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A woman walks up to the security guards outside a shuttered USAID-funded sexual health clinic in Johannesburg’s inner-city district.

She looks around with confusion as they let her know the clinic is closed.

She tells us it has only been two months since she came here to receive her usual care.

Now, she must scramble to find another safe place for her sexual health screenings and Pre-Exposure Prophylaxis (PrEP) – her regular defence against rampant HIV.

On the day he was sworn in as US president for a second time, Donald Trump signed an executive order freezing foreign aid for a 90-day period.

That is being challenged by federal employee unions in court over what it says are “unconstitutional and illegal actions” that have created a “global humanitarian crisis”.

However the order is already having an immediate impact on South Africa’s most vulnerable.

More on South Africa

Her eyes tear up as she processes the news. Like many sex workers in town, free sexual health clinics are her lifeline.

An HIV-positive sex worker shared her patient transfer letter from the same closed clinic with Sky News and told us with panic that she is still waiting to be registered at an alternative facility.

South Africa is home to one of the world’s worst HIV/AIDS epidemics. At least 8.5 million people here are living with HIV – a quarter of all cases worldwide.

Widespread, free access to antiretroviral treatment in southern Africa was propelled by the introduction of George W. Bush’s US President Emergency Plan for AIDS Relief (PEPFAR) in 2003.

PEPFAR is considered one of the most successful foreign aid programmes in history, and South Africa is the largest recipient of its funds.

A sign for USAID on the clinic's window
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A sign for USAID on the clinic’s window

A shuttered USAID-funded sexual health clinic in Johannesburg
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A shuttered USAID-funded sexual health clinic in Johannesburg

The programme has now been halted by President Trump’s foreign aid funding freeze – plunging those who survived South Africa’s HIV epidemic and AIDS denialism in the early 2000s back to a time of scarcity and fear.

“That time, there was no medication. The government would tell us to take beetroot and garlic. It was very difficult for the government to give us treatment but we fought very hard to win this battle. Now, the challenge is that we are going back to the struggle,” says Nelly Zulu, an activist and mother living with HIV in Soweto.

Nelly says access to free treatment has saved her and her 21-year-old son, who tested positive for HIV at four years old.

“It helped me so much because if I didn’t get the treatment, I don’t think I would be alive – even my son.

“My concern is for pregnant women. I don’t want them to go through what I went through – the life I was facing before. I’m scared we will go back to that crisis.”

Nelly Zulu, an activist and mother living with HIV
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Nelly Zulu, an activist and mother living with HIV

South African civil society organisations have written a joint open letter calling for their government to provide a coordinated response to address the healthcare emergency created by the US foreign aid freeze.

The letter states that close to a million patients living with HIV have been directly impacted by stop-work orders and that a recent waiver by US Secretary of State Marco Rubio continuing life-saving assistance explicitly excludes “activities that involve abortions, family planning, gender or diversity, equality and inclusion ideology programmes, transgender surgeries or other non-life saving assistance”.

The shuttered clinic we saw in Johannesburg’s central business district (CBD) comes under these categories – built by Witwatersrand University to research reproductive health and cater to vulnerable and marginalised communities.

An activist and healthcare worker at a transgender clinic tells us everyone she knows is utterly afraid.

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USAID in turmoil: What you need to know

“Corner to corner, you hear people talking about this. There are people living with chronic diseases who don’t have faith anymore because they don’t know where they are ending up,” says Ambrose, a healthcare worker and activist.

“People keep asking corner to corner – ‘why don’t you go here, why don’t you go there?’ People are crying – they want to be assisted.”

South Africa’s ministry of health insists that only 17% of all HIV/AIDs funding comes from PEPFAR but that statistic is offset by the palpable disruption.

On Monday, minister of health Dr Aaron Motsoaledi met to discuss bilateral health cooperation and new US policy for assistance with US charge d’affaires for South Africa, Dana Brown.

A statement following the meeting says: “Communication channels are open between the Ministry and the Embassy, and we continue to discuss our life-saving health partnership moving forward.

“Until details are available the minister called on all persons on antiretrovirals (ARVs) to under no circumstances stop this life-saving treatment.”

