Latest news with #HealthBeat
TimesLIVE
07-08-2025
- Health
- TimesLIVE
Does SA need a Covid-like ministerial advisory committee to deal with HIV funding cuts?
Increase health taxes. Roll out the twice-a-year anti-HIV jab lenacapavir to stop HIV from spreading. Use artificial intelligence (AI) to do more with less. Convene a ministerial advisory committee. These are some of the things that have surfaced as potential solutions to fill the huge gap that US President Donald Trump's administration's sudden funding cuts in February have left. But would they work — and are they doable? Only if we move fast, and get lots of each thing, it seems. Health minister Aaron Motsoaledi told Bhekisisa's TV show, Health Beat, in July, that he 'would strongly consider' a ministerial advisory committee (MAC), like the one we had during the Covid pandemic for which scientists advised the health department on what to do. 'There's nothing wrong with establishing a MAC [to deal with funding cuts],' Motsoaledi admitted ... but we've not yet established anything like that for [the funding crisis].' No MAC or emergency think-tank with input beyond government structures has since been announced by the health department. But scientists warn such a committee should be an important part of the country's response to the crisis. 'We need to urgently convene a national think-tank,' medical doctor and the head of Wits RHI, Helen Rees, cautions. 'There are some really superb people who've been working in the programmes closely and well with the health department who could contribute their ideas and experience ... [and help figure out] what [strategies] can we [the health department] retain that aren't hugely expensive.' In Johannesburg, research released at the Conference on HIV Science in Kigali in July, shows HIV testing between January and March 2025 was 8.5% lower than the same time last year (before the funding cuts), and 31% less people were diagnosed with HIV in 2025. During the same period, there was also a 30% reduction in people who tested positive, who started on antiretroviral treatment, compared to 2024. So what has South Africa done so far? Motsoaledi has managed to raise a small amount of extra funding — R735m — from the treasury through the Public Finance Management Act. But it's less than 10% of the R7.9bn we've lost (and are in all likelihood about to lose in September, the end of the US financial year). The country is, however, starting to make progress with the rollout of lenacapavir, an injection that is taken once every six months, that provides near complete protection against HIV infection. About 170,000 people got newly infected with HIV in 2024, according to the latest Joint UN Programme on HIV and Aids report. A modelling study has shown if between two- and four-million people in the country take the jab, each year, for the next eight years, South Africa could end Aids as a public health threat by 2032. South Africa's medicines regulator, the South African Health Products Regulatory Authority, has told Bhekisisa the shot will be registered in the country before the end of the year. And, at a presentation at the Kigali conference, health department consultant Hasina Subedar said, if all goes well, the department will start to roll out the jab in April 2026. In July, the health department accepted an offer from the Global Fund for Aids, TB and Malaria, to reallocate R520m of its funds to buy lenacapavir from its maker, Gilead Sciences, over the next three years until cheaper generic versions become available. The funds will become available in October. But, if the health department budgets for the $60 per patient per year that the Global Fund has told them to, the grant is only enough to put about 400,000 people on preventive treatment for three years — about 10% of what is needed to end Aids by 2032. One more way to generate 'a stable and predictable funding stream' without donors, according to a July report by the public health organisation Vital Strategies, is to increase taxes on tobacco, alcohol and sugary drinks to a level where taxes constitute 50% of the selling price of the products. That money can then be used, among other things, to improve health infrastructure. According to the report, 45.7% of the price of a box of cigarettes, 27.6% of a bottle of beer and 3.4% of sugar-sweetened carbonated drinks currently go towards taxes in South Africa. Mia Malan recently asked Wits RHI's Helen Rees how the country should go about to find solutions to the HIV and TB funding crisis. Following is an edited version of the full TV interview.
TimesLIVE
03-07-2025
- Health
- TimesLIVE
Can South Africa's HIV fight survive US funding blows?
South Africa's HIV programme, once sustained by US support, is at risk. Without replacement funding, South Africa could see a 38% increase in Aids-related deaths by 2028 and up to 150,000 HIV infections. With some frontline services collapsing and mobile clinics funded by US emergency fund Pepfar lying idle, it's feared many of South Africa's eight-million people living with HIV might forgo their treatment. The average person with HIV in South Africa is aged 41, which means treatment access isn't just about survival; it's about protecting our workforce. But there's a promising breakthrough: the US Food and Drug Administration has approved the HIV prevention jab, lenacapavir, and it could be registered in South Africa by early 2026. Health minister Aaron Motsoaledi told Health Beat he'll find the money to buy the jab if donors can't help. But how much should we pay for it?
