Tag: South Africa

Categories : HIV Obstetrics & GynaecologyTags :

Integrating Health Services for Mom and Baby Could Reduce Clinic Visits by Half

On By ModernMedia
After birth, moms and babies are required to visit healthcare facilities for essential services like immunisations, postnatal care and HIV testing. Photo by William Fortunato on Pexels

By Elri Voigt

In South Africa, many mothers and their babies have to visit the clinic more than 10 times in the first six months of the postnatal period. Early findings from an ongoing implementation science project suggests we can get this down to five. The hope is that the new approach will also help reduce HIV transmission from mothers to their babies. 

Over the last two decades, South Africa has taken huge strides in reducing HIV transmission from mothers to their babies (often called vertical transmission).

Maternal deaths from non-pregnancy-related infections have decreased, because more women are taking HIV treatment, and HIV rates among babies at birth have also gone down. This has all been possible largely because of integrating HIV services with our antenatal services, Dr Jeanette Wessels, of the University of Pretoria’s Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, told delegates at the recent Southern African HIV Clinicians Society (SAHCS) Conference.

However, a closer look at the data shows us that while vertical transmission at or before birth has come down dramatically, HIV transmission in the months after birth remains alarmingly common. This happens particularly when the mother contracts HIV in this period and the virus is then transmitted to her baby before she is diagnosed, or before the virus can be brought under control with antiretrovirals. As Wessels puts it, “our next frontier to tackle is the breastfeeding period”.

During the antenatal period (before birth), pregnant women are offered HIV tests and prevention pills or HIV treatment when they visit clinics for their pregnancy check-ups. However, during the postnatal period (after birth), HIV services are not integrated in the same way. This fragmentation of care after birth is a key driver of vertical transmissions, suggests specialist paediatrician Dr Nthabiseng Serudu-Nageng. The thinking is that the fragmentation and high number of clinic visits makes it less likely that new HIV infections in mothers will be picked up before the virus can be transmitted to their babies and that it makes it less likely that new mothers will take the HIV prevention pills or HIV treatment they might need.

Spotlight previously reported that, according to the latest estimates from Thembisa – the leading mathematical model of HIV and TB in South Africa – of the roughly 7 200 babies who contracted HIV in the country from mid-2023 to mid-2024, only about 2 500 got HIV before or at birth. This means that about 4 700 babies got HIV in the months after birth, and while some of these mothers were on antiretroviral therapy, according to the Thembisa estimates, the majority of mothers had not been diagnosed with HIV yet. Meaning a contributing factor to some of these infections is likely that many of these mothers got HIV after the birth of their babies and were unaware of it.

Wessels told delegates that around 75% of mother-to-child transmission of HIV is happening during breastfeeding, and just over one third (35%) of those are due to new HIV infections in the mother. She added that about 80% of those new infections in babies after birth happen in the first six months.

It is important to realise that in terms of absolute numbers, HIV transmission during the breastfeeding period has gone down, but proportionally more babies are getting HIV after birth, explained Professor Ute Feucht, the Director for the University of Pretoria’s Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies. Feucht is also the Community Paediatrician in the Tshwane District Clinical Specialist Team at the Gauteng Department of Health.

Clinic visits can be halved

To improve care in the postnatal period, researchers in Gauteng have launched an ambitious implementation science project called Sihamba Kunye. Their key idea is that clinic visits for mother and baby can be much better integrated and optimised. This could make it more likely that mother and baby will attend all required clinic visits and get all the healthcare services they need. The project is funded by the Gates Foundation.

During the postnatal period, said Wessels, a mother may have to come to the clinic up to 11 or 12 times in the first six months. This can be to get her baby to the necessary visits for immunisations, as well as family planning, to pick up HIV treatment or prevention pills or postnatal care for herself. Wessels was presenting early observations from the study at the SAHCS conference.

Commenting on this, Feucht, who is the study’s principal investigator, told Spotlight: “That is twice a month, and yes, with a newborn baby!”

To make matters worse, throughout these many visits, mothers and babies are often seen separately, which isn’t optimal since, as Serudu-Nageng pointed out, “whatever affects the mother directly impacts her baby, so integrating their care is essential”.  She is the study’s consultant paediatrician.

“One of the biggest challenges mothers face is having to come to the clinic many times in the first six months. This has a huge impact: it affects food security, especially for unemployed mothers, its transport costs, its time away from work or home, and long waiting hours at the facility. Each visit comes with an emotional and financial cost,” said Serudu-Nageng.

“Through the Sihamba Kunye project, we are addressing this [challenge] by aligning and coordinating the mother and baby’s visits so they can be seen together, on the same day and ideally at the same service point,” she said. “This reduces the number of visits, saves time and cost for the mother, eases the workload for the facility because it means less feet through the clinic all while maintaining quality care for both mother and baby.”

By coordinating these different visits, the total number of times a mother and baby might need to go the facility is reduced to only five visits.

How it works

The researchers conducted time-and-motion studies – where industrial engineering students from the University of Pretoria followed patients around with stopwatches to time how long it took them to move through the clinic from arrival to exit. They also conducted interviews with mothers and infant pairs, had consultations with facility managers, and conducted workshops with healthcare workers, as well as created curated resources and tools to assist with the transition to offering integrated care.

Integration of services was classified into two levels, depending how much the services could be streamlined, said Serudu-Nageng. Level two integration means that a mom and her baby are seen on the same day, but at different parts of the facility and likely by different nurses. Level three integration means they are seen together, on the same day, by the same nurse.

“We worked closely with facility managers, sub-district programme managers and clinicians to redesign processes and adapt the model to fit each facility’s realities,” she said.

The time-and-motion studies helped identify bottlenecks and improve the flow and efficacy at the clinics, Serudu-Nageng said. One big time waster was that if a mom comes in with her baby and the healthcare staff only draw baby’s file but later see mom also needs care, she’ll have to go back to get her own file. To resolve this, the project recommends drawing both mom and baby’s files when they visit the facility, regardless of the reason for the visit.

One major component of integrating care, Serudu-Nageng said, was task-shifting. This is to ensure that professional nurses have the time to spend doing clinical consultations with mom and baby together, since their consultation time has essentially doubled. This means designating tasks like checking vital signs, weighing, giving immunisations and vitamin A and deworming to support staff, leaving professional nurses to do tasks only they are qualified to do.

