Additional funding has saved government’s Thuthuzela Care Centres at the eleventh hour but poorly performing facilities may still close.
Counselling services at many of the country’s centres for rape survivors set to scale down or close in a matter of weeks have be given a last-minute reprieve.
Almost half of government’s service centres for rape survivors were slated to lose counselling services or operate with skeleton staff as of October. The loss of services follows international funding cuts in April. In a bid to try save crucial counselling services, the South African National Aids Council had secured six months of transitional funding from the international health financing mechanism the Global Fund to Fight Aids, TB and Malaria until the end of September.
Late last week, the national body responsible for overseeing Global Fund money in the country received a letter stating that a private donor had made preliminary commitments to fund counselling services at Thuthuzela Care Centres.
The centres provide counselling services, medical care and HIV treatment for rape survivors. Emotional support services, particularly those offered outside of working hours, are usually run by non-governmental organisations (NGOs) largely dependant on Global Fund money.
A committee of civil society and government representatives called a Country Coordinating Mechanism manages Global Fund grants nationally. The Global Fund cut Thuthuzela Care Centre funding in favour of funding for centres in high HIV and tuberculosis areas in South Africa’s latest application.
“By concentrating on the areas with the highest disease burden and highest numbers of sex workers and survivors of gender-based violence, it means that with the same amount of funding, Global Fund-supported programs will be able to nearly double the number of people these programmes help each year,” said Global Fund spokesperson Ibon Villelabeitia.
“For example, the number of sex workers reached with support is currently 24 000 per year. By focusing on the most affected districts, we will reach 40 000 sex workers per year,” he said.
But South African National Aids Council CEO Fareed Abdullah said the country was forced to make cuts following changes in South Africa’s eligibility for funding based on its middle-income status.
“The Global Fund is correct to say that the Country Coordinating Mechanism made the decision [to exclude some Thuthuzela Care Centres from the latest national application], but in all fairness, they gave us guidance that steered us in that direction,” said Abdullah.
“Our decision to target high-burdened areas and sex workers does not mean that we are neglecting Thuthuzela Care Centres. This means that with the same amount of funding we’ll be able to increase the number of people these programmes can help each year,” he said.
South Africa is set to receive $90-million dollars annually for the next three years to fund HIV and tuberculosis programmes.
Although funding has been secured for the centres, it does not mean their futures are secured indefinitely. Abdullah cautioned that centres that see low numbers of patients will likely be shut down in the future as government rationalises services.
He also cautioned against the dependence of these facilities on donor funding. “Thuthuzela Care Centres operate from public health facilities (and) it is important that in the next two to three years government can take over the funding. This will ensure that losing funding does not result in them closing down,” Abdullah said.
In its letter confirming new, additional funding, the Global Fund predicted that the funds will be approved at a 6 October grant approval meeting in Geneva.
Pontsho Pilane is the communications manager at Soul City Institute for Social Justice. Pilane was a health journalist at Bhekisisa from 2017 until 2019.