TimesLIVE
29-05-2025
- Health
- TimesLIVE
A medical breakthrough, or a dangerous shortcut? Health Beat investigates the ketamine craze
In the latest episode of Health Beat, we unpack the growing use of the psychedelic drug, ketamine, to treat severe depression and chronic pain. Research shows it can work quickly to improve mood, but experts are concerned about the rise of unregulated clinics using ketamine in ways that aren't backed by solid evidence or properly supervised. What began as a good anaesthetic because of its pain-beating properties has evolved into a so-called game-changing treatment for depression, but with no clear guidelines, clinics are cashing in. Also linked with the party scene and celebrity scandals, ketamine is promoted online as a treatment for migraines, anxiety, addiction and ADHD, but are these claims credible? In South Africa, doctors can prescribe ketamine, even though drip infusions haven't been approved by our medicines regulator, Sahpra, for anything outside anaesthesia. Specialists warn that ketamine therapy requires expert training and monitoring. Psychiatrist Bavi Vythilingum, who runs a clinic offering ketamine infusions with an anaesthetist present, reports good results, but is concerned about 'cowboy clinics' run by doctors without extra training in psychiatry and anaesthesiology.
Daily Maverick
21-05-2025
- Health
- Daily Maverick
Researchers probe why so many newborns and foetuses are abandoned in landfills and velds in SA
While discoveries like these rarely make the news, it happens all the time. We asked leading forensic pathologist Shakeera Holland what her team found after studying remains at the Diepkloof Forensic Pathology Service in Soweto. They were wrapped in plastic or foil or a piece of clothing, tucked inside a backpack or pulled from a burnt pile of rubbish. Those were how some of the remains of newborns and foetuses were found before ending up at the Diepkloof Forensic Pathology Service in Soweto. While discoveries like these rarely make the news, they are a regular occurrence, discovered in open velds, public toilets and landfills across South Africa. To help figure out why, researchers from Wits University gathered data about the remains that landed up at the Diepkloof facility between 2020 and 2021 and in 2023. They hope that by tracking where the remains were found and the causes of death, they will better understand why so many women are turning to desperate ways of ending their pregnancies instead of seeking legal and safe abortions. Abandoned remains are not only a South African problem. But studies show it is extremely rare in countries like Germany (150 cases in 15 years) or Denmark (11 cases in 12 years). Research published in 2014 in the South African Medical Journal (SAMJ) found more than 1,658 cases in Mpumalanga and Gauteng alone between 2009 and 2011. Of the 158 cases studied in the Diepkloof facility, 68 were found to be nonviable, which means they would not be able to survive outside of the mother; 29 were stillborn – when a foetus dies in the womb after 20 weeks of pregnancy. In one-third of the cases the cause of death couldn't be determined because the bodies were severely mutilated or were too badly decomposed. The researchers – Rachel Gill, Roxanne Thornton and Shakeera Holland – believe the high number of nonviable cases could be linked to illegal abortions, something backed up by the SAMJ study. Their initial findings point to a lack of information and education about abortion and inadequate medical care, which reproductive health specialists agree are the biggest reasons women are driven to unsafe abortion providers. In a recent episode of Bhekisisa's monthly TV programme, Health Beat, we spoke with Holland, who heads up forensic medicine and pathology at Wits University and leads investigations of unnatural deaths across eight forensic pathology facilities in Gauteng – the busiest region in the country, which handles about 28% of all the unnatural death investigations in the country. Mia Malan spoke with her at Soweto's forensic pathology service facilities in Diepkloof. This interview was edited for clarity. Mia Malan: How many abandoned foetuses and newborns are found? Shakeera Holland: We don't have accurate statistics about this because there is no digital database of unnatural deaths in the whole of South Africa. What we do know is that we have about 70,000 unnatural deaths in South Africa, and of those, we estimate that about 2% are abandoned neonates [newborns in the first few weeks of life] and foetuses. MM: In the study you supervised at the mortuary, where were the remains of these abandoned foetuses and newborns found? SH: The majority of the time, the remains are left where it is convenient, and probably where people think they won't be found easily. So usually in open velds, landfills and dumping areas. It's less common to find them in toilets in shopping centres and other public toilets. MM: Is there a difference in the number of female remains versus male remains? SH: Most of the foetuses in our study were male. And most of our paediatric deaths happen to be more common in boys than girls – and this is what we see in international studies as well. MM: What do your autopsies show? What are the causes of death? SH: The most common cause that we see are nonviable foetuses. This means that the foetuses haven't completed sufficient time in the pregnancy for them to survive outside of the mother. We also see a lot of stillbirths. These are babies that have completed enough gestational time in the mom to be considered viable, but they're not born deceased. In a minority of the causes we see trauma, and that can either be accidental or homicidal – but this is in very few cases. MM: What