Open letter to Health Minister Aaron Motsoaledi: Please explain the HIV numbers
Minister of Health Dr Aaron Motsoaledi's recent claim that more than half a million people have been newly started on HIV treatment in less than six months has raised eyebrows in health circles. In this open letter, Anna Grimsrud and Sibongile Tshabalala-Madhlala, associated with Change – South Africa, ask the minister to explain numbers that, on the face of it, seem contradictory.
Dear Minister Motsoaledi,
We write to you in response to your 15 May 2025 press statement and subsequent remarks in Parliament on the current status of the national HIV, Aids, and TB campaign.
You stated that since the launch of the Close the Gap campaign, 520,700 people have been initiated on HIV treatment, reaching 'more than 50% of the target'. You also stated that 5.9 million people were currently on antiretroviral therapy (ART). However, at the campaign's launch on 25 February 2025, you reported the same number on HIV treatment — 5.9 million. This raises a critical question: If more than half a million people have started or restarted treatment, why has the total number of people on treatment not increased?
If both figures are accurate, this would mean that approximately 520,000 people have been lost from care over the past few months — a deeply concerning and unprecedented level of attrition. We respectfully request that you provide the underlying data and clarify the current total number of people remaining on HIV treatment.
There are several reasons why we are concerned:
Static treatment numbers: As noted, the number on treatment was reported as 5.9 million in both February and May 2025. If 520,700 people have been initiated or re-initiated during this period, the same number must have exited care — a scenario that requires urgent explanation.
Slow growth in the number of people on treatment: According to official statements, the total number of people on HIV treatment increased by only 100,000 between March and December 2023 — from over 5.7 million to 5.8 million. The claim that the cohort has now grown by more than 500,000 in a matter of months contradicts recent trends.
Declining lab numbers: National Health Laboratory Service data reported by the Daily Maverick and Reuters, show notable declines in viral load testing and early infant diagnosis in March and April 2025 compared with the same months in 2024. These indicators should increase alongside meaningful growth in treatment uptake — not decrease.
In light of these concerns, we believe it is essential that you provide a transparent accounting of the current number of people on treatment and the metrics being used to assess progress under the Close the Gap campaign. Specifically, we request data demonstrating that the programme is on track to meet its stated goal: increasing the number of people on treatment from 5.9 million to 7 million.
We share your commitment to a strong and effective HIV response, especially in this period of financial and operational strain. Like you, we believe it is vital that accurate and complete information is shared with the public and Parliament at this critical moment. DM
Anna Grimsrud is an epidemiologist with a PhD in Public Health and writes in her personal capacity. Sibongile Tshabalala-Madhlala is openly living with HIV and currently serves as the National Chairperson of the Treatment Action Campaign (TAC). Change is a coalition of more than 1 500 people from civil society organisations in South Africa and around the world — people living with HIV, activists, community health workers, researchers, programme members, epidemiologists, clinicians, economists, and others. Change stands for Community Health & HIV Advocate Navigating Global Emergencies.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
IOL News
8 hours ago
- IOL News
Phoenix's healthcare crisis: a community's plea for change
IN THE heart of Phoenix, Durban, a crisis is unfolding that demands immediate attention. The Mahatma Gandhi Memorial Hospital and the Phoenix Community Health Care Centre, once pillars of hope for the people of this community, have descended into a state of neglect so severe that it now threatens the dignity, health, and lives of those they are meant to serve. For thousands of residents, many of them elderly, frail, and economically vulnerable, these public healthcare facilities represent their only access to medical care. And yet, what awaits them behind these hospital doors is not healing, but hardship. It is no secret that the physical state of both the Mahatma Gandhi Memorial Hospital and the Phoenix Community Health Care Centre is deplorable. Walls are peeling, sanitation is questionable, and essential medical equipment is either outdated or completely absent. Many wards lack basic amenities, and waiting areas overflow with frustrated, tired patients forced to sit for hours - sometimes even an entire day - just to be seen by a healthcare provider. These scenes are not isolated incidents, they are the everyday norm in Phoenix. The tragedy lies in the fact that these facilities were built to uplift the community, not to compound its suffering. The current state of disrepair reflects more than just budgetary constraints - it is a glaring indictment of mismanagement, neglect, and a systemic failure to prioritise public health. One of the most distressing realities facing patients is the chronic shortage of medical supplies and life-saving medications. From insulin and hypertension drugs to basic antibiotics and sterile bandages, stockouts are frequent and prolonged. For individuals suffering from diabetes, high blood pressure, HIV/AIDS, and other chronic conditions, the consequences of such shortages can be deadly. Patients are often told to return in a week - or even a month - when the next batch of medication might arrive. This is not only unacceptable but unethical. The shortage of qualified medical personnel is another ticking time bomb. Doctors, nurses, and administrative staff are spread dangerously thin, leading to unmanageable workloads and exhaustion. The result? Appalling delays in patient care, rushed consultations, and a severe decline in the quality of service. Some patients report waiting for over six hours before even being triaged, only to be told to return another day. In the worst cases, patients are turned away altogether. The most heart-breaking aspect of this crisis is the treatment of the elderly and unemployed. Many are forced to make multiple costly trips to the health facilities, only to be dismissed without being seen by a doctor. For pensioners living on meagre state grants, and for those unemployed due to circumstances beyond their control, this adds an unnecessary layer of suffering to an already dire situation. The bed shortage at both facilities adds another dimension to this tragedy. Emergency cases are often left unattended on gurneys in hallways or even in waiting rooms. Women in labour, patients with broken bones, or individuals in need of urgent surgical attention are all crammed into overcrowded wards or makeshift recovery areas. In such conditions, patient dignity is routinely compromised. To compound the situation, there are growing concerns about the