
Local hospital tackles HIV treatment gaps with new virological failure clinic
This targeted intervention is designed to improve patient outcomes and curb the spread of HIV in surrounding communities.
Initially focused on children with high viral loads due to inconsistent treatment and social issues, the clinic quickly expanded its services.
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'When we started, we primarily worked with children whose viral loads were not decreasing because of irregular treatment and social challenges,' said Serengwane Lethuba, the HIV, Aids, Sexually Transmitted Infections and Tuberculosis (HAST) manager at the hospital.
'Soon, we identified a rising number of adult patients on first- and second-line antiretroviral therapy regimens who were also failing to achieve viral suppression. Many of them were being escalated to third-line treatment, prompting urgent intervention.
'The team did a focused sampling of 89 patients experiencing persistent virological failure to better understand the challenges and adapt their approach.'
Operating every Tuesday, the clinic is run by a clinical team including a doctor, a clinical nurse practitioner and an HIV testing services (HTS) counsellor.
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Lethuba said that together, they provide personalised and comprehensive care.
One of the clinic's key findings has been the impact of non-disclosure of HIV status, which often contributes to poor adherence and ongoing virological failure.
'To address this, we incorporated the social work department into the clinic's multidisciplinary team. Social workers assist in overcoming psychological and social barriers to treatment, helping patients navigate issues around disclosure and providing continuous support.
'This integrated approach has already shown positive outcomes, with many patients achieving viral suppression within three months of targeted intervention.'
He said they also use a proactive system in which nurses review patient data and follow up telephonically to remind and encourage patients to attend appointments.
'Once at the clinic, patients receive co-ordinated care from the full team, which includes medical assessments, counselling and psychosocial support.
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'The initiative supports the national Close the Gap campaign launched by Health Minister Dr Aaron Motsoaledi and Gauteng Health MEC Nomantu Nkomo-Ralehoko.
'The campaign seeks to trace patients who defaulted on treatment, those newly diagnosed but not yet on therapy, and individuals failing to suppress the virus.'
The Tambo Memorial Hospital has localised this campaign to create a dignified, supportive environment for patients to re-engage with their treatment.
HIV-positive individuals in Boksburg, Benoni and nearby areas facing challenges with treatment or viral load suppression are encouraged to visit the Virological Failure Clinic every Tuesday.
'Our specialised clinic is a safe space where patients are empowered and supported to fight HIV effectively,' concluded Lethuba.
The clinic is located inside the Tambo Memorial Hospital. For more information, call 011 898 8331.
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The Citizen
9 hours ago
- The Citizen
Inside SA's multi-million rand plan to fill US funding void
The current tranche of money comes from Treasury's contingency reserve. Health Minister Aaron Motsoaledi recently announced that National Treasury had released roughly R753 million to help plug the gap left by US funding cuts to South Africa's health system. Another R268 million is also being released in the following two years for researchers that lost their US grants. But this may only constitute the first round of emergency funds from government, according to sources we spoke to. ALSO READ: Treasury allocates R750m to offset Pepfar funding withdrawal as Motsoaledi tables health budget The health department is planning to submit a bid for an additional allocation later on, which will be considered by Treasury. But this will likely only be approved if the first tranche of funding is appropriately used. So how is the money supposed to be used? To find out, we spoke with officials from the National Treasury, the National Department of Health and the South African Medical Research Council (SAMRC). Money for provinces is for saving jobs at government clinics The current tranche of money comes from Treasury's contingency reserve, which exists partially to deal with unforeseen funding shortfalls. It was released in terms of Section 16 of the Public Finance Management Act. Of the R753 million that's been announced for this year, Motsoaledi stated that R590 million would be going to provincial health departments via the District Health Programme Grant – a conditional grant for funding the country's public health efforts, particularly HIV, TB, and other communicable diseases. Such conditional grants typically give the National Health Department more say over how provincial departments spend money than is the case with most other health funding in provinces.. To explain how government officials arrived at this figure, it's worth recapping what services the US previously supported within provinces. Prior to Donald Trump becoming US president on 20 January, the US Agency for International Development (USAID) had financed health programmes in specific districts with high rates of HIV. These districts were scattered across all South Africa's provinces, save for the Northern Cape. The funds