“[T]he professional nurses can be used for other things like clinical decision making and we can rather delegate work that doesn’t require clinical decision making to lower cadres of nurses of staff,” she said. “Together, these efforts have helped facilities streamline workflow, strengthen teamwork and deliver this integrated postnatal care package for both mothers and babies.”

Another thing the researchers did was to compile two important tools that pulled together information from all the relevant national guidelines for primary healthcare – like the HIV, TB, ideal clinic and immunisation guidelines – and putting them together in one place called the the First 1000-day Roadmap. This is used alongside an Integration Wheel that helps nurses coordinate the different visits moms might need to come to the clinic for.

Wessels in her presentation explained that the roadmap has different sections categorised according to the type of visit mom and baby are at the clinic for. She gave the example of the 10-week visit, where babies normally receive some of their key childhood immunisations. One section of the roadmap will include “all the care needed for the mom, her general postnatal care, nutrition, VTP [Vertical Transmission Prevention] and screening like TB screening, STIs, mental health, her contraception and extra care”. The other section will cover all the things the baby will need.

The roadmap is used alongside the Integration Wheel, which is designed like a pregnancy wheel. The front of the wheel can spin to the visit the mom and baby are at the clinic for. “It outlines [among other things] what you do for an HIV positive mom, for an HIV negative mom, what contraception do you get every mom,” Wessels said. At the back, the wheel has information on the different visits mom and baby would still need to come to the clinic for and helps nurses align those visits.

The front of the Integration wheel can be spun to the specific visit mom and baby are at the clinic for and help align their next visits to reduce the number of times they have to come to the facility. Source: Screenshot from Professor Ute Feucht’s presentation on the Sihamba Kunye Project at the 2025 SA AIDS conference.
The back of the Integration wheel shows nurses everything they need to do for both mom and baby, depending on their HIV status, baby’s age and mom’s family planning needs and postnatal care. Source: Screenshot from Professor Ute Feucht’s presentation on the Sihamba Kunye Project at the 2025 SA AIDS conference.

With these resources, according to Wessels, nurses at the participating facilities are able to align mom and baby’s visits from their six-day postnatal visit and can reduce those visits to only five in the first six months.

What’s next?

The response to the project has been very positive and created a bit of a “snowball effect”, Feucht said. “The district has actually been asking us, when can we go to the rest [of the clinics in Tshwane]?”

The first phase, she added, was to figure out what is possible in terms of integrating care and how can it be done. “[T]he next step is then taking that toolkit out to the other provinces as well.”

The research team hopes to have several publications showcasing their findings ready to present at key health conferences next year. But they also hope to see the model being more widely used in the future.

“It’s got potential to transform the postnatal period and make it as good as the antenatal period,” Serudu-Nageng said. “[I]ntegrating care and putting the patient at the centre will really, really, be great for outcomes, but for mom and baby as well.”

“Based on my experience, this approach is highly feasible within the broader public healthcare system because it builds on existing structures and staff,” she added. “It is practical and scalable, and we are hopeful that it will serve as a proof of concept for future scale-up across South Africa’s public health system.”

Disclosure: The Gates Foundation is mentioned in this article. Spotlight receives funding from the Gates Foundation, but is editorially independent – an independence that the editors guard jealously. Spotlight is a member of the South African Press Council and subject to the Press Code.

Republished from Spotlight under a Creative Commons licence.

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Categories : Healthcare Politics and Regulations Metabolic DisordersTags :

Patients Left Vulnerable as Diabetes Supplies Dwindle

On By ModernMedia
Photo by isens usa on Unsplash

By Joan van Dyk

Getting to grips with rising diabetes rates is arguably one of the most urgent tasks for South Africa’s public healthcare system, but the setbacks keep coming. While some communities are facing shortages of blood sugar meters and insulin pens, a smaller wave of insulin vial shortages is now on the horizon.

In August, activist Eksoda Mazibuko was sure that years of community organising had finally yielded tangible results for people with diabetes in Hluvukani, a town in Mpumalanga.

The 35-year-old had just received R50 000 from Good Morning Angels, Jacaranda FM’s community upliftment project. It was more than enough for him to buy blood sugar meters and test strips for the fifty-person support group he runs at Tintswalo Hospital in Acornhoek, where stock had run out.

When the body can’t make or use insulin – the hormone that keeps blood sugar in check – people have to watch their levels, so they know how to eat and medicate themselves. It’s a process held together by medicines and an ecosystem of tools ⁠such as meters, strips, pens, lancets, needles, syringes, which unravels when one part is missing. Over time, poorly controlled blood sugar causes cumulative damage to one’s body that can result in severe complications such as amputation, blindness, kidney damage, and stroke.

Most people who take pills to treat diabetes need monitoring from time to time, but for the majority of those who are on insulin treatment, it is essential. People with diabetes who are taking insulin must check their blood sugar levels multiple times a day. To do this, they need glucometers – devices that measure the sugar levels in a drop of blood. But access to glucometers is a challenge. Spotlight previously reported that not everyone who needs these home testing devices is given one and those who do receive them rarely get enough test strips and lances to enable proper monitoring of their blood sugar levels.

Without tests and test strips, people in Hluvukani had no way of knowing how to adjust their insulin. Injecting the wrong amount could in extreme cases result in someone going into a coma or dying.

Mazibuko himself, who was diagnosed in 2003 and has always needed insulin, knows how terrifying it can be when monitoring tools are out of reach.

When the devices and test strips finally arrived, he shared a celebratory photo on social media. Excited messages streamed in on WhatsApp, but among them was an upsetting note from a government pharmacist: “You should have asked me before you ordered.”

Unbeknownst to the hospital staff that helped Mazibuko choose the device, the national government’s supplier would be changing, as it does every three years or so when a new tender is awarded. That means state pharmacies would soon stock a different kind of test strip.

Glucometers generally can’t interpret test strips from a different brand or model, so the glucometers that he’d already started to hand out would soon be useless.

