“They just told us ‘It’s Trump, it’s Trump’ and that we had to share two people to one box of pills”
In South Africa, nearly 2 million people living with HIV are still not on lifesaving HIV treatment — and worryingly many many people have started on treatment and then stopped. Ritshidze has documented hundreds of testimonies and produced countless data that link this retention crisis to the poor conditions in our health system. This is why TAC has been calling for people to get a 6 month supply of ARVs — to make it easier for people living with HIV to stay on treatment by reducing the amount of times people must go to the clinic. Especially just to collect pills.
In December the Minister of Health and Deputy President publicly committed to this when signing our memorandum on World AIDS Day. Yet following the U.S government funding suspension in South Africa, instead of longer supplies, in some clinics people are reporting being sent home with just a handful of pills, making it even harder to stay on treatment. This will only see more people stopping their ARVs. Siyabonga from the Eastern Cape tells us his experience:
In rural communities near Matatiele, in the Eastern Cape, public health facilities can be few and far between. HIV services in these remote areas are a lifeline. It means that any disruptions to the system hit hard, and put lives at risk.
Siyabonga Ndabane is one of the people who understands this firsthand. He uses the Matatiele Clinic in the northern part of the province. Even though it’s the clinic closest to his home, it’s still over an hour’s taxi ride away. A round trip costs him R110.
Siyabonga is 56 years old and currently unemployed. He says finding money for the taxi fare to get to the clinic has been a challenge. He adds that he also has to spend extra money to buy food in the town because the taxis also only run the service early in the morning and late in the afternoon.
“Every time I have to go and borrow money from somewhere. I also leave my house at 5am and I only come home late,” he says of the many hours it takes just to collect HIV treatment.
He adds that it’s not just the taxi fare that has become an issue making it difficult to stay on treatment, but alarmingly it’s also that clinics are now saying they are facing a shortage of ARVs. Stockouts and issues of low stock have become more frequent since the suspension of funding by the United States government came into effect at the end of January.
At his last clinic visit in February he was only given 14 tablets – only enough for two weeks.
“They just told us ‘It’s Trump, it’s Trump’ and that we had to share two people to one box of pills,” he says.
Siyabonga says it’s been a distressing situation for him. He was diagnosed in 2016 and says he’s worked hard to stay on his treatment and to stay healthy over the past nine years. So much so that he’s achieved viral load suppression.
“My viral load was so low that even before COVID-19 the clinic was giving me pills sometimes for three months. It was good because it meant that I didn’t have to travel all the time and I didn’t have to find R110 each and every time,” he says.
Working on his health was also about developing a strong mental attitude. Siyabonga says it helped him fight the stigma of HIV and have a mindset to live positively with his diagnosis: “First it was about accepting my status; then it was not to hide from my HIV – when you don’t hide, you are not trying to run away.”
In February, with just 14 pills and no money for taxi fare he resorted to skipping days on his ART regime. Skipping days on treatment puts people living with HIV at risk of developing drug resistance, which would mean switching to a more complicated drug regimen.
Siyabonga knows it’s not an ideal way to take his medication. He also knows he’s not the only person who faces these new challenges to stay on treatment. As a community activist he says more and more people are being given fewer tablets at clinics on each visit. And it’s a huge step backwards to keep people healthy and to stop new infections.
“I am hearing from some people who were given 14 days worth of pills that they are scared they will lose their jobs because they can’t keep telling their employers that they need the day off to fetch their pills. So many just don’t come back,” he says.
Siyabonga is frustrated, also very worried. He doesn’t believe that the government understands these realities fully. He also doesn’t believe the government is adequately prepared or equipped to adapt to the blow of the loss of funding from the United States.
“The government must wake up and see that this is a very bad situation. We can’t just go to the clinic like they think, there are many reasons people can’t go to clinics.
“The government needs to have better ways to make sure medicines come to the people, especially those of us living in rural areas who don’t have jobs or transport money,” he says.
The government has launched a campaign to get 1.1 million more people on HIV treatment, but this will not happen while it is becoming harder for people living with HIV to collect ARVs. We need the South African government to step in following the suspension and loss of U.S government funding to ensure that services are maintained. This includes ensuring that people are getting longer, not shorter, supplies of ARVs.
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This is part of a series of stories that TAC is collecting to expose the realities in our clinics following the U.S government funding suspension. Follow our website and social media channels as we start to publish testimonies that highlight the impact on the lives of people living with HIV and other public healthcare users.
To find out how we are affected by the funding suspension see: https://www.tac.org.za/news/us-funding-cuts-to-health-and-hiv-services-threaten-lives/
For more information:
Ngqabutho Mpofu: 072 225 9675 | ngqabutho.mpofu@tac.org.za
Xabisa Qwabe: 076 850 6736 | xabisa.qwabe@tac.org.za
