The US has permanently stopped funding thousands of health-care programmes in South Africa, with notifications sent to affected organisations.

The move comes almost a month after US President Donald Trump halted most aid to South Africa after accusing the government of confiscating privately owned land. The nation’s authorities haven’t appropriated any personal land since apartheid ended in 1994.

“The termination orders are coming through in droves,” Desmond Tutu Health Foundation Chief Executive Officer Linda-Gail Bekker said in an interview.

The United States Agency for International Development letters, earlier published by local news service Bhekisisa, were also sent to groups funded by the President’s Emergency Plan for AIDS Relief, or PEPFAR.

While PEPFAR funding accounts for about 17% of South Africa’s HIV/AIDS budget, “the entire programme is at risk, because so many critical projects, such as monitoring and testing, will be weakened,” Bekker and others said in a statement.

A US-funded HIV vaccine trial, where South African Medical Research Council had teamed up with scientists from eight countries on the continent, has been halted because of the terminated financing.

The US earlier this month issued a waiver to allow some PEPFAR activities to resume in South Africa, focusing on “life-saving” tasks such as HIV care, testing, counselling, and medicine procurement. The waiver also covers salaries for critical health workers and staff, and was set for 90 days. Even so, the chaos from how the stop-work orders were implemented resulted in many clinics remaining closed.

“Crucial support staff will be lost as well, putting further pressure on the country’s already stressed public health service,” the group known as Change said. “The South African government has an obligation and duty to act with urgency to respond to both these drastic cuts, and the attack on South Africa’s HIV and TB programming.”