FUNDING FALLOUT: CONDOMS, ART SUPPLIES AT RISK

MBABANE - The distribution of antiretroviral supplies, HIV, viral load and other lab test kits and condoms have been greatly disrupted by the USAID funding cut.

This has had a negative impact so much that stock-outs are foreseen in the next three to six months, according to an update report released by UNAIDS.

United Nations Programme on HIV/AIDS (UNAIDS) provides the strategic direction, advocacy, coordination and technical support needed to catalyse and connect leadership from governments, the private sector and communities to deliver life-saving HIV services, in collaboration with other United Nation organisations.

According to the report, the current challenges and disruptions include a decline in HIV case identification and contact tracing, which will result in limited availability of HIV testing (including self-testing, workplace testing and community-based approaches).

“As a result of being unaware of their HIV status, pregnant women living with HIV may have compromised access to vital services to prevent vertical transmission of HIV.

Testing

“Due to limited access to testing, there has been a significant decline in HIV case identification, contact tracing efforts and peer-based linkage, particularly among high-risk populations such as men and youth,” reads the report in part.

The report also reflects that one of the challenges and disruptions is the healthcare worker job cuts.

It indicates that HIV programme officers have had - and others may have - their jobs cut.

For those who have retained jobs, there is a proposal to align their salaries with government pay scales as detailed in the report.

“This has affected the capacity of facilities/service points that provided antiretroviral therapy, leading to reduced availability of HIV testing and other services. Data collection at all facilities/service points continues, but data quality control and data collation are affected,” reads the report.

The report stipulates that primary HIV prevention services have been disrupted, including reduced availability of PrEP services, suspension or reduction of HIV prevention education and awareness campaigns, limited or suspended implementation of voluntary medical male circumcision services, and delays or disruptions in community-based HIV prevention outreach programmes.

Also outlined is that HIV prevention programmes for adolescent girls and young women (AGYW) have been impacted, affecting between 120 000 -150 000 AGYW.

Delays

These include a reduced capacity of service delivery points for HIV prevention, delays in linkages to HIV prevention services, discontinuation of AGYW-specific outreach programmes, reduced availability of HIV prevention education and awareness campaigns and a reduction in the availability of counselling and social support services for AGYW.

The DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) programmes targeting AGYWs are no longer operating, which is creating disruptions in PrEP access for AGYW and increasing their risk of HIV infection, while also negatively impacting their behaviour change in the long-term as detailed in the report.

“Human rights, key and vulnerable populations Eswatini received US funding for work on stigma, discrimination and enabling legal environments. Some programmes have stopped; other work is ongoing with reduced capacity. This funding has not been redirected to other programmes,” reads the report.

According to the report, mitigation actions by government and country partners include the integration of HIV services into other health services and mobilising domestic resources to fill the financial gap.

There is a country-level task team in place to discuss the impact on service delivery and identify mitigation measures. People living with HIV are part of the task team, while key populations are represented by the Ministry of Health’s HIV programme focal point.

Community-led organisations (CLOs) reported to be at risk of closure or severe reduction in services.

The country reports suspension of services, loss of staff or funding cuts among CLOs involved in service delivery; reduced participation in policy discussions, limited ability to advocate for key issues and shift in focus due to funding constraints among CLOs involved in policy design, advocacy and work on societal enablers; and reduced ability to collect and report data, loss of funding for monitoring activities and increased difficulty in accessing government or donor support among CLOs involved in community-led monitoring and data generation.

Mitigate

This publication recently reported that to mitigate the repercussions of the USAID defunding in Eswatini, the Ministry of Health has submitted an urgent budget request to Cabinet.

The Minister for Health, Mduduzi Matsebula, stated that the ministry, working with development partners, has assessed the implications of the defunding by the US Government.

“The Ministry of Health has made the calculation, and a supplementary budget will be presented. The full report will be shared with Parliament through the health portfolio committee,” he said as quoted at the time. The minister was responding to questions from senators regarding the ministry’s actions to secure domestic support for programmes previously financed by US funding.

He added that patients on the second line of treatment will have access to ART as the government purchases the ARVs for the first line. Matsebula further stated that paediatric, second and third-line patients will be more affected. Testing and prevention will also be affected, the minister added.

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