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Mail & Guardian
3 days ago
- Business
- Mail & Guardian
Conventional and complementary healthcare professionals need to work together
Earlier this year, the US government took the drastic decision to terminate about 40 USAid-funded health projects in South Africa, a move that threatens the sustainability of these projects. The halting of funding has led to the closure of many clinics and a decrease in services rendered, such as HIV testing and treatment. To mitigate the problem, the health department, together with the South African National Aids Council, the Joint UN programme on HIV/Aids and World Health Organisation, has launched the Close the Gap campaign, which aims But this intervention leaves a gap of more than 2 million people who are lost to treatment for different reasons. According to the health department, nearly 8 million people are living with HIV in South Africa, with 5.7 million people stable on antiretroviral drugs (ARVs). Among the reasons for the lost numbers could be the use of complementary medicine, instead of the conventional medicine offered in the mainstream healthcare system. Despite South Africa having diverse communities with multifaceted healthcare needs, who seek assistance from both conventional and complementary medicine practitioners, research shows that access to complementary medicine remains largely unsupported. According to the WHO, 80% of the world's population uses it. Complementary medicine includes treatments such as homeopathy, Unani-Tibb, ayurveda, traditional Chinese medicine, aromatherapy and Western herbal medicine. South African studies have highlighted the high use of complementary medicine, especially Western and traditional herbal medicine, among people living with HIV. Additionally, these studies have shown that people living with HIV use complementary and ARVs concurrently without the knowledge of their healthcare providers. This is a huge risk as it can compromise the safety and effectiveness of ARVs and cause herb-drug interactions. This is exacerbated by the lack of inter-professional communication between conventional and complementary healthcare practitioners. Professional inter-referral is a practice of healthcare practitioners referring patients to other practitioners to ensure complete, safe and high-quality patient-centred care. This practice is a requisite to improve patient outcomes and enhance the efficiency of healthcare delivery. Despite the increasing evidence and popularity of complementary medicine use in South Africa, there is no formal inter-referral system between conventional and complementary healthcare professionals. Studies show that conventional healthcare practitioners do not refer patients to complementary practitioners, even though they receive referrals from them. For instance, complementary medicine practitioners refer patients to hospitals for laboratory blood tests and X-rays, as well as to various specialists. This finding is concerning and needs to be highlighted to improve the management of multidisciplinary care and continuity of patient care. Furthermore, evidence shows that the lack of an inter-referral system between conventional and complementary practitioners can lead to the fragmentation and compromise of the delivery of quality healthcare. This suggests that inter-referral relationship is a significant practice needed for comprehensive patient care, especially in South Africa, where diverse people use different modalities for healthcare. It demands that healthcare practitioners realise that their area of expertise is important — but not sufficient alone. This is not easy for some to accept and warrants highlighting. Inter-referral relationships require practitioners to step outside their professional pride to appreciate others. A 2025 South African study showed that conventional healthcare practitioners were willing to suggest that patients seek advice from complementary practitioners, yet they were unable to make a formal referral themselves. One can assume that conventional practitioners might have a perception that practising complementary medicine is not a legitimate profession. Their insufficient knowledge of complementary medicine could also be a reason for not referring patients. In South Africa, complementary medicine is regulated by the Allied Health Professions Council of South Africa. The licensing and registration requirements are regulated by the South African Health Products Regulatory Authority. These bodies prioritise the quality and efficacy of medicines and patient safety. Complementary healthcare practitioners are clinically trained as diagnosticians in higher institutions across South Africa. For instance, the Department of Complementary Medicine at the University of Johannesburg offers a postgraduate diploma in phytotherapy (medicinal plant-based therapy) to medical doctors to increase their scope of practice, enhance the cross-disciplinary approach and help them provide a holistic treatment for patients. The dominance of evidence-based medicine is identified as the main barrier to the inter-referral system. There is increasing documented scientific and clinical evidence on complementary medicines and safety data on the toxicology and possible herb-drug interactions. This evidence is sufficient to convince conventional healthcare practitioners to refer patients to complementary practitioners. A formalised referral system is significant to strengthening the healthcare system, especially within the integrated National Health Insurance that is to be implemented in South Africa. The lack of a formalised inter-referral system has implications for patient safety in the delivery of healthcare. The delivery of healthcare in South Africa needs to be considered alongside the broader cultural and social contexts, which necessitate a collaborative approach. South African healthcare must offer a holistic patient-centered approach that considers patients' preferences and includes them in the treatment plan. This will ensure that patients receive appropriate service according to their needs. Dr Tebogo Tsele-Tebakang is head of the Department of Complementary Medicine, in the Faculty of Health Sciences, at the University of Johannesburg. She writes in her personal capacity.