were typically channelled by USAID to non-governmental organisations (NGOs), which used the money to assist the districts in two ways. The first is that NGOs would hire and deploy health workers at government clinics. The second is that the NGOs would run independent mobile clinics and drop-in centres, which assisted so-called key populations, such as men who have sex with men, sex workers, transgender people, and people who inject drugs. Following the US funding cuts, thousands of NGO-funded health workers lost their jobs at government clinics, while many of the health centres catering to key populations were forced to close. In response, the health department began negotiations with Treasury to get emergency funding to restore some of these services. As part of its application, the health department submitted proposals for each province, which specified how much money was needed and how it would be used. (Though this only took place after significant delay and confusion). Since Treasury couldn't afford to plug the entire gap left by the US funding cuts, the provincial-level proposals only requested money for some of the services that had been terminated. For instance, funding was not requested for the key populations health centres. Instead, the priority was to secure the jobs that had been lost at government health facilities. READ MORE: Over 8 000 SA healthcare jobs lost – and more could follow – after US Pepfar aid cuts As such, the total amount that was requested from Treasury for each province was largely calculated by taking the total number of health workers that NGOs had hired at clinics and working out how much it would cost to rehire them for 12 months. Rather than paying the NGOs a grant to deploy these workers as was done by USAID, the health department proposed hiring them directly. This meant that they calculated their wages according to standard government pay scales which is less than what these workers would have earned from the NGOs. The total came to just under R1.2 billion for all the provinces combined. Treasury awarded roughly half of this on the basis that the money would be used to finance these wages for six months, rather than 12. This amounts to the R590 million for provinces that was announced by Motsoaledi. If all goes smoothly and this money is used effectively to hire these staff over the next six months, then a new tranche of Section 16 funding could be released in order to continue hiring them. Funds might also be released to fund the key populations health sites. A concern, however, is that the money may just be used by provinces to augment their ordinary budgets. If the funds aren't actually earmarked to respond to the US cuts, then it is much less likely that more emergency funding will be released. At this stage, it is too early to tell how provinces will use the money, particularly given that it appears that at least some of them haven't gotten it yet. Spotlight and GroundUp sent questions to several provincial health departments. Only the Western Cape responded. The province's MEC for Health and Wellness, Mireille Wenger, said that the funds have not yet been received by her department, but that once they were, they would be directed to several key priority areas, including digitisation of health records, and the strengthening of the primary healthcare system. It's thus not clear whether the province will be earmarking any of the funds to employ health staff axed by US-funded NGOs. In response to a question about this, Wenger stated that 'further clarity is still required from the National Department of Health and National Treasury regarding the precise provincial allocations and conditions tied to the additional funding'. What about research? Of the R753 million that's been released for this year, R132 million has been allocated to mitigate the funding cuts for research by US federal institutions, primarily the National Institutes for Health (NIH). Unlike USAID, the NIH is not an aid body. It provides grants to researchers who are testing new treatments and medical interventions that ultimately benefit everyone. These grants can be awarded to researchers in the US or abroad as part of a highly competitive application process. Researchers in South Africa are awarded a few billion rands worth of grants from the NIH each year, largely due to their expertise in HIV and TB. But over the last few months, much of this funding has been terminated or left in limbo. (See a detailed explanation of the situation here). The R132 million issued by Treasury is supposed to assist some of these researchers. It will be followed by another R268 million over the following two years. The Gates Foundation and Wellcome Trust are chipping in an additional R100 million each – though in their case, the funds are being provided upfront. All of this money – R600 million in total – is being channelled to the SAMRC, which will release it to researchers via a competitive grant allocation system. According to SAMRC spokesperson Tendani Tsedu, they have already received the R132 million from Treasury, though they are still 'finalising the processes with the Gates Foundation and Wellcome Trust for receipt of [their donations]'. The SAMRC is also in negotiation with a French research body about securing more funds, though these talks are ongoing. In the meantime, the SAMRC has sent out a request for grant applications from researchers who have lost their US money. The memo states: 'Applicants may apply for funding support for up to 12 months to continue, wind down or complete critical research activities and sustain the projects until U.S. funding is resumed or alternative funds are sourced.' 