This slow growth means that South Africa is unlikely to reach the 95% treatment target by 2025, as the number of people going on treatment is not increasing fast enough to close the gap. The data shows that progress is being made, but it is slow and not sufficient to meet the ambitious targets set by the UN.
The challenges in reaching the treatment targets are multifaceted. People who have been on ARVs before may stop treatment for various reasons, such as relocation, work commitments, or fear of judgment at health facilities. These interruptions in treatment make it difficult for individuals to re-engage with the healthcare system, leading to gaps in care.
Furthermore, the healthcare system’s rigid appointment schedules and potential stigma faced by key populations can deter individuals from seeking treatment. The slow progress in closing the treatment gap highlights the need for more patient-centered approaches that address the barriers preventing individuals from accessing and staying on treatment.
As funding shortages and program closures continue to impact HIV services in South Africa, the government must prioritize efforts to support individuals in staying on treatment. The data shows that while progress is being made, it is not enough to meet the ambitious targets set by the UN. More needs to be done to ensure that everyone with HIV has access to life-saving treatment and care. Recent funding cuts from the US have disrupted HIV treatment programmes in South Africa, leading to concerns about the sustainability of progress in the fight against the epidemic. According to experts like Johnson, the assumption that programmes will continue to run smoothly as they have in the past may no longer be realistic.
One of the challenges contributing to a small net gain in HIV treatment coverage each year is the high dropout rate among patients. While many individuals start treatment, a significant number also discontinue their medication for various reasons. Some may restart treatment after a short break, while others may remain off medication for an extended period.
In 2023, for instance, around 793,500 individuals who were previously on treatment had stopped, but approximately 728,000 restarters received medication, as per data from the Thembisa model. This fluctuation in treatment adherence highlights the dynamic nature of HIV treatment coverage and the need for ongoing monitoring and support.
Health economist Gesine Meyer-Rath emphasizes the importance of reducing treatment interruptions and ensuring quick re-engagement for those who pause their medication. Data analysis suggests that improving retention rates among existing patients can help bridge the treatment gap, especially in the face of dwindling funding support.
Meyer-Rath’s research underscores the significance of accurate data in guiding policy decisions and resource allocation. The recent loss of US-funded data capturers in South Africa poses a significant challenge, as it may hinder the availability of crucial information needed to shape effective HIV programmes.
Without robust data collection and analysis, the country risks operating with limited visibility into the progress of its HIV response efforts. Meyer-Rath warns that inadequate data could lead to uncertainties and disagreements over the available information, potentially impeding the country’s ability to achieve its goal of ending AIDS as a public health threat.
As South Africa navigates the complexities of HIV programme management amidst funding uncertainties, the need for reliable data becomes more critical than ever. Ensuring accurate and up-to-date information is essential for driving informed decision-making and sustaining progress in the fight against HIV/AIDS.
This article was produced by the Bhekisisa Centre for Health Journalism. Stay informed by signing up for their newsletter.