“They were already open so I couldn’t send them back. After I worked so hard to get those machines for my community members,” said Mazibuko. “It was heartbreaking.”

According to a report from the Clinton Health Access Initiative, in poorer countries companies make most of their profit on the test strips rather than the glucometers used to read the strips. Spotlight understands that some companies go as far as giving away the devices to lock people into using their specific test strips. According to Cathy Haldane, who leads the non-communicable diseases team at FIND (a global diagnostics alliance), there have been some efforts toward encouraging universal interoperability of test strips, but these efforts haven’t gathered much steam.

Why diabetes is still a national guessing game

South Africa is one of the few countries that buys blood glucose meters and test strips en masse, but there are still lots of people who are treated with insulin who don’t have access to them.

One reason for this is that the national health department buys machines and strips for the public sector but it’s up to provinces to manage stock at pharmacies and clinics, explains Haldane.

A lack of good quality diabetes data could be making harder for health department staff to predict how much they’ll need, she says. Unlike the country’s digital HIV & TB tracking system, there’s no centralised database for diabetes and other chronic diseases such as high blood pressure and cancer. As Spotlight previously reported in-depth, there is a serious lack of reliable diabetes data for South Africa. Haldane says, “that’s how people on insulin treatment who should get a machine and monthly test strips end up going without”.

Not having reliable data leaves national planners, doctors and nurses in the dark about how many people need blood sugar monitors, where the system is failing and how the country is faring against targets outlined in the health department’s action plan for chronic diseases, which lapses in 2027. The plan states that by 2027, the health department wants at least 50% of people receiving care for diabetes to have their blood sugar under control. The available data though, all from pockets of academic research, suggests that we are falling far short of this target.

The diabetes data that is available paints a harrowing picture.

According to a StatsSA report on non-communicable diseases, diabetes was the leading underlying cause of death for women and second biggest underlying cause of death for men in 2018. While other reports suggest that diabetes is lower on the list of top killers, it clearly does claim many lives in the country. The International Diabetes Federation estimates that about half of people with diabetes in South Africa haven’t been diagnosed.

If trends continue, 2018 research suggests the treatment, management and complications of type two diabetes could cost the government as much as R35-billion by 2030.

In rural KZN, insulin pen stockouts persist

Meanwhile, more than 700 kilometers from Hluvukani, in KwaZulu-Natal’s rural King Cetshwayo district, some healthcare staff are using their own money to help keep diabetes services going.

Indira Govender, a doctor affiliated with the Rural Doctors Association of South Africa (Rudasa) who works in the area, says clinic managers are often the ones buying new batteries for blood sugar meters used in the facility and by patients.

The devices use the coin-like batteries also used in some watches, which aren’t easy to find in far flung areas.

Govender worries about the patients on insulin who still have to use a glass vial and syringe to inject themselves. “Not everybody has a fridge to store the insulin in. People struggle to draw up the right amount of insulin, sometimes because they can’t see well,” says Govender.

South Africa ran out of pens in 2024 when the health department’s longtime supplier, Novo Nordisk, stopped manufacturing pens prefilled with the cheapest form of insulin. The news came as global demand surged for one of Novo Nordisk’s long-acting diabetes medicines, semaglutide, because it was shown to also be effective for weight loss. Semaglutide is also provided in pens rather than vials.

In a 2024 letter to Novo Nordisk’s chief executive officer, MSF demanded that the pharma giant either ensure continued supply of the cheapest insulin pens in South Africa or that it offer a newer kind of pen at $1 each. That’s the amount that MSF’s research found would cover production costs, a fair profit margin and an allowance for tax.

The newer pens are filled with a form of insulin that takes effect faster and lasts for longer than previous versions. Novo Nordisk signed a deal in May in which it commits to providing these pens to South Africa until 2027. The department was charged just under $4 (around R75) per pen.

At the government clinic where Govender works in KwaZulu-Natal, however, insulin pens have reportedly not returned to pharmacy shelves.

“We haven’t had pens here since at least 2024,” says Govender.

The KwaZulu-Natal health department did not respond to Spotlight’s queries about the delivery delays.

Local consequences of global disruptions

While some communities are still waiting for insulin pens, a smaller wave of vial shortages is on its way for South Africa, according to an October circular.

Novo Nordisk told the health department to expect six to eight week delays in the delivery of short-acting, medium-acting and longer-acting insulin sold in 10ml vials. The department did not respond to Spotlight’s queries, but the circular listed four alternative prefilled pens that are available and expects stock to stabilise by January 2026.

One of the listed alternatives, Novo Nordisk’s NovoMix30, is also on a list of insulin pens and vials that will be discontinued in 2026, according to a directive issued by the health ministry in New Zealand.

No such directive has been issued by South Africa’s health department. Candice Sehoma, advocacy advisor for MSF Access in Southern Africa, says she would be surprised if the country avoids it.

It’s part of a concerning pattern of shortages of essential medicines worldwide, she says.

“We’re seeing more and more companies deprioritising insulin and discontinuing affordable medicines,” says Sehoma.

When there’s insulin but no food

While his stock of test strips lasts, Mazibuko takes them along when he visits members of his support group in Hluvukani.

They could technically find matching strips in the private sector, but they’re likely to be too expensive. A 2024 study found that for someone earning South Africa’s minimum wage, a single blood-sugar test in the private sector costs more than an hour of work, and a month of basic diabetes supplies can swallow three full days’ wages.

Many of the people on Mazibuko’s route are facing far more serious problems than the loss of glucometers. Those who aren’t working are often not taking their medication well either, Mazibuko says. “They don’t have food so they skip breakfast and also skip their insulin because they’re scared.”

Injecting insulin on an empty stomach can cause a sudden blood sugar crash that could lead to dizziness, confusion or a seizure.

Mazibuko is working on a skills programme to help these people make a living that might also protect them from lapses in basic supplies at government health facilities, which he claims happens often.

“Sometimes you go to the clinic, they tell you that they’ve run out of insulin, or they tell you to buy your own needles and syringes. You will have to do that with borrowed money,” says Mazibuko.

The Mpumalanga health department also did not respond to Spotlight’s requests for comment.

Republished from Spotlight under a Creative Commons licence.