A demand much harder to execute than declare.

“There is already a shortage of the medication – even if you ask for three months’ treatment, they will give you one or two months worth then you have to go back,” says Nelly.

“Now, it is worse because you can see the funding has been cut off.”

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Pope Leo to lead first holy mass in Sistine Chapel after paying surprise visit

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Pope Leo to lead first holy mass in Sistine Chapel after paying surprise visit

Pope Leo will lead his first holy mass as pontiff this morning – after already paying a surprise visit to see staff at his former residence.

Robert Prevost’s life changed forever on Thursday when he went from being one of 252 cardinals to the first-ever American pope.

His was chosen after just four rounds of voting in the Sistine Chapel – a conclave that lasted just 25 hours.

New pope unveiled to the world – as it happened

The 69-year-old Chicago-born cardinal was not seen as a frontrunner but quickly secured the required two-thirds majority.

There was jubilation in St Peter’s Square when white smoke emerged and about an hour later the Pope’s identity was revealed when he stepped onto the balcony.

The choice of Leo is the first time the name has been used since Leo XII – the pope from 1878 to 1903.

More on Pope Leo

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Moment new pope emerges on balcony

Faithful react to the announcement that U.S. Cardinal Robert Prevost has been elected by the conclave as new pope, with the name Pope Leo XIV, at the Vatican, May 8, 2025. REUTERS/Eloisa Lopez     TPX IMAGES OF THE DAY
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People celebrated the new pope’s announcement in St Peter’s Square. Pic: Reuters

Sky News understands one of the first things the Pope did was greet staff at his former residence, Sant’Uffizio Palace, just outside the Vatican.

All eyes will now be on his first mass, when he and other cardinals return to the Sistine Chapel around 10am.

Pope Leo’s first words as leader of 1.4 billion Catholics on Thursday evening were “may peace be with all of you”.

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Conclave: How the last 48 hours unfolded

His balcony speech also paid tribute to his predecessor – who only made him cardinal two years ago and brought him from Peru for a senior Vatican role.

“The pope that blessed Rome gave his blessing to the whole world on that Easter morning. So let us follow up that blessing,” said Leo.

He also called for a “church that builds bridges” and is “able to receive everybody that needs our charity, our presence, dialogue and love”.

Read more:
Who is the new Pope?
What does the Pope’s name mean?
The Pope vs his predecessors

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Trump comments on first US pope

There has long been a taboo against a US pope – given the influence the country already has – but Leo was promoted as a “compromise candidate” ahead of conclave.

His many years as a missionary in Peru are also believed to have given him more universal appeal, especially among the cardinals from Central and South America.

President Donald Trump told reporters having an American in the role for the first time was a “great honour” – and Time magazine has already revealed its cover celebrating the moment.

However, the Pope appears to have taken issue with some of the Trump administration’s views and policies.

His X account posted a link in February to an article criticising comments by the vice president entitled: “JD Vance is wrong: Jesus doesn’t ask us to rank our love for others”.

In April, when President Trump met El Salvador’s leader about using a notorious prison for suspected US gang members, he shared another post stating: “Do you not see the suffering? Is your conscience not disturbed? How can you stay quiet?”

‘Pope played Wordle before conclave’

With many now waiting on the Pope’s next public comments, his brothers have revealed their surprise when they saw him emerge in the white robes on TV.

Eldest brother Louis Prevost told Sky’s US partner NBC News it was “mindblowing”.

“When the cardinal came out and started to read his name, as soon as he went “raw” I knew he was gonna say ‘Roberto’ – and he did – and I just freaked out.”

Mr Prevost added: “We’ve kind of known he was special, and we used to tease him about being pope when he was six years old and stuff.”

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The Pope’s other brother said he had been in contact with him before conclave and joked about watching the hit film of the same name.

“I said did you watch the movie Conclave so you know how to behave,” John Prevost told NBC News.

“And he had just finished watching the movie so knew how to behave; so it’s that kind of stuff because I wanted to take his mind off of it – because this is now an awesome responsibility.”

He also revealed the brothers had played online puzzles Wordle and Words with Friends to take the Pope’s mind off things in the run-up to the election.

