More than 1 400 cervical cancer patients in Gauteng will be transferred to already overstretched public hospitals after the abrupt closure of several cervical cancer screening and prevention clinics operated by the Clinical HIV Research Unit (CHRU), in the wake of the US funding stoppages.
CHRU clinics have played a critical role in the early detection, diagnosis, and treatment of cervical cancer for 20 years, writes Yoliswa Sobuwa for Health-e News, and the future of affected women looks bleak.
Cervical cancer is a leading cause of cancer-related deaths among South African women, being the second most common cancer in women, with an estimated 6 000 new cases diagnosed annually and nearly 3 000 women dying from the disease annually.
“Our colposcopy (follow-up service for women with abnormal PAP smears) clinic has been a lifeline for surrounding clinics, with a referral base from clinics as far as Springs, Randburg, Bellavista, Soweto, Roodepoort and Hillbrow. We’ve been able to manage a waiting time of just two to three weeks, but now, these same clinics will be faced with months of delays, and women will be turned away,” said Dr Mark Faesen, a specialist gynaecologist and fertility expert at CHRU.
Faesen adds that many of the women served by CHRU present with severe pre-malignant conditions, which, if left untreated, can rapidly progress to cervical cancer.
“At the clinic, we diagnose more than 15 cases of cervical cancer every year. Alarmingly, more than 50% of these cases are in women under 50, and 20% affect women younger than 40,” he said.
Vital research under threat
Beyond patient care, the funding cuts also threaten the future of vital cervical cancer research conducted at four clinical research sites at Helen Joseph Hospital, Sizwe Tropical Disease Hospital, King Dinuzulu Hospital, and Empilweni TB Hospital.
CHRU conducts research to prevent and treat infectious diseases like HIV, TB, HPV, hepatitis B and C, and Covid-19, and over the past two decades, has carried out numerous clinical studies and contributed to more than 35 peer-reviewed publications that have advanced the understanding and management of cervical cancer in resource-limited settings.
Faesen said all of this research has come to a complete stop.
Salome Meyer, director of Cancer Alliance comprising more than 30 cancer-focused organisations and advocates, said any funding cuts that affected cervical cancer research are deeply concerning.
“With South Africa’s high HIV burden, many women are also likely to be HPV positive, and persistent HPV infection is the primary cause of cervical cancer. Monitoring women who have HIV for HPV is therefore critical to early detection and prevention.”
Retrenchments loom
CHRU has had to go through a retrenchment process and impose salary cuts, and the impact has been devastating.
Faesen said the CHRU’s budget came entirely from US funding agencies; they have no choice but to suspend all activities.
“Staff will be retrenched, and patients will have to seek screening and treatment elsewhere,” he said.
At a recent press briefing, Health Minister Dr Aaron Motsoaledi said the government had held meetings with potential donors and funders but no new income streams had yet been secured.
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