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Categories : UncategorizedTags :

Release of Useful Health Statistics: 2015 to 2025

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Mycobacterium tuberculosis drug susceptibility test. Photo by CDC on Unsplash

By Marcus Low and Nathan Geffen

The National Health Laboratory Service has provided HIV, TB, syphilis and cholesterol data, which Spotlight and GroundUp obtained through the Promotion of Access to Information Act.

Earlier this year, we made a request for data to the National Health Laboratory Service (NHLS) using the Promotion of Access to Information Act. In October, we were provided with the data we requested (and more).

We are grateful and impressed that the NHLS provided the data without fuss and without the need to go to court. Other state institutions could learn from this.

We used the data to analyse HIV viral load data in light of the withdrawal of US aid. It led to us publishing this article: Withdrawal of US aid has hurt South Africa’s HIV programme.

From the outset, we’ve intended to make the data public. No information on patients is recoverable from this data as the finest detail is at the monthly provincial level. We are therefore publishing this data, as an open document format spreadsheet, today. We are of the view that the data provided is useful for scientists and journalists and we hope the NHLS will regularly publish updates to it.

The spreadsheet contains monthly tallies per province of viral load tests, CD4 counts, TB tests, syphilis tests, full blood counts and cholesterol tests. The period covered is January 2015 to September 2025.

Download the spreadsheet

Much of the data is not straightforward to interpret. For example, after we puzzled over the decline in cholesterol tests, one expert pointed out to us that the decrease is probably due to changes in the standard second-line HIV treatment used in the public sector (some older HIV medicines had potential side effects that made cholesterol tests necessary). Similarly, changes in the number of TB tests conducted will have been impacted by guidelines that expanded eligibility for TB testing.

The NHLS informed us of the following caveats:

  1. All counts reflect the number of tests captured on the NHLS TrakCare (LabTrak) Laboratory Information System (LIS) as at the time the counts were performed (21 October 2025).
  2. A system-generated date from the time a sample was captured onto the LIS was used to total counts per month/year.
  3. There may be anomalies in counts for a few months from July 2024 because of disruptions caused by a cyber-attack.
  4. As test counts were requested, rejected tests and unreviewed results were included.
  5. As test counts were requested, the counts provided reflect the number of tests done, not the number of patients tested, as multiple tests may be performed on one patient sample. For example, for a full blood count, each individual test was counted.
  6. The “Pregnant or postnatal women” group was identified according to the NHLS maternal eGK (electronic gatekeeping) codes.

(We have amended the NHLS spreadsheet by inserting a new sheet with the above caveats and a link to this article. No other material changes have been made to the spreadsheet.)

This article was jointly produced by Spotlight and GroundUp.

Republished from Spotlight under a Creative Commons licence.

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Categories : HIVTags :

Trial Results Shows the Value of Patient Navigation in Humanising HIV Care

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Eastern Cape HIV Programme demonstrates success in resource-constrained setting

Photo by Pexels on Pixabay

A new randomised controlled trial conducted in the Eastern Cape has shown that adding structured patient navigation to same-day antiretroviral therapy (ART) can make a meaningful difference for people newly diagnosed with HIV. The trial found that patients who received support from trained navigators were far more likely to stay in care and keep their viral load low over six months. Those with navigator support had a 79% retention rate, compared with 64% under standard care.

Among patients who achieved a viral load of fewer than 50 copies per millilitre, 64% remained in care, compared to just 39% without this extra support(1). Patient navigation combines personal support, such as home or virtual check-ins and WhatsApp reminders, with practical help like linking people to services and monitoring their progress. It was especially effective for people who started treatment on the same day as their diagnosis.

“This approach humanises HIV care. It builds a bridge between the clinic and the community, helping patients stay connected to treatment and ultimately saving lives,” said lead author Siyakudumisa Nontamo, Facility Team Lead: Care & Treatment Programme at TB HIV Care.

In August 2024 the Human Sciences Research Council released findings from the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the Eastern Cape. The results show that HIV prevalence in the province stabilised, moving from 15.9% in 2017 to 13.7% in 2022. This is an estimated 980 000 people living with HIV, down from about 1 million in 2017. Access to treatment has improved significantly. ART coverage increased from 67.8% in 2017 to 83.5% in 2022, meaning about 723 000 people in the province are now receiving treatment. However, gaps remain among young people: only 70.9% of adolescents and youth aged 15–24 living with HIV are on ART, compared to 84.8% of adults aged 25-49. Among females, coverage is much lower for young women (68.7%) than for women aged 25-49 (88.2%). ART use also varies across districts, ranging from 69.4% in Nelson Mandela Bay to 92.0% in Alfred Nzo(2). Nationally, the proportion of people living with HIV who are currently on antiretroviral treatment (ART) rose to 80.9% in 2022, up from 63.7% in 2017.

Despite major advances in antiretroviral therapy, retention in care remains a persistent challenge within South Africa’s HIV programme, especially in rural provinces such as the Eastern Cape. Many patients initiate treatment but later disengage due to stigma, transport difficulties, and limited ongoing support. The study shows that low-cost, human-centred interventions can significantly strengthen treatment outcomes. The trial, titled “Impact of Patient Navigation on Retention in Care and HIV Viral Load Suppression Among Newly Diagnosed Persons Living with HIV in the Eastern Cape,” compared standard HIV care to an approach where trained patient navigators provided ongoing support to patients starting antiretroviral therapy (ART). Beyond improved retention and viral suppression, the trial also showed that patients supported by navigators experienced fewer deaths and dropouts, with substantially lower losses to follow-up and reduced mortality than those receiving standard care, ultimately strengthening HIV programmes(1).

Patient navigation, in particular, helps bridge the gap by pairing practical healthcare coordination with empathy and community-based follow-up. Navigators assist patients with managing appointments, maintaining adherence, and accessing psychosocial services, thereby fostering trust, continuity, and sustained engagement in care. This approach aligns with South Africa’s national HIV strategy, which prioritises differentiated, patient-centred models of care to achieve the UNAIDS 95-95-95 targets.