'The plan,' Tsedu said, 'is to award these grants as soon as possible this year.' READ MORE: Health experts warn of 'huge disaster' as USAID terminates Pepfar HIV funding in SA Professor Linda-Gail Bekker, CEO of the Desmond Tutu Health Foundation, told us that the hope is that the grants could fill some of the gaps. 'This is a bridge and it is certainly going to save some people's jobs, and some research,' she said, but 'it isn't going to completely fill the gap'. Indeed, the SAMRC has made clear that its grants aren't intended to replace the US funding awards entirely. This is unsurprising given that the money that's being made available is a tiny fraction of the total grant funding awarded by the NIH. It's unlikely that research projects will continue to operate as before, and will instead be pared down, said Bekker. 'It's going to be about getting the absolute minimum done so you either save the outcome, or get an outcome rather than no outcome,' she said. In other cases, the funds may simply 'allow you to more ethically close [the research project] down,' Bekker added. For some, this funding may also have come too late. Many researchers have already had to lay off staff. Additionally, patients who had been on experimental treatments may have already been transitioned back into routine care. It's unclear how such projects could be resumed months later. In response, Tsedu stated: 'For projects that have already closed as a result of the funding cuts, the principal investigator will need to motivate whether the study can be appropriately resurrected if new funds are secured.' The SAMRC has established a steering committee which will adjudicate bids. They will be considering a range of criteria, Tsedu said, including how beneficial the research might be for the South African health system, and how heavily the project was impacted by the US funding cuts. They will also consider how an SAMRC grant could 'be leveraged for future sustainability of the project, personnel or unit,' he said. An endless back and forth The job of the SAMRC steering committee will likely be made a lot more complicated by the erratic policy changes within the NIH. On 25 March, the body sent a memo to staff, – leaked to Nature and Bhekisisa – instructing them to hold all funding awards to researchers in South Africa. After this, numerous researchers in the country said they couldn't renew their grants. However, last month, Science reported that a new memo had been sent to NIH staff which said that while South African researchers still couldn't get new grants, active awards could be resumed. Since then, some funds appear to be trickling back into the country, but certainly not all. For instance, Spotlight and GroundUp spoke to one researcher who had two active NIH awards before the cuts. He stated that one of these was resumed last month, while the other is still paused. READ MORE: SA funds 90% of its HIV/Aids ARV programme, Motsoaledi reveals amid Pepfar uncertainty Bekker also told us that she had heard of one or two research grants being resumed in the last week, though she said the bulk of active awards to South Africa are still pending. 'Where people are the prime recipients [of an NIH grant] without a subawardee, there seems to be a queue and backlog but some [of those awards] are coming through,' said Bekker. 'But how long this is going to take and when it might come through we're waiting to hear.' She said a strategy might be to apply for the SAMRC bridging funding and 'if by some miracle the [NIH funding is resumed]' then researchers could then presumably retract their SAMRC application. In the meantime, health researchers will have to continue spending their time working out how to respond to the abrupt and increasingly confusing changes to funding guidelines that have dogged them since Trump assumed office. 'It's such a dreadful waste of energy,' said Bekker. 'If we were just getting on with the research, it would be so much better.' This article was republished from GroundUp under a Creative Commons license. Read the original article here.

IOL News
2 days ago
- IOL News
Innovative strategies by South African researchers to combat gender-based violence
Nangipha Mnandi, a research technologist at the South African Medical Research Council's Gender and Health Research Unit. Image: Supplied South African researchers are driving innovation and shaping the future in combating the scourge of gender-based violence, with some of their work already informing the country's policy. These emerging researchers are with the South African Medical Research Council's (SAMRC) Gender and Health Research Unit (GHRU). Notably, they are all PhD candidates. Nangipha Mnandi, a research technologist, said that the Siyaphambili Youth Project and Stepping Stones Creating Futures+ (SSCF+), which he has worked on, are research initiatives aimed at benefiting young people in resource-strained communities who are at risk of intimate partner violence (IPV), poor mental health, substance misuse, and HIV acquisition driven by several contextual factors. 