Yahoo
4 days ago
- Business
- Yahoo
Trump blames Europe as deadly impact of US cuts on Aids pandemic grows
Donald Trump has accused European countries of not helping with the HIV/Aids pandemic, as the UN warned sweeping US cuts to its HIV response programme will cost millions of lives. Speaking to The Independent, comments included in a new documentary on the impact of the cuts, the president said the United States had spent 'billions and billions of dollars' to combat the disease and was the 'only country' assisting, adding that now it was Europe's turn to step up. 'Nobody does anything but the United States… Other countries should be helping us with that,' he said onboard Air Force One during a trip back from Florida this month. 'We're the only country. Where are the others? Where is France? Where is Germany? We've spent billions and billions of dollars.' Although the US has by far been the largest funder of HIV support worldwide – providing more than two-thirds of the cash, according to the UN's Aids agency (UNAIDS) – France, Germany, and the UK are also among the top five contributors globally. The President's Emergency Plan for Aids Relief (Pepfar) was first introduced by Republican president George W Bush in 2003 and is widely regarded as one of the world's most successful responses to a global disease crisis, having saved over 26 million lives. UNAIDS told The Independent that Pepfar was integral to putting the world on track to end the HIV/Aids pandemic by 2030. But that progress is now in jeopardy. In a shocking move during the first few hours of his presidency, Mr Trump signed an executive order freezing almost all foreign assistance for 90 days while programmes were reviewed to ensure they aligned with 'American interests'. That included a funding freeze for Pepfar, disrupting supplies and treatment for 20 million people worldwide. Although a waiver was later issued by the State Department to allow the continuation of life-saving services, it remains unclear if the waiver is being implemented on the ground. The 90-day freeze period has now passed without a permanent decision made on the future of funding for programmes like Pepfar. A documentary investigation by The Independent, which includes reporting from remote areas in Uganda and Zimbabwe, shows that money is not getting through. Clinics are having to close and patients have lost access to their medication, causing illness, death and medication-resistant HIV strains. The Independent's own calculations, based on UNAIDS data, show that if funding is not reinstated and nothing changes, the HIV/Aids death toll will triple by 2030 — reaching the devastating levels seen in the 1990s and early 2000s. At the same time, there could be an additional 6 million new infections, including 1 million children, due to mother-to-child transmission. Pepfar's impact tracker has predicted that, as a result of the aid freezes, an estimated 35,000 deaths have already occurred. On the ground in Uganda, The Independent met women like Hadja, 27, a mother of three in Uganda, who is HIV positive and pregnant but unable to get hold of antiretrovirals – meaning she cannot prevent transmission of HIV to her unborn child. The documentary also features Hardlife, a 15-year-old Zimbabwean who lost both his HIV-positive parents earlier this year because they could not afford or find their medications. The film also visits an HIV/Aids clinic in southern Uganda that was 100 percent funded by USAID. Staff said they had to shut down for two months, then reopen with a skeleton crew working without pay. They now have only two months' worth of drug supplies left and worry about the future of their patients. Angeli Achrekar, deputy executive director of UNAIDS, told The Independent there were 'challenges' in applying the waiver. 'The whole HIV service delivery system is an ecosystem. Any one kink in the system could cause a real ripple effect across the entire HIV ecosystem,' she said. When asked about the apparent failure of the waiver, MrTrump told The Independent that it 'shouldn't be happening' and urged the countries involved 'to act properly on the waiver'. 'But I do ask: why are we the only country doing it? I'm a big fan of getting this solved,' he added. Although the US was carrying the lion's share of the financial burden of funding the fight against HIV/Aids – and is in the words of UNAIDS 'the most important donor' – it is not the only donor. According to data shared by the Global Fund to Fight Aids, tuberculosis and malaria, Germany and France are among the largest donors. The Global Fund is another major part of the global response to HIV/Aids that pools resources from governments, civil society, and the private sector to fund programmes to end these diseases. Their data shows France, a founding member of the Global Fund is the largest European donor and the second-largest public donor overall, behind the US. They have contributed €6.9bn since the fund was started 20 years ago. In the last replenishment conference in 2022, France pledged €1.6bn for the years 2023 to 2025 — nearly a quarter increase from its previous contribution. Germany, meanwhile is the fourth-largest public donor overall, contributing over €5.3bn since the fund was created 20 years ago. It pledged €1.3bn for the 2023–2025 cycle, according to the Global Fund. UNAIDS officials told The Independent that while the US has provided the most funds, countries have also played a significant role relative to their economic size. There has also been a move to increase domestic funding and resilience from countries hardest hit by the HIV/Aids pandemic. 