At scale, TB HIV Care’s programmes are grounded in person-centred, integrated service models that reflect the real lives and needs of people affected by HIV and TB. This study reinforces TB HIV Care’s belief that support beyond clinic walls is essential for achieving lasting impact. In the 2024/25 reporting period, the organisation reached more than 1.9 million people with HIV testing services and initiated 27,873 individuals on ART, achieving a 95% viral suppression rate among clients in care.

“By bridging the gap between diagnosis and ongoing care, patient navigation aligns with our outreach for key populations and our shift toward holistic service delivery. We look forward to translating this evidence into practice, ensuring fewer people fall through the cracks and more sustain treatment success”, said Professor Harry Hausler, CEO at TB HIV Care.

Additional findings from the Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI) for the Eastern Cape.

  • In the Eastern Cape, HIV remains most common among adults aged 25-49, with a prevalence of 27.7%, and women in this age group are especially affected at 35.4% compared to 17.1% for men.
  • The survey also found geographic differences: HIV prevalence among men was highest in urban areas (8.7%), while among women it was highest in rural informal or tribal areas (19.8%).
  • By district, prevalence was highest in Chris Hani (14.4%), Amathole (14.1%), Alfred Nzo (13.9%), and lowest in Nelson Mandela Bay (9.7%).
  • At a national level, the survey showed that 81.4% of all people living with HIV were virally suppressed. The survey found encouraging progress in the Eastern Cape, where viral load suppression (VLS) among people living with HIV rose to 79.3% in 2022, up from 66.3% in 2017. However, children aged 0-14 years had much lower suppression levels, at 61.4%. Among people aged 15-49 years living with HIV, 78.6% were virally suppressed. Within this group, women had far higher suppression rates (83.9%) than men (65.4%).

About the Randomized Controlled Trial

The randomised controlled trial involved participants from HIV testing sites in the O.R. Tambo District (Flagstaff, Mthatha Gateway, and Tsolo Clinics). It was approved by the Eastern Cape Health Research Committee and Walter Sisulu University’s Ethics Committee. The study was supported by the Chemical Industries Education and Training Authority (CHIETA) and the South African Medical Research Council’s Strategic Health Innovation Partnerships (SHIP).

References:

  1. Nontamo, S., Kamsu, G.T., Ndebia, E.J., et al. Impact of Patient Navigation on Retention in Care and HIV Viral Load Suppression Among Newly Diagnosed Persons Living with HIV in the Eastern Cape – South Africa. Access.
  2. Human Sciences Research Council. Sixth South African HIV Prevalence, Incidence, and Behaviour Survey (SABSSM VI). Access.

Categories : CancerTags :

Right to Life Hangs in the Balance for Two SA Girls This World Children’s Day

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SAG Leukaemia. Credit: Scientific Animations CC0

At four years old, a child’s world should be full of crayons, playgrounds, and fairy tales. For Dianty and Nqobimpi, it has become a world of chemotherapy, blood transfusions, and sterile hospital rooms. As the world observes World Children’s Day on 20 November and its theme of “My day, my rights,” their fight for the basic right to life casts a light on the most critical need of all: a second chance, which can only come from a matching stem cell donor.

A Donor for Dianty

Hailing from Randfontein, Dianty is a bright and joyful four-year-old whose smile can light up any room. Yet, behind her cheerful spirit lies a harrowing health battle. It began last year with inexplicable fevers and stomach pains, initially dismissed as a sinus issue and later as growing pains. When Dianty suddenly lost the ability to walk, her mother, Claudine, knew something was terribly wrong.

After she was admitted to the hospital, blood tests revealed the devastating truth: Dianty had leukaemia. Chemotherapy began immediately. “The ups and downs were relentless,” Claudine explains. Despite initial progress, Dianty relapsed just after her fourth birthday this year, forcing her family back to square one.

The search for a stem cell donor has been fraught with disappointment. With no suitable match found within her family, Dianty’s hope now rests on the public registry. “You never think it will happen to you until it does,” says Claudine. “I encourage every single person to go and do the cheek swab… You can save the life of a little child. You can give them a second chance.”

Nqobimpi Needs a Match

Nqobimpi from Pretoria is facing a similarly terrifying reality. Her journey began with persistent nosebleeds and terrifying episodes of vomiting blood, which left her weak and pale. Her mother rushed her to a clinic, which led to a referral and eventually a diagnosis of T-Cell Acute Lymphoblastic Lymphoma (T-Cell ALL).

Expressing the shock that rocked their family, her mother shares, “I wasn’t aware children could get cancer.” Nqobimpi was pulled out of crèche, and her life became a cycle of month-long hospital stays for treatment. The strain has rippled through their family, affecting her siblings’ ability to focus at school as they worry constantly about their baby sister. All Nqobimpi wants is to return home and play with her dolls, a simple childhood pleasure now dependent on finding a selfless stranger willing to register as a donor.

The Power to Save a Life

“For children like Dianty and Nqobimpi, a stem cell transplant from a matching donor is their only hope for a cure,” highlights Palesa Mokomele, Head of Community Engagement and Communications at DKMS Africa. Every new person who registers brings fresh hope to them and the many other patients waiting for a lifeline.”

“On this World Children’s Day, as we reflect on the rights of every child, consider giving the ultimate gift: the right to life,” she concludes.

Register today at https://www.dkms-africa.org/save-lives.

Categories : Metabolic DisordersTags :

The Cost of Inaction: Why South Africa Cannot Afford to Ignore the Diabetes Crisis

On By ModernMedia
Photo by Breakingpic on Pexels

Johannesburg, 11 November 2025: As we approach World Diabetes Day on November 14, civil society organisations warn that the cost of inaction on non-communicable diseases (NCDs) such as diabetes is already being paid for in lives, livelihoods and lost potential. The Healthy Living Alliance (HEALA) is calling on the South African government to increase the Health Promotion Levy (HPL) on sugary drinks from 11% to 20%, to help curb sugary drinks consumption and reduce the financial burden on the health system from rising non-communicable diseases.

“Diabetes is now the second leading cause of death in South Africa,1 yet every year we allow preventable diseases to claim more lives,” says Nzama Mbalati, CEO of HEALA. “Raising the Health Promotion Levy is one of the simplest, most effective steps government can take to protect people’s health, especially children, who are consuming sugar at dangerous levels.”