'Through understanding the relationship between these contextual drivers, we designed and developed a scalable intervention that will reduce IPV and poor mental health risk among young people and strengthen their agency in challenging contexts. The key challenge we encounter with implementing such a project is the structural challenges of poverty and unemployment, which are mostly beyond our control but largely influence or shape IPV and poor mental health outcomes in marginalised community settings,' he said. Video Player is loading. Play Video Play Unmute Current Time 0:00 / Duration -:- Loaded : 0% Stream Type LIVE Seek to live, currently behind live LIVE Remaining Time - 0:00 This is a modal window. Beginning of dialog window. Escape will cancel and close the window. Text Color White Black Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan Transparency Transparent Semi-Transparent Opaque Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps Reset restore all settings to the default values Done Close Modal Dialog End of dialog window. Advertisement Video Player is loading. Play Video Play Unmute Current Time 0:00 / Duration -:- Loaded : 0% Stream Type LIVE Seek to live, currently behind live LIVE Remaining Time - 0:00 This is a modal window. Beginning of dialog window. Escape will cancel and close the window. Text Color White Black Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan Transparency Transparent Semi-Transparent Opaque Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps Reset restore all settings to the default values Done Close Modal Dialog End of dialog window. Next Stay Close ✕ Mnandi added that socio-structural challenges such as poverty, unemployment, and broader social hardships significantly influence the effectiveness of the interventions. 'Many young people face daily pressures to secure income or food for themselves and their families, which often takes precedence over attending scheduled sessions. Even though we strategically deliver interventions within communities to reduce barriers to access, attendance remains inconsistent. 'This is not due to a lack of interest or engagement, but rather the urgent need for participants to 'hustle' for survival. These realities highlight the importance of designing flexible, context-sensitive interventions that acknowledge and adapt to the lived experiences of the communities we serve,' Mnandi highlighted. He is currently working on the Zithandani (Couples) project, which aims to reduce violence in young heterosexual couples from urban informal settlements. 'Our data from the Siyaphambili Youth Project and Zithandani Project shows how poverty, violence, and masculine norms intersect to shape the poor mental health of young men. Our work reveals that while young women may experience higher rates of mental health challenges, however, young men are more likely to engage in substance misuse and suicide ideation, often as a result of unaddressed trauma and social expectations. 'The absence of fathers further compounds these issues, as many young men grow up without male role models in contexts shaped by apartheid and HIV/Aids. Young men's lived experiences are also likely driven by a desire to challenge harmful gender norms and promote healthier, more equitable masculinities,' Mnandi said. He added that two interlinked promising findings could be scaled up to other communities. 'First, the importance of engaging young people in a meaningful way in the development of projects and interventions. In both projects, we have worked hard to ensure young people are engaged. In SSCF+, we hired young people as Youth Peer Research Assistants (YPRAs) to co-create and deliver SSCF+, and this has emerged as a powerful strategy. 'This approach cultivates trust, ownership, and contextual relevance of the final intervention. Moreover, peer-facilitated community-based interventions can be very effective in improving health outcomes in communities with limited access to public healthcare services. Young people tend to be far more responsive to public health initiatives that involve their peers based in the same communities that they come from,' Mnandi said. Nonhlonipho Bhengu-Simelane, a senior research technologist at the South African Medical Research Council's Gender and Health Research Unit. Image: Supplied Nonhlonipho Bhengu-Simelane, a senior research technologist, said the Masibambane Ladies Chat, which she worked on, showed that digital platforms can increase access to pre-exposure prophylaxis (PrEP) information and make peer support more reachable for young women. PrEP is a medicine that people at risk for HIV take to prevent getting HIV from sex or injection drug use. 'One of the biggest lessons from the Masibambane Ladies Chat was that a gender-empowerment approach, delivered through an accessible platform like WhatsApp, can do far more than share information; it can shift mindsets. 'As facilitator and project coordinator, I saw how creating a safe, women-only space online encouraged honest conversations about HIV prevention, broke down stigma, and helped young women see PrEP as a personal choice they could own. The combination of peer recruitment, relatable content, and open dialogue built confidence, challenged harmful norms, and motivated women to take the next step towards protecting their health,' Bhengu-Simelane said. For the Ntombi Vimbela Study, she facilitated a sexual violence risk reduction programme for lesbian, bisexual, and queer women, addressing mental health and resilience. Bhengu-Simelane said lesbian, bisexual, and queer (LBQ) women need safe, identity-affirming spaces and trained providers. Group sessions built confidence, improved help-seeking, and highlighted gaps in mainstream services. She added that meaningful youth participation in every phase of the design, delivery, and evaluation is an important aspect. Zamakhoza