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Who is Pope Leo XIV? American Robert Prevost announced as leader of Catholic Church

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Who is Pope Leo XIV? American Robert Prevost announced as leader of Catholic Church

The Vatican has announced the first ever US leader of the Catholic Church – Robert Prevost, who will be known as Pope Leo XIV.

The 69-year-old cardinal was born in Chicago and spent many years as a missionary in Peru.

Follow live updates: New pope elected

He was made a cardinal by Pope Francis in 2023 and appointed head of the dicastery for bishops, a powerful position responsible for selecting new bishops.

Significantly, he presided over one of Francis’s most revolutionary reforms when he added three women to the voting bloc which decides on the bishop nominations sent to the Pope.

In this photo released by the Diocese of Chulucanas, Bishop Robert Prevost leads an anniversary celebration of the Diocese in Chulucanas, Peru, Monday, Aug. 12, 2024. (Diocese of Chulucanas via AP)
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Bishop Robert Prevost leading a celebration in Peru last August. Pic: AP

As cardinal, he said little on key issues of the church, but some of his positions are known.

He is reportedly very close to Francis’s vision regarding the environment, outreach to the poor and migrants. He said in 2024 “the bishop is not supposed to be a little prince sitting in his kingdom”.

More on Pope Leo

He also supported Pope Francis’s stance on allowing divorced and remarried Catholics to receive Holy Communion.

However, he only showed mild support for Francis allowing priests to bless same-sex couples.

New Cardinal Robert Francis Prevost receives his biretta as he is appointed cardinal by Pope Francis in 2023.
Pic: EPA/Shutterstock
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Cardinal Prevost being appointed by Francis in 2023. Pic: EPA/Shutterstock

Pope Leo has years of experience in leadership roles within the church.

He was twice elected to the top position of the Augustinian religious order and Francis clearly had an eye on his progress – moving him from the Augustinian leadership back to Peru in 2014, where he served as administrator and later archbishop of Chiclayo.

He acquired Peruvian citizenship in 2015 and remained in Chiclayo until 2023, when Francis brought him to Rome.

In this photo released by the Diocese of Chulucanas, Bishop Robert Prevost leads the celebration anniversary of the Diocese in Chulucanas, Peru, Aug. 12, 2024. (Diocese of Chulucanas via AP)
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Pope Leo’s years in Peru made him a more universal candidate for the papacy. Pic: AP

While there has long been a taboo against a US pope – given the geopolitical power the US already wields – Leo was being promoted as a “compromise candidate” ahead of the conclave.

The amount of time he has spent in Peru also allowed him to be seen as a more universal candidate.

The world learned a new pope had been chosen at around 6.08pm local time (5.08pm UK time) on Thursday as white smoke suddenly emerged from the chimney of the Sistine Chapel.

Read more:
First US pope chosen

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New pope elected by conclave

The 133 cardinals sequestered in the chapel picked the new leader of the Catholic Church on the second day of the conclave.

As the smoke appeared, cheers went up in St Peter’s Square, where thousands of people had gathered in the hope of witnessing history.

Just over an hour later, the Pope was introduced on the central balcony of St Peter’s Basilica as a crowd of an estimated 50,000 people looked on.

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Pope Leo’s first address

Delivering an address from the balcony, Pope Leo – speaking in Italian – told the crowds: “Peace be with you all.”

He then thanked his predecessor and repeated Francis’s call for a church that is engaged with the modern world and “always looking for peace, charity and being close to people, especially those who are suffering”.

Newly-elected Pope Leo XIV appears on the balcony of St Peter's Basilica at the Vatican. Pic: Reuters
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Newly-elected Pope Leo XIV appears on the balcony of St Peter’s Basilica at the Vatican. Pic: Reuters

“Together we must try to find out how to be a church that builds bridges, establishes dialogue and is open to receiving everybody,” he said.

Speaking in Spanish, he added: “I would particularly like to say hello to my compatriots from Peru.

“It was a great pleasure for me to work in Peru.”