Since the introduction of the HPL in 2018, beverage companies have reduced the sugar content of their drinks, leading to cuts in average per-capita sugar consumption. But the gains have stalled. HEALA and its partners warn that without further cuts in consumption, the policy’s impact will fade, while rates of diabetes will continue to climb.

South Africa’s obesity rate is already twice the global average, and even one sugary drink a week raises a child’s risk of obesity and diabetes.2,3 One in four diabetes cases in the country is caused by sugary drink consumption.4 These numbers are not just statistics; they represent real people and families forced to navigate lifelong illness and financial hardship.

The economic toll is equally alarming. Treating obesity related conditions such as diabetes already costs South Africa more than R33 billion each year or about 15% of total government health spending.5 Modelling by PRICELESS SA (University of the Witwatersrand) shows that increasing the levy to 20% could save approximately 72 000 lives and prevent 85 000 strokes over two decades while easing the fiscal pressure on a health system already stretched beyond capacity.5

HEALA’s new national campaign, which launched in November, brings this message to the fore in two phases. The first calls for stronger health taxes across sugary drinks, alcohol and tobacco, continuing South Africa’s proven track record of using taxation to advance public health. The second sharpens focus on raising the HPL, calling for its increase as part of a consistent, evidence-based approach to protecting lives.

Through personal stories of South Africans living with diabetes, the campaign reveals the real cost of inaction and unites civil society under the banner #OneVoice, calling on government to put public health before profit.

Alphinah Setumo, a 52-year-old mother from Mathibestad, lost both her legs and her eyesight after years of consuming sugary drinks without understanding the risks. “Back then, drinking two litres of a sugary drink a day was nothing,” she recalls. “If I had known what I know now, my life would be different.”

Mpho Thebe, a maths and science tutor from Kroonstad, tells a similar story. Once a daily consumer of fizzy drinks, he lost his left leg to diabetes at 45. Today, he walks with a prosthetic leg and teaches children about perseverance and prevention. “I thought sugar was harmless,” he says. “Now I know it can take everything from you.”

These stories mirror thousands of others across the country, where diabetes silently devastates families, especially in low-income communities where affordable, healthy food and clean water remain scarce.

The campaign, supported by actress and mother Samela Tyelbooi, urges government to act. “As a parent, I worry about how sugar can make my kids sick,” says Tyelbooi. “We need government to increase the HPL, protect our children’s future, and stop putting profit before people.”

HEALA’s coalition partners, including health advocates, researchers and civil society organisations, are speaking with one voice ahead of the Medium-Term Budget Policy Statement and the 2026 Budget Speech. Their collective message is clear: the HPL is not just another tax, it’s a health tax, like those on alcohol and tobacco, designed to save lives, prevent disease and safeguard South Africa’s future.

“This is not about taking away people’s choices, it’s about giving South Africans the chance to make healthier, more informed choices,” adds Mbalati.

Diabetes and other NCDs already account for over 50% of deaths from preventable diseases in South Africa.5,6 Without decisive fiscal measures, the burden will continue to fall on the households least able to bear it.

Globally, countries from Mexico to the UK have proven that health taxes reduce sugar consumption and improve health outcomes.

HEALA is urging citizens to join the call by signing the petition and demanding that government increase the HPL to 20%.

“We have the evidence, we have the stories, and we have the will,” concludes Tyelbooi. “Now we need action.”

Categories : Medical IndustryTags :

FundiHealth: Quality Healthcare Now Accessible for Students

On By ModernMedia
Photo by Andrea Piacquadio on Pexels

Fundi, South Africa’s leading education finance and student solutions provider, has launched FundiHealth: a healthcare platform designed to meet the unique needs of students, young professionals and organisations committed to supporting the health and wellbeing of their people.

As part of its digital transformation and enablement strategy, Fundi has launched its own healthcare platform: FundiHealth.

Born out of Fundi’s deep understanding of the challenges students face and the recognition that health is a critical enabler of success, the platform offers affordable quality healthcare solutions for students and young professionals. “We’ve always believed that education unlocks potential, but we also see every day how poor health and the inability to afford care can derail even the most promising futures,” explains Benedict Johnson, Fundi Executive Head: EBS and New Initiatives. “Our platform was created with one clear purpose in mind: to remove healthcare as a barrier to education, productivity and meaningful participation in the economy.”

Fundi CEO Mala Suriah, moderator on the day ,Thembekile Mrototo and Fundi Executive Head Benedict Johnson at the FundiHealth launch.

The solution has been launched at a time when South Africa is grappling with a significant gap in healthcare coverage. According to the Council for Medical Schemes (2024), over 80% of South Africans do not belong to a medical aid scheme and rely entirely on the overstretched public health system. Young people are particularly vulnerable notes Charles Irumba, FundiHealth Executive: “Research from the Board of Healthcare Funders (2023) shows that fewer than 12% of students and young professionals under the age of 30 have adequate medical cover. This lack of access has serious implications not only for individual wellbeing but also for South Africa’s productivity and growth.” Data from Statistics South Africa (2024) further supports this; with absenteeism due to preventable illness costing the economy over R16 billion annually, with students and entry-level workers among the most affected.

“When students drop out of school because of untreated illnesses – including stress, depression or anxiety – or when young professionals miss work and lose income as a result, it has a detrimental effect on them as well as their families,” says Irumba. “FundiHealth ensures that young South Africans stay healthy in class and at work, contributing meaningfully to their futures and to our country’s growth and development.”

The new platform offers affordable, accessible medical cover that includes access to private doctors, medication, mental health support and preventative care services, all designed to fit the budgets of students, families and young professionals. “Critically, we’ve also created an option that allows organisations to offer their entry-level staff healthcare benefits at a fraction of the cost of traditional schemes. This is ideal for SMMEs and growing businesses, as it will assist them improve staff retention, morale and productivity,” adds Johnson. “Employers often underestimate the economic impact of poor health among their youngest and most vulnerable employees. By offering a healthcare solution like FundiHealth, they’re not just supporting their people, they’re strengthening their businesses too. Healthy employees are more engaged, more present and more productive. It’s a win-win.”

