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HIV/Aids: ARV cash patients increase in SA

Some 183 195 individual patients paid in cash for their antiretrovirals (ARVs) between April 2017 and May 2021. File picture: Siphiwe Sibeko/Reuters

Some 183 195 individual patients paid in cash for their antiretrovirals (ARVs) between April 2017 and May 2021. File picture: Siphiwe Sibeko/Reuters

Published Dec 7, 2021


Durban – The number of South Africa patients paying for their antiretroviral treatment programme (ART) in cash has more than doubled between 2017 and 2020, according to Coceka Nogoduka from the SA National Aids Council (Sanac).

Some 183 195 individual patients paid in cash for their antiretrovirals (ARVs) between April 2017 and May 2021, while almost half of these cash-paying patients are in the 35 to 49 age cohort, Nogoduka revealed.

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Nogoduka was presenting socio-economic findings during a virtual address on Tuesday at the International Conference on AIDS and STIs in Africa (Icasa), which is held at the ICC in Durban, KwaZulu-Natal.

With numerous state and non-governmental organisation-run programmes set up throughout the country to help reduce the spread of HIV, she said 64 069 patients were paying directly for their treatment by 2020, an increase of over 30 000 since 2017.

“This represents a steady annual increase from 0.76% of people on ART in 2017 to 1.21% in 2020. Although this is a small percentage of the total treatment programme, it will make a substantial contribution to the treatment gap as the country closes in on targets.

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“Cash-paying patients contribute both to total ART provision, and to a seamless continuum of care. Patients may initiate their treatment privately, and later transition into private health insurance or the public sector, or may use cash as a fall back to avoid treatment interruptions,” she said.

South Africa has one of the biggest HIV epidemics in the world, with KwaZulu-Natal at the centre of that epidemic. Around 7.7 million people were estimated to be living with HIV in South Africa in 2018, according to the Joint UN Programme on HIV/Aids (UNAids).

Since its inception in 2003, the country’s ART programme has grown to be one of the world’s largest. The ART programme is monitored through two mediums, the public sector ART statistics, including the number of people on treatment and the Council of Medical Schemes data on private clients.

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Sanac collaborated with IQVIA, a clinical research company based in the US, to deduce patient pharmacy data on ARV drugs dispensed from April 2017 to March 2022. The information has been sifted out for demographics, geographical distribution and time trends of cash-paying patients.

On Wednesday, a political declaration will be made on how to accelerate implementations around measures to put an end to the global epidemic, with a presentation by Dr. Angeli Achrekar, the principal deputy US Global Aids co-ordinator.

Deputy President David Mabuza on Sunday said that sustainability of the response in reaching the new global Aids strategy targets will not be possible if human rights are not key priority in ensuring non-discrimination and ending inequalities.

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Mabuza was speaking during the Icasa opening address at the ICC on Monday and was joined by KZN Premier Sihle Zikalala, Health Minister Joe Phaahla, WHO regional director Dr Matshidiso Moeti and UNAids director Winnie Byanyima.

Mabuza said lessons learnt from the Covid-19 vaccination roll-out have shone a light on the need to invest in African manufacturing capabilities “to overcome the hogging of vaccines by wealthier nations”.

“Our scientific prowess as Africa is proven,” Mabuza said.

“That is why our scientists were able to detect and sequence the genome of the Omicron variant and its mutations with precision, and in the process contributing to global efforts and initiative of understanding and defeating the Covid-19 pandemic and its mutations.

“As Africans, we have always spoken of unity of purpose beyond existing artificial borders in order to achieve development and integration of our economies and our people.

“This is the time to move beyond rhetoric and forge collaborative platforms for research and innovation to promote intra-Africa co-operation in the development and provision of health solutions that all the peoples of this continent need,” Mabuza said.

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Political Bureau