The body’s cells start to ignore the hormone and sugar builds up in the blood. This can lead to diabetes, especially in people who are genetically predisposed to the condition or who eat a lot of sugar and don’t get much exercise.
When people with HIV don’t take their ARVs, they have a higher chance of getting TB. And once they have TB, they are also more likely to develop diabetes.
That’s because TB can trigger a diabetic state, said the International Diabetes Federation’s South African chapter in a 2025 report. That means that even after people with TB have finished their treatment and are cured of the infection, they can still develop diabetes.
The Global Diabetes Compact, a plan backed by the World Health Organization to reduce diabetes cases by 2030, says that health workers should start checking for diabetes in people with TB.
But if there are fewer people on ARVs, because of funding cuts, it could mean more people with HIV get sick with TB and then diabetes. That’s because people who don’t take their ARVs properly could get sicker and need more treatment overall.
Both conditions need long-term care and cost a lot to treat. If people don’t get the right treatment for TB, the germ might become resistant to the medicines used to kill it. And if they don’t manage their diabetes, they can lose their sight, have problems with their kidneys and even die.
People with HIV and diabetes at higher risk from COVID-19
People who are older than 50 and have HIV are more likely to get sick from the coronavirus than those without the virus, studies have found.
And if they also have diabetes, their chances of falling severely ill rise even more. People with diabetes are more likely to suffer severe complications from COVID-19, studies have shown.
Diabetes affects the immune system and can make it harder for the body to fight off infections, including the coronavirus. This means that people with HIV and diabetes could get sicker from COVID-19 than those with just one of the conditions.
But with fewer people on ARVs, more people with HIV could get sick and need hospital care. And with less money for health, people with diabetes might not get the care they need to manage their condition.
This could mean that more people develop severe COVID-19 and need hospital care. And with fewer hospital beds and less money for health, people could die from the virus, HIV, TB and diabetes — all diseases that can be treated with the right care.
Less money for clinics, less care for everyone
With the US government pulling the plug on HIV funding in South Africa, many clinics that used to be funded by the US government to treat people with the virus have had to close their doors.
This means that people with HIV now have to go to government clinics for treatment. But these clinics are already overburdened and don’t have enough money or staff to take on all the new patients.
That could mean that people with HIV and NCDs like diabetes, heart disease and mental health problems might not get the care they need. And with less money for health, the clinics could run out of drugs and other supplies needed to treat these conditions.
Less care for people with HIV and NCDs could mean more people get sick and die from these conditions. And with the added threat of COVID-19, the situation could become even worse.
What can be done to prevent a health crisis?
To prevent a health crisis caused by the funding cuts to HIV projects in South Africa, there are several steps that can be taken:
- Increased funding from the South African government to fill the gaps left by the US government’s withdrawal of support
- Training more healthcare workers to provide care for people with HIV and NCDs
- Improving access to medications and treatments for HIV, diabetes, heart disease, and mental health issues
- Implementing screening programs to detect diabetes in people with TB
- Strengthening healthcare systems to better respond to the needs of people with multiple health conditions
By taking these steps, South Africa can mitigate the impact of the funding cuts on the health of its population and prevent a potential health crisis in the future.
The intersection between infectious diseases and non-communicable diseases (NCDs) is becoming increasingly evident, especially in countries like South Africa. The recent closure of the cervical cancer screening and prevention clinic at Helen Joseph Hospital in Johannesburg due to US funding cuts highlights the impact on public health. Cervical cancer, preventable through vaccination and regular screenings, is a significant concern in South Africa, particularly among women with untreated HIV infections.
Individuals with HIV who are left without treatment as a result of funding cuts are at increased risk of developing mental health conditions such as depression and anxiety. The presence of untreated HIV can lead to HIV encephalopathy, which damages brain tissue and increases the likelihood of depression and anxiety. Stigma and discrimination related to HIV also contribute to mental health challenges, making it harder for individuals to adhere to treatment regimens.
Moreover, NCDs like diabetes and hypertension are often underdiagnosed in South Africa, partly due to a lack of resources and healthcare providers. With fewer nurses available to provide care, the detection and management of NCDs become even more challenging. The reduction in funding for programs that support community health workers to screen individuals for HIV, TB, and other diseases further exacerbates the healthcare system’s strain.
The interconnectedness of infectious diseases, NCDs, mental health conditions, and healthcare access underscores the importance of comprehensive and integrated healthcare services. Addressing the root causes of these health disparities, including funding cuts and staffing shortages, is crucial to improving health outcomes and reducing the burden of diseases in vulnerable populations. Through sustained investments in public health infrastructure and support for healthcare workers, we can work towards a healthier future for all individuals, regardless of their health status. Sign up for the Bhekisisa newsletter to stay informed about the latest health news and updates. Our newsletter provides valuable insights and information on a wide range of health topics, including COVID-19 updates, public health policies, and healthcare innovations.
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Stay informed and empowered with the Bhekisisa newsletter. Sign up today to stay ahead of the curve and make informed decisions about your health and well-being. Subscribe now and join our community of health-conscious individuals who are committed to staying informed and educated about important health issues. The world of technology and innovation is constantly evolving, with new advancements being made every day. One of the most exciting fields within this realm is artificial intelligence (AI), which has the potential to revolutionize industries and improve our daily lives in countless ways.
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