The United States is planning to gradually reduce its direct financial support for Namibia’s HIV response programs, with the expectation that Namibia will take over funding its own initiatives by the 2027 fiscal year. According to a joint statement from both countries, the U.S. will provide $45 million for Namibia’s HIV response in 2027 but will shift to offering "technical cooperation" instead of direct financial aid. Namibia has historically received about $45 million annually through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), and the U.S. claims it has contributed over $1.1 billion to Namibia’s HIV efforts since 2003. The decision to reduce funding comes after Namibia rejected proposed terms that would have allowed the U.S. to access health data and biological specimens from the country. Namibia cited concerns about privacy, national sovereignty, and legal compliance in its decision. This aligns with a broader strategy by the Trump administration to reduce donor dependency in recipient countries, encourage domestic funding, and protect American interests. Since late last year, the U.S. has signed similar agreements with approximately 30 countries, many located in Africa. However, other nations have also resisted similar data-sharing proposals. For example, Ghana rejected a proposed agreement over concerns about access to sensitive health data, Zimbabwe withdrew from a $367 million funding package over similar issues, and Kenya’s $2.5 billion agreement is currently on hold due to a court challenge. Zambia has also raised objections to U.S. data-sharing demands. Namibia had previously stated that the original terms of the agreement were "not in compliance with Namibia's national laws" and violated constitutional privacy protections and national sovereignty over biological resources. Both countries are currently negotiating a new bilateral health agreement. The joint statement noted that Namibia has exceeded UNAIDS targets, with 96% of people living with HIV knowing their status, 98% of those diagnosed receiving treatment, and 98% of those treated achieving viral suppression. The U.S. and Namibia stated that over the next year, the support will transition into a technical cooperation model, integrating the HIV response into Namibia’s sustainable national health system, in accordance with Namibia’s national laws. This shift in U.S. policy is part of a broader trend. Recently, the U.S. announced it would phase out more than $400 million in annual support for South Africa’s HIV programs. It has also begun a "phased drawdown" of PEPFAR, a program that has supported South Africa’s fight against HIV and AIDS for 20 years and is widely credited with saving more than 20 million lives during that time.