The activists gathered on the steps of the cathedral in the center of Cape Town. Most were older women, faces lined beneath their head wraps. They converged around a gray-haired man in an oversized coat, his shoulders hunched against the morning chill.
Linking arms, they set out to infiltrate a meeting across the street.
“Ready?” the man said, sounding a little weary, a little nervous.
It had been a while since Zackie Achmat confronted his government about matters of life and death.
Twenty-five years ago, Mr. Achmat co-founded what became the most powerful social movement in post-apartheid South Africa. He led a showdown against the government that won lifesaving medical treatment for millions of people with H.I.V. — and nearly killed him.
Until just a few months ago, Mr. Achmat, 63, thought those days were well behind him. He was spending time on a pomegranate farm, caring for rescue dogs and watching Korean telenovelas. He made a failed bid for parliament on an anti-corruption platform, but he was enjoying watching new generation of activists lead.
As for H.I.V., the issue that once dominated his life, he hardly thought about it. He didn’t need to, so robust was the national treatment program that grew out of the victories that Mr. Achmat and his colleagues won two decades ago.
Then came January, and the Trump administration’s decision to slash its foreign assistance, including funding for the President’s Emergency Fund for AIDS Relief, or PEPFAR. As part of an overall reduction in funds sent overseas, which Mr. Trump has called wasteful and a misuse of taxpayer dollars, PEPFAR’s budget has been sharply reduced.
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