Over 1,400 cervical cancer patients in Gauteng are set to be transferred to already overstretched public hospitals following the abrupt closure of several cervical cancer screening and prevention clinics operated by the Clinical HIV Research Unit (CHRU).
The closures come after the CHRU, a leading cervical cancer screening and research unit in South Africa, announced it would cease operations due to recent U.S. funding cuts under President Donald Trump’s administration, which saw the abrupt withdrawal of support from programmes like President’s Emergency Plan for AIDS Relief (PEPFAR) and National Institute of Health (NIH) backed clinical research initiatives.
For the past 20 years, the CHRU clinics have played a critical role in the early detection, diagnosis, and treatment of cervical cancer.
Cervical cancer remains a leading cause of cancer-related deaths among South African women. It is the second most common cancer in women, with an estimated 6,000 new cases diagnosed annually and nearly 3,000 women dying from the disease each year.
“Our colposcopy (follow-up service for women with abnormal PAP smears) clinic has been a lifeline for surrounding clinics, with a referral base from clinics as far as Springs, Randburg, Bellavista, Soweto, Roodepoort, and Hillbrow. We’ve been able to manage a waiting time of just 2-3 weeks, but now, these same clinics will be faced with months of delays, and women will be turned away,” Dr Mark Faesen, a specialist gynaecologist and fertility expert at CHRU said in a statement.
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Faesen tells Health-e News that many of the women served by CHRU present with severe pre-malignant conditions, which, if left untreated, can rapidly progress to cervical cancer.
“At the clinic, we diagnose more than 15 cases of cervical cancer every year. Alarmingly, more than 50% of these cases are in women under the age of 50, and 20% affect women younger than 40,” he says.
Vital research under threat
Beyond patient care, the funding cuts also threaten the future of vital cervical cancer research conducted at four clinical research sites at Helen Joseph Hospital, Sizwe Tropical Disease Hospital, King Dinuzulu Hospital, and Empilweni TB Hospital.
CHRU conducts research to prevent and treat infectious diseases such as HIV, TB, HPV, Hepatitis B and C, and COVID-19.
Over the past two decades, the unit has conducted numerous clinical studies and contributed to over 35 peer-reviewed publications that have advanced the understanding and management of cervical cancer in resource-limited settings.
Faesen says all this research has come to a complete stop.
Salome Meyer, director of Cancer Alliance, a civil society network made up of more than 30 cancer-focused organisations and advocates, adds that any funding cuts that affect cervical cancer research are deeply concerning.
“With South Africa’s high HIV burden, many women are also likely to be HPV positive, and persistent HPV infection is the primary cause of cervical cancer. Monitoring women living with HIV for HPV is therefore critical to early detection and prevention,” she says.
Retrenchments loom
According to Faesen, CHRU has had to go through a retrenchment process and impose salary cuts.
Xolani*, one of the managers at King Dinuzulu Hospital, says the impact is devastating for staff.
“We saw what happened to our colleagues at Wits Reproductive Health & HIV Institute (Wits RHI), who lost their jobs when their clinic shut down early this year. The future is uncertain, and retrenchments are happening in phases,” he explains. “While the immediate concern is job loss, the broader impact on research and public health will be significant.”
A colleague at Helen Joseph Hospital adds that staff have been advised not to share information until more clarity is provided.
Faesen says the CHRU’s budget came entirely from U.S. funding agencies; they have no choice but to suspend all activities.
“Staff will be retrenched, and patients will have to seek screening and treatment elsewhere,” he says.
Government’s response
At a recent press briefing, Health Minister Dr Aaron Motsoaledi said the government has held a series of meetings with potential donors and funders in response to the recent U.S. funding cuts. But no new funding has been secured as yet to support South Africa’s HIV programme.
The Department of Health did not respond to questions about which other public health programmes are affected beyond those related to HIV funding. – Health-e News