lack of empathy and compassion among some healthcare workers. While it is important to acknowledge the incredible strain placed on staff, it does not excuse the dismissive or even hostile attitudes patients often encounter. For people who are already vulnerable, being treated with indifference only adds psychological pain to physical ailments. A call for radical reform: It is evident that a mere increase in funding or supplies will not suffice. What the Phoenix's healthcare system needs is a complete and unapologetic overhaul - starting with its management. The leadership at both the Mahatma Gandhi Memorial Hospital and the Phoenix Community Health Care Centre must be held accountable. This is not the time for political appointments or bureaucratic tokenism. We urgently need a management board that is rooted in the community it serves - composed of local residents with a genuine understanding of the social, economic, and cultural context of Phoenix. These board members must have credible backgrounds in community healthcare, leadership, and organisational management. Additionally, skills in fundraising, marketing, communication, and community development should be prioritized. This type of leadership can help bridge the gap between state resources and community needs, while restoring trust and transparency in the system. The way forward: Public healthcare is a basic human right, not a privilege for the few. The situation in Phoenix is not just a local issue - it is a reflection of a broader national crisis that must be addressed with urgency and sincerity. Civil society, local businesses, religious institutions, and NGOs must come together to pressure government stakeholders into taking action. It is only through a united front that we can begin to restore dignity and health to the people of Phoenix. Moreover, health oversight mechanisms must be implemented to monitor progress, with public reporting channels to ensure accountability. Technology can also play a vital role in improving administration, tracking supplies, and ensuring better patient flow. However, none of this will work without dedicated and compassionate leadership. The suffering of Phoenix residents cannot be tolerated as an unfortunate norm any longer. The dilapidated state of these two facilities is a stain on our collective conscience. It is time for the community to demand better - not in whispers, but in a unified voice that echoes across municipal, provincial, and national platforms. The health of a nation begins in its most vulnerable communities. Phoenix is calling.
Eyewitness News
a day ago
- Eyewitness News
Gauteng DSD: No jobs in HIV and AIDS programme will be lost despite R108m budget shortfall
JOHANNESBURG - Gauteng's Department of Social Development is facing a R108 million shortfall in its HIV and AIDS programme budget, but officials insist no jobs will be lost. Treasury has slashed funding to R332 million in 2025, down from R440 million, forcing the department to restructure operations while trying to protect services for vulnerable groups. The commitment? To keep social workers, community carers and child and youth care workers employed and to continue funding non-profits supporting those affected by HIV. The department said all psycho-social services — including those offered to orphans, vulnerable children and HIV-positive households — will continue uninterrupted. Those who deliver them — including auxiliary social workers and registered community carers — will remain on payroll. Food relief, however, will now be handled centrally through distribution centres run by the sustainable livelihoods unit as part of a move to streamline resources. The department argues this shift will still prioritise households with no income and is part of a longer-term strategy to capacitate communities instead of relying on ongoing aid. And while incentive grant funding for work opportunities through the Expanded Public Works Programme (EPWP) has dropped dramatically since 2023, social development says job numbers have been maintained, thanks to reallocation from its main budget.
The Herald
a day ago
- The Herald
NHI is fiscally impossible, says the Health Funders Association
The Health Funders Association (HFA) has described the National Health Insurance (NHI) Act as fiscally impossible and has tabled a hybrid funding model that will enable private healthcare providers to provide services in tandem with the NHI. The HFA, accounting for 46% of the private healthcare market and representing 21 medical schemes and three administrators, this week became the latest entity to legally challenge the NHI for undermining the right of medical aid members to choose how to access health services. HFA commissioned an independent study released this week which found the NHI required substantial tax far beyond South Africa's fiscal capacity. 'What's more, the proposed model offers no guarantee of improved outcomes, while restricting the mechanisms that currently drive quality and innovation in health care,' said the FHA. Commenting on the report, HFA CEO Thoneshan Naidoo said South Africa needs a healthcare system that delivers equitable, quality care for all. 'However, in its current form, and without private sector collaboration, the NHI Act is fiscally impossible and operationally unworkable, and threatens the stability of the economy and health system affecting everyone in South Africa,' he said. Naidoo said the NHI Act centralises control of all healthcare financing in a single, state-run fund, removing the ability of medical schemes to offer cover for healthcare services reimbursable by the NHI. 'We continue to advocate for a more inclusive, hybrid funding model that incorporates medical schemes in NHI. We believe such a model would expand access to care while protecting the rights of all South Africans,' said Naidoo. The NHI, which introduces universal health coverage, has been challenged in court by Solidarity, the Board of Healthcare Funders, the South African Private Practitioners Forum, the Hospital Association of South Africa and the South African Medical Association. Foster Mohale, the health spokesperson, on Friday confirmed the department had received court papers. 'This is case number six. We have an evolving court process and we'll allow that process to take its course,' said Mohale. FHA commissioned a report by Genesis Analytics, which showed that personal income tax will need to increase from the current average rate of 21% to an average of 46% of income, pushing marginal tax rates in the lowest income bracket from 18% to 41%, and in the highest bracket from 45% to 68%. The Genesis model also considered a scenario of pooling existing healthcare expenditure, citing that personal income tax would need to increase from its average of 21% to 31%. At the same time, medical scheme members would face a 43% reduction in the level of healthcare services relative to what they currently received. 'In simple terms, the equation for medical scheme members therefore becomes 'Pay 1.5 times more tax for 43% less healthcare'. Such tax increases are fiscally impossible, particularly given South Africa's narrow personal income tax base of 7.4-million tax payers,' said the FHA. TimesLIVE