'We do recognise and want to celebrate that the US has been the largest donor and has done an amazing job during the last decades. Thanks to that we are where we are in the HIV response, so it has been amazing leadership and contributions,' Jaime Atienza Azcona, a director at UNAID, told The Independent. 'Others have done their part, but to a lesser degree. Going forward, we need a more balanced approach among the different donors. But we still need donor support and we still need the US leadership, even if it is at a lower scale.' The Independent reached out to the foreign ministries of both France and Germany for comment on President Trump's accusations but has yet to receive a reply. This story has been produced as part of The Independent's Rethinking Global Aid series
IOL News
17-05-2025
- Health
- IOL News
More than 520,000 people initiated on HIV treatment in South Africa's Close the Gap campaign
Minister of Health Aaron Motsoaledi announced that more than 520,000 people have been initiated onto antiretroviral treatment as part of the government's Close the Gap campaign, aiming to end the AIDS epidemic by 2030. Image: File Minister of Health Aaron Motsoaledi revealed on Thursday that more than 520,000 people living with HIV/AIDS have been initiated onto the antiretroviral (ARV) treatment programme as part of the government's Close the Gap campaign aimed at reaching targets to end the AIDS epidemic by 2030. The Minister was speaking during a briefing on the status of the HIV/Aids and TB Campaign in South Africa. Motsoaledi said UNAIDS has calculated that to bring an end to AIDS as a public health threat, a country should reach a target of 95-95-95. This means that 95% of HIV positive people must know their status, 95% of those who are positive should be put on treatment, and 95% of those on treatment should achieve viral suppression, whereby they stop transmitting the virus to other people. 'We know that there are 7.9 million people in South Africa who are estimated by UNAIDS to be HIV positive. At the moment, in terms of UNAIDS targets, we are at 96-79-94. Today we have about 5.9 million people on ART. Mother-to-child transmission has reduced dramatically, and we have reduced deaths from HIV and concomitantly reduced the deaths from TB.' This indicates that the largest gap in the country's HIV response is among those who have tested positive but are not receiving treatment. Motsoaledi said the Department has calculated that to move from the 79 to 95, 1.1 million people who are known to be HIV positive but not on ARVs need to be initiated into treatment. He said with a budget of R659m for the campaign, the government's initial target of 100,000 people reached by this stage has already been surpassed. 'I can report to you today that we have reached 520,700 people living with HIV/Aids and initiated them on treatment, which includes women, men, and children. This is more than 50% of the target we set ourselves to reach by 31 December 2025. This work has been made possible by the budget reprioritised from the HIV/AIDS conditional grants.' 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 Next Stay Close ✕ Ad Loading Motsoaledi attributed this success within a short space of time to the weekly check-in meetings with provinces, where reports that come from the ground are verified in the presence of all provincial colleagues before they are regarded as final figures for reporting. 'It is for this reason that we are even able to disaggregate the number of newly diagnosed/initiated against those who are returning to care. Based on this, we are confident that we will reach the target of 1.1 million by the end of the year.' The Minister also commended the role played by civil society in the mobilisation. 'Without them, we would have come nowhere near this figure.' He noted that as part of this response, the team from the National Department of Health and the South African National AIDS Council (SANAC) have started a programme of provincial roadshows through which they engage provincial structures, including provincial and district AIDS Councils, traditional leaders, and civil society. He said targets were set for all nine provinces, districts, and facilities. The Minister added that the country has a stable supply of ARVs because we procure 90% of ARVs from government fiscus, supported by 10% from the Global Fund. He stated that the Global Fund has pledged an extra R1billion for ARV procurement to ensure a sustainable supply and that some of these orders have already been signed off. Referring to the withdrawal of the President's Emergency Plan for AIDS Relief (Pepfar) by the US, which amounts to R7.9bn, Motsoaledi said: 'We want to [make] it categorically clear, under no circumstances will we allow this massive work performed over a period of more than a decade and a half to collapse and go up in smoke.'
