a missing-persons case.

Madeleine went missing on 3 May 2007 while on holiday with her parents. She vanished from the ground-floor apartment where the family was staying, while her parents were at a restaurant close by. Her young twin siblings had been in the room with her.

Hans Christian Wolters, a lead investigator in the case, reiterated in a recent interview his belief that Brückner was responsible for the girl’s disappearance. “We believe that he is responsible for the disappearance of Madeleine McCann and that he killed Madeleine McCann,” he said in a recent statement.

Prosecutors have urged authorities to ensure Brückner is fitted with an electronic ankle tag so that his movements can be tracked, but it is unclear whether the court will agree to this. They have also requested that Brückner relinquish his passport and report regularly to authorities, citing fears that he might try to leave the country.

German police have been investigating Brückner since 2017. State prosecutors have said they have circumstantial evidence indicating his possible involvement in Madeleine’s disappearance. These include that his mobile phone was on and logged in in the area where she vanished, and the sworn testimony of three witnesses who say he confessed to them.

After being alerted about Brückner following a TV crime programme in Germany that called for information a decade after the child’s disappearance, the federal criminal police office named him as a suspect in 2020. They revealed he had convictions going back decades for child sex offences and other crimes, including drug trafficking, burglary and petty theft.

Brückner had lived in the Algarve region of Portugal between 1995 and 2007, and had worked at the Praia da Luz resort as a pool maintenance assistant.

Last autumn, Brückner was cleared by a court in the northern German city of Braunschweig of several unrelated sexual offences, alleged to have occurred between 2000 and 2017. He has consistently denied any involvement in Madeleine’s disappearance.

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Ahead of Brückner’s release, his lawyer, Friedrich Fülscher, said in a statement that no comment would be made to the media outside the prison either by him or Brückner.

Brückner has refused a request by British authorities, made through an “international letter of request”, for an interview on his release.

DCI Mark Cranwell, a senior investigating officer for London’s Metropolitan police, said the request had been “refused by the suspect”. He added that the Met would “nevertheless continue to pursue any viable lines of inquiry”.

After completing his seven-anda-half-year sentence for the 2005 rape, Brückner had been expected to stay behind bars until January 2026 because of his owing €1,447 (£1,253) in fines for a separate offence. However, a former police officer who had worked on the investigation into Brückner paid the fine because, she has said, she “felt sorry” for him. She has since said she made a mistake.



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