Khoza, a research technologist at the South African Medical Research Council's Fedisa Modikologo Durban site. Image: Supplied Zamakhoza Khoza, a research technologist at SAMRC's Fedisa Modikologo Durban site, whose research engages young men incarcerated for sexual offences to understand their experiences, social contexts, and belief systems that led to their actions, said prevention and the eventual elimination of gender-based violence are impossible without tackling its root causes. She specialises in the rehabilitation and reintegration of male juvenile sexual offenders, and is running a SEED project within the GHRU. Khoza added that the Competitive Seed Funding Initiative is linked to her PhD, which focuses on co-developing a gender-transformative intervention for young men (18–25 years old) incarcerated in juvenile or youth correctional centres for sexual offences in South Africa. Valuable evidence over the past three decades has shaped the global understanding of GBV perpetrators, with much of this evidence being produced by the SAMRC's GHRU, she said. 'But for younger offenders, particularly those who enter the justice system and are incarcerated, there's still much we don't know. Most of the dominant theories in this area still come from the Global North; these theories may not capture the critical contextual, socio-cultural, and economic realities of the Global South. 'We need to incorporate local theories with the established theories from the Global North. We also need to broaden our lens beyond male perpetrators and heteronormative understanding, while recognising that the majority of offenders are male. Continued efforts should include research and prevention work with women and LGBTQIA+ perpetrators,' Khoza said. She added that correctional centre-based research demands careful navigation of trust, ethics, and power, which means ensuring participants don't feel further persecuted, while still holding space for accountability. Her long-term vision is for perpetrator-focused research and interventions to be recognised as a non-negotiable component of GBV prevention. Asiphe Ketelo, a project lead at the South African Medical Research Council's Gender and Health Research Unit. Image: Supplied Asiphe Ketelo, a project lead at the GHRU, who is dedicated to investigating gender-based violence (GBV), femicide, injury mortality, and male victimisation, said that during the Covid-19 period, there was a small but statistically significant increase in intimate partner femicide cases. 'Our 2020/21 study highlighted the critical role of alcohol in femicide risk during the pandemic. Periods of a complete alcohol sales ban saw a decrease in both overall femicides and intimate partner femicides, but once the bans were lifted, cases rose again. This 'natural experiment' demonstrated the substantial impact of alcohol on femicide rates and underscored the urgent need to address alcohol use in prevention efforts,' Ketelo said. Since 2020, Ketelo has contributed to high-impact studies, collecting data under the leadership of Professor Naeemah Abrahams on two national femicide surveys (2022, 2024), which have made significant contributions to national policy. Ketelo said the GHRU of the SAMRC has developed a Femicide Prevention Strategy, commissioned by the Department of Justice and Constitutional Development. 'This strategy draws on over three decades of GHRU research into gender-based violence and femicide. Although it has not yet been formally adopted, it has been presented at multiple government meetings, and we remain hopeful it will soon be implemented as a much-needed step toward reducing GBV and femicide in South Africa,' Ketelo said. Regarding her PhD research on women's use of violence against male partners, she said, as GBV researchers, in different spaces, they are often asked, 'What about men?'


The Citizen
3 days ago
- The Citizen
Mpumalanga MEC for health leads campaign to encourage healthy lifestyle choices
The MEC for health, Sasekani Manzini, led healthcare professionals in a door-to-door initiative to implement the Cheka Impilo Campaign in Siyatsemba on Tuesday, August 5. According to Manzini, the campaign is part of the department's ongoing efforts to increase testing and screening for HIV/Aids, TB, STIs and non-communicable diseases such as hypertension and diabetes, to initiate more people on HIV treatment and to encourage healthy lifestyle choices. 'The campaign also aims to find and treat missing TB cases and reduce the burden of disease in the province,' said Manzini. Manzini emphasised that the Department of Health in Mpumalanga is committed to improving performance on primary healthcare indicators by ensuring communities use the campaign to detect diseases early and receive appropriate treatment to live healthier lives. ALSO READ: Mbombela beauty queen wish to inspire others through initiative 'The campaign is crucial in ensuring that diseases are detected and treated at an early stage to prevent illness and maintain a strong immune system. We therefore urge communities to prioritise their health and undergo regular check-ups at their nearest health facilities at least every three months,' said Manzini. ALSO READ: Mandela Day Boxing Championship brings thrilling action to KaNyamazane The campaign also visited a local day care centre to encourage women to make use of available healthcare services, such as cervical cancer screening and other primary healthcare offerings. It also ensured that all children at the centre received their immunisations.