The Citizen
16-05-2025
- Health
- The Citizen
US funding withdrawal will not collapse HIV programme, says health minister
US funding withdrawal will not collapse HIV programme, says health minister The withdrawal of billions in US government funding to South Africa will not collapse the fight against HIV/Aids. This is the assurance of Health Minister Dr Aaron Motsoaledi amid growing concerns over the withdrawal of R7.9-billion in funding. ALSO READ: US grants strengthen communities He said it is 'inconceivable that out of R46.8-billion spent by the country on HIV programmes, the withdrawal of R7.9-billion by President Trump will collapse the entire programme'. 'Today we have about 5.9 million people on antiretroviral therapy (ART), mother-to-child transmission has reduced dramatically. We have reduced deaths from HIV and concomitantly reduced the deaths from TB. 'When we started this programme, we needed R3.5-billion, today we spent R46.8-billion of which R7.9-billion was from the US President's Emergency Plan for Aids Relief (PEPFAR),' said Dr Motsoaledi. He said PEPFAR was supporting the Department of Health in 27 HIV high burden districts out of 52 districts in the country. This includes seven districts in KZN. The minister said, in these 27 districts there were only 12 specialised clinics independent from the government, managed by the NGOs providing services mainly for key populations funded by PEPFAR. 'When the PEPFAR funder clinics were closed, we removed their files from those clinics to the nearest public facilities, and we can confirm that all 63 322 have been moved. 'Then the work to contact their owners to transfer them to public health facilities where their files are, started in earnest and continues. 'In the process, some clients requested they be referred to different facilities which are more accessible and convenient for them,' said Motsoaledi. This is together with a stable supply of ARVs. 'We procure 90% of ARVs from government fiscus, supported by 10% from the Global Fund. 'The Global Fund has pledged extra R1-billion for ARV procurement to ensure sustainable supply. Some of these orders have been signed off,' said Motsoaledi. 'UNAIDS has calculated that to bring an end to Aids as a public health threat, a country should reach a target of 95-95-95, meaning 95% of HIV-positive people must know their status, 95% of those who are positive should be put on treatment, and 95% of those on treatment should achieve viral suppression whereby they stop transmitting the virus to other people. 'We know there are 7.9 million people in South Africa who are estimated by UNAIDS to be HIV-positive. At the moment, in terms of UNAIDS targets, we are at 96-79-94.' HIV funding gap update by Minister of Health, Dr Aaron Motsoaledi today (15 May ). — National Department of Health (@HealthZA) May 15, 2025 Don't have the ZO app? Download it to your Android or Apple device here: HAVE YOUR SAY Like our Facebook page and follow us on Twitter. For news straight to your phone invite us: WhatsApp – 060 784 2695 Instagram – zululand_observer At Caxton, we employ humans to generate daily fresh news, not AI intervention. Happy reading!
