Authorities abruptly withdrew a funding lifeline earlier this year. Now the Western Cape is rethinking its response to two pressing public health challenges. These are HIV and tuberculosis (TB).
But instead of despair, a quiet determination is growing.
The province’s battle against HIV and TB faces a critical turning point. Key international donor support ended earlier this year.
In response, provincial leaders are accelerating efforts to build a more sustainable, targeted approach. They are using data and technology to ensure the system leaves no one behind.
Provincial council convenes
On 24 June, the Western Cape Provincial Council on AIDS and TB convened. The meeting addressed the fallout from the USAID funding withdrawal in January. This funding had supported a wide network of community health programmes.
Furthermore, the funding cut has severely impacted several non-governmental organisations (NGOs) and non-profit organisations (NPOs). These groups delivered HIV and TB services to some of the province’s most vulnerable communities.
Premier Alan Winde, speaking at the council meeting, called the situation a “devastating setback.” However, he emphasised the province’s commitment to adapt.
“It has led to a major setback in the critical work done by our government and the non-governmental and non-profit sector in addressing HIV-AIDS and TB in our province. But as we have shown in the past, we are confronting this challenge together.”
Building a multi-pronged strategy
The Western Cape Department of Health and Wellness has already begun scenario planning to stabilise the health system. The department has laid out a multi-pronged strategy to stretch limited resources.
This includes digitising HIV and TB patient registers to improve service tracking. It also includes expanding e-scripting and medication access points. Furthermore, officials are refocusing attention on high-burden areas where infection rates are highest.
Amelia Mfiki, co-chair of the council, said the current challenge also presents an opportunity. It allows the province to rebuild stronger, smarter systems.
“Access to healthcare facilities remains one of the biggest barriers in our community response, particularly for those who want to re-engage with the health system,” she said. “If we can reach people in ways that reflect their realities, by bringing services closer and cutting red tape, we can do more with less.”
NGOs in limbo
Meanwhile, the USAID withdrawal has left many NGOs in limbo. Consequently, some are scaling back outreach activities or closing community clinics.
This threatens to reverse gains made over the past decade in testing, treatment adherence and public awareness. The crisis stretches community health workers and local clinics thin. These are often the first point of contact for marginalised people.
In townships and rural areas, patients who previously relied on these networks now face long travel distances. Alternatively, they face treatment interruptions.
Focus on efficiency
Despite these challenges, provincial health officials say the crisis has galvanised a new focus. This focus centres on efficiency, sustainability and local innovation.
Officials stress that evidence and community engagement will guide rebuilding efforts. Additionally, they aim to integrate HIV and TB services more seamlessly into primary care.
