the BBC. Dr Aaron Motsoaledi, responding to US termination notices issued late on Wednesday, said the cuts could lead to deaths, but he had instructed state-funded clinics to ensure no patient went without life-saving drugs.

There is chaos as many affected organisations scramble to find alternative help for some 900,000 HIV patients by the end of the day. "Instead of a careful handover, we're being pushed off a cliff," said Kate Rees from the Anova Health Institute, one of the biggest recipients of special US funding to counter the spread of HIV.

These cuts to the US's HIV programme, known as the US President's Emergency Plan for Aids Relief (Pepfar), are part of wider cost-cutting drive to reduce American government spending. Pepfar was launched in 2003 by then US President George W Bush and its funding is distributed via the US government's main overseas aid agency USAID. It has been regarded as a ground-breaking scheme that has enabled some of the world's poorest people to access anti-retroviral drugs (ARVs) and has saved more than 25 million lives worldwide.