Trump's HIV funding cuts will also hit diabetes, cervical cancer and depression hard

Mail & Guardian

27-05-2025

The impact of the Trump administration's slashing of over half of South Africa's HIV and TB projects funded by the US government, transcends reduced access to HIV testing and HIV prevention and treatment drugs. Treatment for diabetes, high blood pressure, cervical cancer, depression and anxiety will become harder to come by too. (Flickr)
The impact of US President Donald Trump administration's slashing of
As government clinics take on HIV patients who were previously treated by Pepfar-funded projects, the treatment of conditions like
And mental health issues such as depression and anxiety — also noncommunicable illnesses — will probably become more common among people with HIV, because many now face extra stress, such as having to travel further to clinics for treatment and groups
At a
In 2020, NCDs were the cause of more than
We look at five ways in which HIV funding cuts could affect NCDs.
Fewer data capturers, fewer people to keep track of NCDs
Today,
Bhekisisa
's data team
As people age, their chance of developing health problems like high blood pressure, heart disease and diabetes rises, which means more and more people will have to be treated for these conditions — on top of getting HIV care.
Because antiretroviral drugs (ARVs) keep people healthy and increase their life expectancy, the scale-up of treatment in South Africa — public sector treatment
So, as the peak of the HIV-infected population shifts into an older age band,
Studies have shown that people with HIV who are older than 50 have
But without tracking the numbers — which would be challenging with the loss of thousands of US government-funded data capturers in the wake of foreign aid cuts — putting plans in place to care for an ageing HIV population will be hard.
And with many countries' governments,
Employing health workers to capture and manage health data will be a hard sell, said Kate Rees, a public health specialist with the
Bhekisisa
and the Southern African HIV Clinicians Society webinar — something that, for a public health issue that might be ignored because its fallout isn't immediately visible — could just make the problem so much worse.
Fewer people on ARVs leads to people with diabetes
When people with HIV are not on treatment, or if they don't use their ARVs correctly, the virus gets a chance to make copies of itself
That's when their immune systems get weak, and some then fall ill with diseases that scientists call
And that's where the catch for
The condition is one of four NCDs World Health Organisation-member countries have
But
The TB germ
In fact, among people who have high sugar levels in their blood when getting diagnosed for TB, studies show that
But, the opposite is also true — people with diabetes have a
So, in short, when there's less money to help people with HIV to get diagnosed or to make it easy for diagnosed people to get on to treatment, and stick to it,
Fewer women on ARVs mean more with cervical cancer
Last week, the
'This closure will significantly impact cervical cancer prevention efforts in SA, which faces one of the highest rates of cervical cancer in the world,' the unit
Cervical cancer is the
'With timely screening and early detection being key to preventing cervical cancer, the closure of this screening unit at Helen Joseph Hospital leaves a major gap in services and will further strain the health service,'
Women with
Cervical cancer is the
About a
The ending of USAid programmes has resulted in fewer HIV testing and treatment services which, in turn, affects how many women become vulnerable to developing cervical cancer.
Depression and anxiety will become more common
Mental health conditions are also NCDs.
If more people with HIV are left without treatment as a result of US government funding cuts, mental health conditions like depression and anxiety will become more common.
Why? Because Pepfar-
Without ART, some people develop
People with HIV already face stigma which
Depression makes it harder for people to stick to their treatment. Studies
Fewer nurses means NCDs fall through the cracks
NCDs are underdiagnosed in South Africa, experts say.
'If we went into the community aggressively looking for high sugar and blood pressure, we would do such a better job,' says Venter. 'Instead, we sit back and wait [until people turn up at clinics], which is why we do so badly with diabetes and hypertension.'
Even at clinics, people are rarely tested, mostly because there are too few nurses at our clinics with too much to do. On top of
And after February's US funding cuts,
Pepfar also funded 2 705 lay counsellors, health department data
And when nurses have more work, they have less time to treat each patient which, Venter says, makes it even harder to pick up NCDs. 'Because of that, the actual interaction would take probably an hour and a half. When you've got a mile-long queue outside your door, you just don't have that time.'
'So they [nurses] go for the absolute basic stuff.'
Additional reporting by Linda Pretorius and Jacques Verryn.
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