Experts have warned that South Africa risks a return to the dark days of multiple Aids-related deaths unless it resolves the funding cut crisis, and escalates its progress towards achieving the UNAids 95-95-95 target, reports TimesLIVE.
A visit to Umlazi, KwaZulu-Natal last week by the Aids Healthcare Foundation (AHF) global board was meant to be a reaffirmation of support. Instead, it was a sobering encounter of the harsh realities faced by South Africa’s frontline health workers – where the fight against HIV/Aids is waged not only in clinics, but in communities gripped by poverty, violence and dwindling resources.
The sprawling township is the epicentre of the national HIV pandemic, carrying the country’s highest prevalence rate: South Africa itself is home to the largest population of HIV+ people globally – an estimated 7.8m.
But the withdrawal of US funding has left local clinics scrambling to maintain services, with staff stretched thin and security threats rising.
At Umlazi K Clinic, which serves more than 6 000 patients – half of them HIV positive – Sister Nonhlanhla Ntombela has weathered nearly three decades of this storm, and, she said, challenges are mounting.
“We’ve come a long way since the 90s, when people were dying in numbers because ARVs weren’t available,” she told delegates. “But we’re losing patients not to the virus, but to poverty, crime and neglect.
“Some patients default on treatment because they can’t afford transport. Others are migrants who disappear before we can trace them. And many young girls, barely in their teens, are infected after being exploited by older men who offer them money or phones,” she said.
Ntombela was hijacked inside the clinic in July. “Doctors are afraid to come here. Patients have been stabbed outside. But we carry on. We have to.”
AHF, which began in 1987 as a hospice in Los Angeles, now supports more than 2.5m patients across 48 countries. South Africa is its largest programme, with 261 000 patients served through 51 clinics: 27 in KwaZulu-Natal, 17 in the Eastern Cape, five in Mpumalanga and two in Gauteng.
The organisation’s first South African clinic, Ithembalethu in Umlazi, was destroyed during the July 2021 riots.
Dr Logandran Naidoo, AHF’s national medical director, expressed concern about the slow progress of the UNAids 95-95-95 targets. “We were making progress. Now, we risk sliding back to the days when HIV was a death sentence.”
He added that the loss of US funding has had a devastating impact on the fight against HIV and Aids in Africa.
“We’ve lost nurses, counsellors, data capturers and tracers – and even research capacity. We cannot afford to return to the environment of 20 years ago, where millions died simply because ARVs weren’t available.”
He also warned that the health system must now pivot to address comorbidities.
“Just before the funding cut, we had made tremendous progress. More people were dying of diabetes, hypertension and renal disease than HIV. Even patients with HIV don’t die from it – they die from the other diseases.”
Rodney Wright, who led the board delegation, said the visit was part of a regional tour that includes Zimbabwe and Zambia, and that they would be presenting their findings to AHF’s headquarters in the US.
“Clearly, we need more funding. We need more of these partnerships (with the Health Department) because they save lives.”
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