Beyond immediate productivity benefits, FundiHealth also has the potential to alleviate pressure on South Africa’s public health system by shifting some demand into the private sector and by promoting preventative care among young people. “If we want to grow as a nation, we have to keep our young people healthy in body, mind and spirit,” notes Irumba. “That’s what FundiHealth is all about. Good health is not a ‘nice-to-have’. It is a fundamental part of what it takes to succeed.”

FundiHealth is available to students, their families, young professionals and organisations at fundihealth.co.za. Customers can both explore different plan options and sign-up online.

“With FundiHealth, we’re tackling one of the most overlooked challenges to achieving one’s full potential: health. Good health underpins everything. By keeping our students and young professionals healthy, we’re keeping their dreams alive and South Africa moving forward,” Johnson concludes.

Categories : HIVTags :

SAHPRA Registers Lenacapavir

On By ModernMedia
Photo by Elen Sher on Unsplash

Pretoria, 27 October 2025 – The South African Health Products Regulatory Authority (SAHPRA) is pleased to announce the registration of Lenacapavir. Lenacapavir is an antiviral medicine that is recommended, in combination with safer sex practices, for pre-exposure prophylaxis (PrEP) to prevent HIV-1 infection in adults and adolescents weighing at least 35kg.

An application by Gilead was submitted to SAHPRA in March 2025. The SAHPRA review process was done in collaboration with the European Medicines for All Procedure (EU-M4all).  This procedure enables the European Medicines Agency (EMA), together with the participating regulatory authorities, to provide scientific opinions on high-priority medicines, such as Lenacapavir, intended for markets outside the European Union. The benefits of this pathway are to strengthen regulatory systems and accelerate access to essential medicines.

Lenacapavir mechanism. Credit: Dzinamarira, T et al., 2023. CC 4.0

Dosage

This product, developed to prevent new HIV infections, is a six-monthly injection. There is an initiation dose of a subcutaneous injection (administered just under the skin) with tablets (taken on days 1 and 2). It is used to reduce the risk of HIV in adults and adolescents who weigh at least 35kg, are HIV negative, and are at risk of getting HIV. Lenacapavir for PrEP should always be used in combination with safer sex practices, such as using condoms, to reduce the risk of getting other sexually transmitted infections.

“The registration of Lenacapavir is a game-changer, given the high prevalence rate of HIV in South Africa. This product is the most effective HIV prevention measure thus far,” indicated Dr Boitumelo Semete-Makokotlela, CEO: SAHPRA.

Source: SAHPRA

Categories : Cancer IT in HealthcareTags :

Altron HealthTech Set to Pilot South Africa’s First Oncology Companion App

On By ModernMedia

ThriveLink to connect patients, doctors, caregivers, and medical schemes in a seamless digital platform

The last thing someone dealing with a life-threatening disease wants is the pain of endless administrative paperwork and confusion that arises when aspects of their care are not easily coordinated. Altron HealthTech is set to pilot a solution designed to minimise these burdens by integrating various aspects of care management into one solution.   

The company announced today that it will soon begin piloting ThriveLink, South Africa’s first platform to connect patients, doctors, caregivers, and medical schemes in one integrated digital space. The oncology companion app is designed to help cancer patients flourish during a trying time by providing seamless care coordination, access to key information and educational content and removal of administrative obstacles. 

“We’ve built this tool with the ultimate goal of making life easier for cancer patients to be empowered throughout managing their treatment journey,” says Altron HealthTech MD Leslie Moodley. “They’ll receive appointment tracking, medication reminders, and secure communication with their care team – all customised for their unique treatment plan in one digital space – so they can focus on what matters most: their health and wellbeing.” 

Addressing a growing crisis

The development team was inspired to create ThriveLink after frontline agents logged an alarming increase in cancer diagnoses. Cancer cases in South Africa are projected to nearly double from 62 000 in 2019 to 121 000 nationally by 2030 based on data compiled by the SA Journal of Oncology, driven by an aging population and increased lifestyle risks. 

“We have insight into anonymised and aggregated data, and were shocked at the increase in cancer volumes,” says Moodley. “We realised there was value in developing a tool that could span the entire healthcare value chain and all the various touchpoints, to solve for a very real issue. This insight sparked a critical question: how can we make it easier for oncologists, our key stakeholders, to focus on what matters most – patient care? 

ThriveLink brings together data from specialists, medical aids, pharmacies, and other relevant sources to coordinate care to connect healthcare providers. Beyond appointment tracking and medication reminders, the app offers educational content, emotional support tools, and secure communication channels. 

“The solution enables these data points to collaborate in a technical sense to coordinate care,” explains Moodley. “Our response was to build a technology-driven platform that not only streamlines authorisations and treatment protocols but also enables real-time interoperability. This empowers oncologists to coordinate care more efficiently, track treatment pathways, and adapt plans based on patient-specific outcomes. Patients won’t have to worry about burdensome details and will get reminded when it’s time to take their medication or schedule a follow-up.” 

Built on medical expertise and security

The app serves as the vital link in a complex ecosystem, ensuring secure information flow, informed decision-making, and trust at every stage.  

Altron HealthTech consulted widely with oncologists, patients, and other medical professionals before beginning development. A base application was rolled out to specialists about a year ago, and feedback from that pilot informed the expanded platform now ready for patient testing. 

The app has been built on secure, cloud-based software-as-a-service architecture in compliance with the Protection of Personal Information Act and all relevant regulatory requirements. Patients must provide informed consent before signing up. 

Beyond supporting patients directly, ThriveLink is designed to help control healthcare costs. Cancer is among the most expensive therapeutic burdens, with the Cancer Alliance having predicted that this disease will cost the public sector an additional R50 billion between 2020 and 2030. 

“By streamlining processes and integrating claims, authorisations, and clinical data, we remove duplication and costs from the system,” says Moodley. “This can indirectly help keep medical aid premiums down, benefiting all medical scheme patients.” 

Altron HealthTech is in early-stage discussions with medical aid schemes interested in integrating the app into their mobile solutions. 

Categories : Expert Opinion Healthcare Politics and RegulationsTags :

#InsideTheBox with Dr Andy Gray | Public Participation in Medicines Selection and Regulation – Lacking?

On By ModernMedia
#InsideTheBox is a column by Dr Andy Gray, a pharmaceutical sciences expert at the University of KwaZulu-Natal and Co-Director of the WHO Collaborating Centre on Pharmaceutical Policy and Evidence Based Practice. (Photo: Supplied)

By Andy Gray

In several countries, the public is given an opportunity to share their views with regulators before new medicines are registered or to engage with those choosing essential medicines. In South Africa, however, opportunities for such public participation remains limited. In his latest #InsideTheBox column, Dr Andy Gray takes a look at how public participation is handled elsewhere and how it could be improved here.

One of the rallying cries of patient and community-based organisations has long been “nothing about us, without us”. The “patient voice” is, however, not always heard in medicines selection or medicines regulation.

How it works in the US and Europe

Recent highly contested medicines regulatory decisions in the United States, such as the warnings about paracetamol use in pregnancy, have highlighted the role of advisory committees to the Food and Drug Administration (FDA). The FDA relies on a number of such committees to provide advice on regulatory questions, such as whether to approve a new medicine or how to manage emergent safety signals. The FDA usually follows the advice provided by these independent structures, but is not bound to do so.

The fact that advisory committees meet in open session, and that their recommendations are transparent to the public, means that the final decision by the FDA can be contrasted with the scientific advice. The curricula vitae of advisory committee members are posted on the FDA website and updated annually. Critically, when an advisory committee meeting is scheduled, the date and time is announced at least 15 days in advance of the meeting, and this serves as an invitation to interested parties to register to make oral submissions during the Open Public Hearing portion of the meeting.

In addition to providing opportunities for public engagement in this manner, the FDA has also operated a Patient Representative Program since 2024. FDA Patient Representatives are appointed, provided with training, and may then engage with the scientific and other expert members of the advisory committees. Among the criteria applied in their selection are personal experience with a particular disease as a patient or primary caregiver, knowledge about the treatment options and research in that area, and the willingness and ability to communicate in public, as well as being objective while representing the concerns of others affected by the disease.

Similar mechanisms have been put in place in Europe. The European Medicines Agency (EMA) has enabled the appointment of patients as members of its management board and scientific committees. In addition, the EMA Patients’ and Consumers’ Working Party provides a venue for ongoing engagement. The EMA engagement framework explicitly aims to ensure “access to patients’ real-life experiences of living with a condition, its management and the current use of medicines, complementing the scientific evidence provided during the evaluation process” and “the generation, collection and use of evidence-based patient experience data for benefit-risk decision-making”.

How it works in South Africa

Section 3(9) of the Medicines and Related Substances Act, 1965, instructs the chief executive officer of the South African Health Products Regulatory Authority (SAHPRA) to appoint advisory committees. The wording is peremptory, but also broadly enabling: “The Chief Executive Officer shall, in consultation with the Board, appoint committees, as he or she may deem necessary, to investigate and report to the Authority on any matter within its purview in terms of this Act.” Provided there is consultation with the Board of the Authority, the number of committees and their membership is left to the CEO to decide.

To date, however, there has been no deliberate effort to include patient or consumer representatives on any of the advisory committees.

More importantly, meetings of the committees are not open to the public, nor are their recommendations to the regulatory authority placed in the public domain. The “patient voice” is therefore potentially missed, and stakeholders are unable to determine when or how final decisions taken by the Authority may differ from the recommendations made by the technical advisory committees. In that sense, SAHPRA is no more transparent than its predecessor the Medicines Control Council, which also laboured under the same antiquated secrecy provision in the Act. Section 34 of the Act is actually labelled “Preservation of secrecy”.

Similar concerns with medicines selection

Medicines regulators determine whether medicines should be allowed onto the market and how those should be controlled. Similar dynamics are at play in determining which medicines are “essential” and should be procured or reimbursed by health systems.

At a global level, the World Health Organization (WHO) updates its Model List of Essential Medicines every two years. The Model List is a starting point for many countries’ efforts to develop national essential medicines lists, guiding procurement in their public sectors. Although the expert committee responsible for this work does not explicitly include patient representatives, all proposals submitted are placed in the public domain, as are the reviews conducted, and an account of the final decisions. On the first day of the meeting, an open session is held at which stakeholders are invited to apply to present.

One of the most trusted medicine selection bodies is the UK National Institute for Health and Care Excellence (NICE), which also has a deliberate process for stakeholder engagement at multiple steps in its guideline development. For example, right at the outset, this invitation is issued: “NICE invites all stakeholder organisations to attend a scoping workshop. You will be sent a first draft of the scope, which will be discussed at the meeting. We encourage you to send someone who knows about and can represent patients and carers’ interests.”

Medicines selection in the South African public sector is evolving, embracing the challenge of health technology assessment. While there are as yet no patient representatives on either the Expert Review Committee or the National Essential Medicines List Committee, there are opportunities for stakeholder engagement with draft guidelines and increasing transparency, with medicines evaluation reports posted on the Department of Health website.

Full medicine reviews follow an evidence-to-decision framework that was first piloted during the height of the COVID-19 pandemic. One of the questions posed reads: “Is there important uncertainty or variability about how much people value the options?” This question is aligned with what the WHO Handbook for Guideline Development refers to as “values and preferences”. For example, the WHO guidance calls for evidence of the “values and preferences of the people receiving the intervention or experiencing the outcomes the intervention can affect”. While that evidence may sometimes be reported in the scientific literature, all too often it is lacking.

Ultimately, “nothing about us, without us” should not only be a demand made by patients, but also by those who care about the quality, reliability and acceptability of medicines selection and regulatory decisions. Improving the transparency of decision-making processes is critical, but so is creating, promoting and protecting the spaces for an effective “patient voice”. Doing so is a critical investment in building trust, which is so easily eroded.

*Dr Gray is a Senior Lecturer at the University of KwaZulu-Natal and Co-Director of the WHO Collaborating Centre on Pharmaceutical Policy and Evidence Based Practice. This is part of a series of #InsideTheBox columns he is writing for Spotlight.

Disclosure: Gray is a member of South Africa’s National Essential Medicines List Committee and co-chairs its Expert Review Committee.

Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.

Republished from Spotlight under a Creative Commons licence.

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