IOL News
15-05-2025
- Health
- IOL News
Motsoaledi defends government's HIV/AIDS response amid criticism and funding cuts
Minister Motsoaledi reaffirms South Africa's commitment to HIV/AIDS efforts, despite PEPFAR cuts, with 'Close the Gap' campaign already reaching over 500,000 people and reprioritizing R659 million in funding. Image: GCIS Health Minister Aaron Motsoaledi has responded to growing concerns about the future of South Africa's HIV/Aids program amid a significant funding cut from the US President's Emergency Plan for AIDS Relief (Pepfar), emphasising the government's commitment to continue its work and correct misinformation spreading in the public. Speaking at a media briefing on Tuesday, Motsoaledi highlighted both the progress made in the fight against HIV and Aids and the immediate steps being taken to address the funding shortfall and its impact on key populations and healthcare workers. 'We are not here today to state that this could all be made. What we are here today is to provide facts and legal, and an account of what we have done,' said Motsoaledi. 'In this case, we are prepared to be fact-checked by the media houses because we are aware that some media houses have established a check system.' South Africa currently has an estimated 7.9 million people living with HIV. The minister said the government's goal remains aligned with UNAIDS targets of 95-95-95, meaning 95% of people living with HIV should know their status, 95% of those should be on antiretroviral treatment (ART), and 95% of those on ART should be virally suppressed. 'We have calculated that to move the '79' ,the middle 79 ,to '95', we need 1.1 million people who are known to be HIV positive but are not on ARVs. We call this campaign 'Close the Gap,'' Motsoaledi said. Motsoaledi acknowledged the devastating effect of PEPFAR's funding reductions, which led to 8,061 healthcare workers losing their jobs. These workers were among the 15,589 PEPFAR-funded staff within a larger HIV workforce of over 271,000. 'Out of 271,606 people working on HIV programs, 15,589 were funded by PEPFAR. Because PEPFAR is off, 8,061 are out of jobs. That's very unfortunate, but we can confirm,' he said. However, Motsoaledi said 7,478 Pepfar-supported staff will remain employed through Centers for Disease Control and Prevention (CDC) funds until at least September 2025. Despite reduced resources, the department continues its efforts, having reprioritized R659 million from HIV/AIDS conditional grants to support the campaign. The minister revealed that the government has already reached over 500,000 people through the 'Close the Gap' campaign, far surpassing the initial December 2024 target of 100,000. 'The reason that we're able to reach half a million people in a very short piece of time was because of weekly check-in meetings in the provinces,' he said, noting the close involvement of civil society and provincial health authorities. Weekly meetings and real-time verification of ground reports helped keep the campaign responsive and efficient, allowing for real-time adjustments and monitoring of new diagnoses and ART initiation, he said. Motsoaledi said the department is also addressing healthcare access challenges for key populations such as sex workers, men who have sex with men, and truck drivers in high transmission areas. Between January and March 2025, 88.66% of the department's 154,298 target for key population outreach was achieved. 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 Next Stay Close ✕ He noted that four NGOs, the Alliance Against HIV and Aids, the Center for Positive Care, the National LGBTI Health Campaign, and NOFTA Alliance, have received direct state funding to serve these communities. A total of 1,012 clinicians and 2,377 non-clinicians have been trained to offer more sensitive and respectful services to key population groups, with training ongoing in the remaining provinces. 'The training is aimed at empowering health workers to appropriately engage the key population clients with dignity and the respect they deserve,' Motsoaledi said. Responding to public criticism from prominent HIV/Aids advocates, Motsoaledi urged all stakeholders to stop sowing division and instead unite in the fight to eliminate Aids as a public health threat. 'Fighting each other, interrogating each other, pointing fingers, reporting and spreading disinformation is definitely not the way,' he said. 'Rather, this is a time to come together, unite, and fight this one strong belief.' He emphasised the inclusive role of the South African National AIDS Council (SANAC), which comprises 18 sectors of society and coordinates national responses to HIV/Aids. 'No single South African can be declared free that SANAC doesn't represent them and give them a chance to participate and convey their views, their beliefs, their desires, and their fears,' he said. Motsoaledi reaffirmed the government's ongoing efforts and openness to collaboration, stating: 'As government, our doors are open. Get your news on the go, click here to join the IOL News WhatsApp channel. IOL Politics