are the most common causes of the trauma? SH: A lot of the common causes are head injuries, and a few are related to suffocation, and we've maybe had one or two where there's sharp-force injury. For example, the foetuses or neonates have had their necks cut. MM: Why did you do the study? SH: We see these cases of abandoned neonates and foetuses every day. You see newspaper reports about these cases, but they make it seem as if they never happen. In fact, they are happening every single day. I had a student who was particularly passionate about the topic and wanted to look at what is exactly going on in this area, and hopefully spark research in other places, because we don't know much about it. MM: So when a foetus or neonate lands here, what happens to it? SH: They undergo a medical and legal postmortem examination, which includes an autopsy. That autopsy includes any investigations that are necessary to determine the cause and circumstances of death. Once that is completed we compile a postmortem report. That report then goes to the South African Police Service for further investigation, for them to decide whether or not there needs to be prosecution in this case and what happens to the remains. In foetuses that are less than 26 weeks the remains are discarded as medical waste. Neonates of 26 weeks and older are buried as paupers if nobody claims the remains, which means the state assumes the cost of the burial. MM: Do you have enough doctors to conduct these autopsies? SH: At present our doctors are doing between 500 and 600 postmortems per doctor per year. The ideal would be about 250 because we need to take into consideration that the process is not just doing autopsies. In fact, the doctor has to do the autopsy then compile a meticulous report that needs to stand up in court. MM: We have more than 1,000 unemployed doctors in this country. Why can't you use them? SH: We do not have enough funded posts for doctors, even though we do have a lot of doctors who would like to come and work in our service. MM: Have you got a specific policy intervention you'd like to see? SH: That's exactly why we do these studies. We're hoping that if we are able to shine a light on where the problems lie, we are able to give a basis for policy development to show where intervention is necessary. I think it's very sad that the law provides for women as young as 12 to have access to contraception without parental consent if the child has a clear understanding of the process. But I feel like perhaps girls do not know enough about it, or they are not getting safe access to the service – and it's the same with termination of pregnancy. So it's a lack of knowledge perhaps, or perhaps it's a lack of access for these young women. DM This story is based on our Health Beat TV programme, 'Why are thousands of babies dumped each year in SA instead of being safely aborted?' which was broadcast on 29 March on eNCA. Watch the full programme on Bhekisisa's YouTube channel. If you are seeking information about abortion services, Where to Care has a list of providers in South Africa, which is regularly updated.
TimesLIVE
19-05-2025
- Health
- TimesLIVE
Why are so many newborns and foetuses being abandoned in landfills and velds in SA?
They were wrapped in plastic or foil or a piece of clothing, tucked inside a backpack or pulled from a burnt pile of rubbish. Those were just some of the ways the remains of newborns and foetuses were found before ending up at the Diepkloof Forensic Pathology Service in Soweto. While discoveries like these rarely make the news, they are a regular occurrence, discovered in open velds, public toilets and landfills across South Africa. To help figure out why, researchers from Wits University gathered data about the remains that landed up at the Diepkloof facility between 2020 and 2021 and in 2023. They hope by tracking where the remains were found and the causes of death, they will better understand why so many women are turning to desperate ways of ending their pregnancies instead of seeking out legal and safe abortions. Abandoned remains are not just a South African problem. But studies show it is extremely rare in countries like Germany (150 cases found over 15 years) or Denmark (11 cases over 12 years). Meanwhile, research published in 2014 in the South African Medical Journal (SAMJ) found over 1,6581 cases in Mpumalanga and Gauteng alone between 2009 and 2011. Of the 158 cases in the Diepkloof facility studied, 68 were found to be non-viable, which means they would not be able to survive outside the mother; 29 were stillborn — when a foetus dies in the womb after 20 weeks of pregnancy. In one-third of the cases, the cause of death couldn't be determined because the bodies were severely mutilated or were too badly decomposed. The researchers — Rachel Gill, Roxanne Thornton and Shakeera Holland — believe the high number of non-viable cases could be linked to illegal abortions, something backed up by the SAMJ study. Their initial findings point to a lack of information and education about abortion and inadequate medical care, which reproductive health specialists agree are the biggest reasons women are driven to unsafe abortion providers. In a recent episode of Bhekisisa's monthly TV programme, Health Beat, we spoke with Shakeera Holland, who heads up forensic medicine and pathology at Wits University and leads investigations of unnatural deaths across eight forensic pathology facilities in Gauteng — the busiest region in the country, which handles about 28% of all the unnatural death investigations in the country. Mia Malan spoke with her at Soweto's forensic pathology service facilities in Diepkloof. This interview was edited for clarity. The full Health Beat programme:
