Health and Wellness
In the light of clinics, such as the Ivan Toms Centre for Men’s Health, which provided essential services not only to HIV and TB patients, but also to gay men, trans people, sex workers and IV drug users, that have been closed since the withdrawal of PEPFAR:
- (a) How many clinics in the province have had to (i) reduce services or (ii) cease all services, (b) how many people have been affected since the funding cut and (c) what services have been offered in the interim to those effected in order to ensure continuity of care;
- whether there is a long-term action plan or sustainable solution in place to support clinics in restoring full service delivery following the PEPFAR funding cuts; if not, (a) what are the reasons for the absence of such a plan, (b) when can we expect such a plan to be implemented, if not already implemented, and (c) if such a plan has been implemented, what are the relevant details of this plan?
(1)(a) Following the withdrawal of PEPFAR funding, a total of 74 facilities in the Cape Metro District and two rural districts, namely the West Coast and Cape Winelands, experienced a reduction in services. Two key population clinics, the Wits RHI Transgender Clinic and the Ivan Toms Men’s Clinic, ceased all services.
(b) An estimated 4,000 clients have been directly affected by these funding cuts. These individuals have been referred to their nearest public health facilities. As clients come from different geographic areas, referrals have been distributed across multiple facilities to maintain access and continuity of care.
(c) Public health facilities have continued to provide uninterrupted HIV and TB services. Non-profit organisations involved in the programme supported the referral of affected clients to nearby clinics in their areas to ensure continuity of care.
(2) Yes, a long-term action plan has been implemented to support sustainable service delivery. This plan forms part of the Western Cape's broader health system strengthening approach. Key measures include multi-month dispensing of antiretrovirals, accelerated digitisation of HIV and TB registers, and the expansion of electronic scripting and prescribing systems. The integration of health promotion and counselling through the ACTS model, as part of the Make Every Contact Count counselling strategy, is also being implemented.
These interventions are intended to ensure the resilience of the HIV and TB programme and to maintain quality services for vulnerable and key populations, despite the withdrawal of external funding.