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The demands and challenges facing the new pope

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The demands and challenges facing the new pope

There is a long list of demands in the new pope’s in-tray, ranging from the position of women in the church to the ongoing fight against sexual abuse and restoring papal finances.

People both inside the Catholic Church and around the world will be watching how the new pontiff deals with them.

US Cardinal Robert Francis Prevost was elected as the new pope on Thursday after just two days of conclave.

The 69-year-old, who becomes the first American pope, will take the name Leo XIV.

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‘Evil will not prevail, we are all in the hands of God’, the new American Pope told the crowd.

On Friday, Pope Leo will lead his first holy mass as pontiff after already paying a surprise visit to see staff at his former residence.

Here, Sky News Europe correspondent Siobhan Robbins takes an in-depth look at the challenges facing the new pontiff.

Sexual abuse

Many Catholic insiders credit Pope Francis with going further than any of his predecessors to address sexual abuse.

He gathered bishops together for a conference on the issue in 2019 and that led to a change that allows cooperating with civil courts if needed during abuse cases.

But it didn’t go as far as forcing the disclosure of all information gathered in relation to child abuse.

Any abuse allegations must now be referred to church leaders, but reformers stopped short of decreeing that such cases should also be automatically referred to the police.

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Clerical abuse victim says church still has ‘so much to do’

While many abuse victims agree they saw progress under Pope Francis, who spent a lot of time listening to their accounts, they say reforms didn’t go far enough.

The next pope will be under pressure to take strong action on the issue.

Newly-elected Pope Leo XIV appears on the balcony of St Peter's Basilica at the Vatican. Pic: Reuters
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Newly-elected Pope Leo XIV appears on the balcony of St Peter’s Basilica at the Vatican. Pic: Reuters

Women

Pope Francis also did more to promote women in the Vatican than any other pontiff.

Two years ago, he allowed women to vote in a significant meeting of bishops.

While he was clear he wanted women to have more opportunities, he resisted the idea that they needed to be part of the church hierarchy and didn’t change the rules on women being ordained.

A woman kneels at St. Peter's Square, on the first day of the conclave to elect the new pope, at the Vatican, May 7, 2025. REUTERS/Eloisa Lopez
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A woman kneels at St. Peter’s Square, on the first day of the conclave to elect the new pope. Pic: Reuters

His successor will need to decide if they push this agenda forward or rein it back in.

It’s a pressing concern as women do a huge amount of the work in schools and hospitals, but many are frustrated about being treated as second-class citizens. 10,000 nuns a year have left in the decade from 2012 to 2022, according to Vatican figures.

Inclusion

“Who am I to judge?” Pope Francis famously said when asked about a gay monsignor in 2013.

His supporters say he sought to make the church more open, including allowing blessings for same sex couples but while critics argue he didn’t go far enough, some conservatives were outraged.

A gay couple kisses each other as thousands of catholics and conservatives gather together against the legalization of gay marriage and to defend their interpretation of traditional family values in Monterrey City, Mexico September 10, 2016. REUTERS/Daniel Becerril
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A gay couple kiss at a Catholic protest against the legalisation of gay marriage in Mexico. File pic: Reuters

African bishops collectively rejected blessings for same sex couples, saying “it would cause confusion and would be in direct contradiction to the cultural ethos of African communities”.

How welcome LGBTQ+ people feel in the church will depend partly on decisions made by the pontiff.

Conversely, the Pope must also bring together disparate groups within the Catholic faith.

Many are demanding a leader who can unite the various factions and bring stability in an increasingly unstable world.

The global south

While the Catholic church is losing members in its traditional base of Europe, it’s growing rapidly in the global south.

The area has become the new centre of gravity for Catholicism with huge followings in countries like Brazil, Mexico and the Philippines.

Pope Francis tried to expand representation by appointing more cardinals from different areas of the world, and the new Pope will be expected to continue this.

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Behind the scenes at the conclave

Finance

The Vatican is facing a serious financial crisis.

The budget deficit has tripled since Pope Francis’s election and the pension fund has a shortfall of up to €2bn (£1.7bn).

These money worries, which were compounded by COVID-19 and long-standing bureaucratic challenges, represent a major concern for the next pope.

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