S. African HIV/AIDS Treatment Closures Shameful Consequence of Obama Global AIDS Cuts

In Global, South Africa by AHF


South Africa’s McCord Hospital, a 103-year-old institution and one of the most respected hospitals in Durban, will close in March due to funding loss – defeat for hospital as a whole comes just months after its HIV/AIDS clinic was closed due to PEPFAR cuts, and is coupled with the closure of Hope for Life, a local non-government organization that provided HIV-related treatment and care

Obama administration is first to retreat on global AIDS battle and cuts target country with world’s highest HIV/AIDS burden – leading nonprofit AIDS Healthcare Foundation (AHF) calls for White House to “Keep the Promise” on AIDS

WASHINGTON (January 31, 2013) – The AHF-led “Keep the Promise” March on Washington last July called on the United States to continue to fulfill its commitment to the President’s Emergency Plan for AIDS Relief (PEPFAR), the respected US global AIDS program spearheaded by President George W. Bush. However, recent funding cuts to PEPFAR are already being felt around the world—some with drastic ripple effects.

In South Africa, nearly 4,000 HIV-positive adults and 1,000 children were forced to seek lifesaving antiretroviral treatment (ART) elsewhere when the McCord Hospital near Durban was forced to shut down its HIV/AIDS clinic several months ago. The clinic closure followed an announcement by officials from PEPFAR that they intended to phase out funding for the HIV/AIDS clinic. According to the hospital administration, all patients currently on lifesaving ART will be transferred to public health clinics. The facility that housed the clinic on the McCord campus is now being used for storage.

“We are already observing an influx of HIV patients to our clinic from McCord Hospital’s treatment site,” said Hilary Thulare, the Country Program Manager at AHF’s Ithembalanbantu (People’s Hope) clinic in Durban, South Africa. “The ART program closure at the hospital is having a tangible impact on the community and patients who must stringently adhere to an antiretroviral regimen are now at risk of treatment interruptions as they look for new places to access their lifesaving medications.”

An additional blow to patients trying to live with HIV/AIDS in South Africa comes with the elimination of funding to Hope for Life, an NGO in Winterveld in the northern region of the City of Tshwane that provided HIV-related services including antiretroviral treatment and home-based care.

One Hope for Life patient, Dolly Mabasa said: “This is very shocking because we came here to get away from the bad treatment we received at the clinics, and now we are told to go back. This is really traumatizing. I beg the Department of Health to come and compare services from the public health facilities and non-governmental organizations.”

“Cutbacks in PEPFAR funding for lifesaving treatment programs, like the one at McCord Hospital, in South Africa—a country with the largest burden of HIV/AIDS in the world—are putting millions of lives in danger,” said Terri Ford, Chief of Global Advocacy at AHF. “By taking the unprecedented step of reducing funding for PEPFAR and actually shutting down successful treatment facilities, the Obama Administration is flip-flopping on its own recent promise to put 6 million people on treatment by 2013. This action jeopardizes the remarkable progress that South Africa has recently achieved in its revitalized efforts to stop AIDS.”

The cutbacks to PEPFAR that led to the decision to shut down the hospital come a few months after President Obama announced on World AIDS Day (December 1) that the United States would scale up its commitment to fighting AIDS by providing treatment for up to 6 million people by 2013. However, a recently released budget proposal for fiscal year 2013 indicates that the Administration actually plans to cut funding for PEPFAR and scale up contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria. As a consequence of the proposed changes, the combined funding for both programs would be significantly reduced by about $220 million, inevitably leading to reduced services and treatment for people living with HIV globally.

“This shell game signals an alarming retreat in the United States’ commitment to fighting AIDS,” said Michael Weinstein, President of AIDS Healthcare Foundation. “The closure of McCord’s Sinikithemba antiretroviral clinic last year already meant that some of the 5,000 ART patients treated there could get lost during the transition to other clinics or drop out of treatment altogether and develop drug resistance. Now, with the entire hospital forced into closure, patients suffering from injuries and infections other than HIV/AIDS will also be forced to seek treatment at other facilities in and around Durban. These PEPFAR cuts and the shameful consequences are a black eye on the US, tarnishing one of our most well-intentioned and successful diplomacy efforts over the past decade.”

McCord Hospital has survived several attempts by government institutions to shut it down: in the early 1970s, it nearly fell victim to an Apartheid law that forbade hospitals in “white areas” from treating black patients – since the McCord staff refused to bow to this discriminatory policy, known as the Group Areas Act, it was given the option of either shutting down or moving to an area that would permit them to serve patients of color, and even then the staff would have been restricted from providing care to certain patients who were not legally classified as Africans under South African law.

But through legal ingenuity and the dogged persistence of the hospital’s management, McCord avoided closure or relocation forty years ago. The hospital now falling victim to PEPFAR cuts could not have come at a worst time for South African patients: Addington Hospital, a public hospital in Durban where many of McCord’s displaced HIV/AIDS patients have sought care and where a multitude of South Africans receive treatment for various maladies, is also facing temporary closure in the near future for repairs. This simultaneous elimination of two treatment facilities in the same city will cause an unprecedented burden on already-strained public clinics and hospitals in Durban and surrounding areas.

“We cannot have a situation where Addington is collapsing and McCord is closing at the same time,” Jacob Mphatswe, the South African Medical Association’s coastal branch president, told local newspaper the Daily Maverick. “Who is going to absorb the crisis? McCord needs to stay open while Addington’s problems are attended to.”

Never before has a U.S. President sought to reduce America’s commitment to fighting AIDS. The lives of real people are at stake.

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