Tag: NGO

Categories : Healthcare Politics and RegulationsTags :

Over 15 000 South African Health Workers’ Jobs are at Risk as US Cuts Aid

On By ModernMedia
Photo by Scott Graham on Unsplash

By Jesse Copelyn

If the US President’s Emergency Plan for AIDS Relief (PEPFAR) is halted, the South African public health system “will face a severe crisis” that could endanger millions of lives. This is according to a coalition of 17 health service organisations in South Africa, including large ones such as Anova Health, Health Systems Trust, TB HIV Care, The Aurum Institute and Wits RHI.

In a statement, they appealed to private sector donors and “high net-worth individuals” to help fund the shortfall caused by US aid cuts.

Read the statement

PEPFAR is a multi-billion dollar US initiative that supports HIV and TB-related health services around the world. In South Africa alone, over 15 000 staff (mostly health workers) are funded by PEPFAR, according to the national health department.

But a series of executive orders issued by US President Donald Trump has suspended some of this funding and the rest remains precarious. The orders include a 90-day pause on all US foreign development assistance and another that explicitly bars South Africa from aid (with some leeway allowed).

Some health service providers in South Africa continue to receive money from PEPFAR under a limited waiver that allows for the continuation of certain “life-saving HIV services”. But the waiver hasn’t protected all PEPFAR beneficiaries. As a result, some organisations have had to close their doors, while many others have had to curtail what they can provide.

The waiver doesn’t cover all health services, and many health programs that target high-risk groups (such as people who use drugs) have not been protected. This is even if they provide life-saving HIV services.

Services suspended for the most vulnerable

Under the waiver, PEPFAR can continue to fund programs that offer treatment and testing for HIV, including antiretroviral (ARV) services. Projects can also continue to provide condoms and HIV prevention medication, known as PrEP, but only to pregnant and breastfeeding women.

The waiver does not allow for continued funding of PrEP medication or condoms to anyone else. It also doesn’t cover crucial research, like population surveys which tell us how many people have HIV and where they’re located. Additionally, it doesn’t allow for continued funding of methadone maintenance programs for people who use heroin. This is despite the fact that this is the most effective way to help people to stop using heroin and to curb the sharing of drug needles (something which contributes to the spread of HIV).

Dr Gloria Maimela, who represents the coalition of organisations behind the statement, told GroundUp and Spotlight: “The staff who are providing [HIV] testing and treatment [are] back at facilities to provide those services, but staff that are providing other services not included in the waiver have been stopped, and are waiting for further guidance.”

In addition, organisations that help key populations have not been protected by the waiver, according to Maimela. Key populations are groups that are more at risk of becoming infected with HIV, such as people who inject drugs, sex workers, transgender people, and men who have sex with men. South African policy documents and the World Health Organisation recommend that health programs focus on these groups since they’re more likely to acquire and transmit HIV.

Despite this, US-funded organisations that target key populations have been forced to shut their doors in South Africa. Maimela says that this is even in cases where they were offering the kind of life-saving ARV treatment covered in the waiver.

“For us, this is of grave concern,” Maimela says, “because we know that right now that is where most of the [HIV] infections lie”.

So far, organisations which provide HIV treatment and prevention services to LGBTI people have been forced to shut down, including the Ivan Toms Centre and Engage Men’s Health.

Additionally, GroundUp and Spotlight have identified two PEPFAR-supported harm reduction centres that have had to close. These centres provided methadone and clean needles to people who inject drugs (when drug users have access to clean needles, they’re less likely to resort to sharing them, which brings down HIV transmission).

Ricardo Walters, who provides consulting services to health service organisations across Africa, told Spotlight and GroundUp that a similar trend could be seen across the continent.

“Many organisations that were specifically offering services to key populations were not suspended; their project funding was terminated,” he said. “They will not be coming back.”

These organisations were assisting patients “who often could not access services in a general [health] setting”.

Walters says the reasons given for the termination of these programs vary across organisations and countries.

“Where there are reasons, it’s often [stated] that it’s because the program contains components of DEIA [Diversity, Equity, Inclusion and Accessibility] and gender ideology, which is directly from a previous executive order [in which the Trump administration terminated all federal funding for DEIA]. The terms are never defined … no one says don’t treat gay men.”

Appeal to private sector

Beyond the shuttering of existing organisations, providers that are covered under the waiver remain unsure about whether funding will restart after the 90-day period. Also large sections of the US aid establishment have been gutted.

The recent statement by health organisations argues that if this aid is terminated “patients, including children, will lose access to life-saving antiretroviral treatment, while thousands of healthcare workers will be unable to provide essential HIV care. The consequences will be immediate. Fewer people will receive timely testing and treatment, leading to more undiagnosed cases, rising infections, and the spread of drug resistance. Mortality will increase, opportunistic infections will surge, and TB rates will escalate – putting the entire population at risk.”

As such, the statement calls on private corporations, donors and philanthropists to assist in supporting these health services.

“We encourage people to get in touch with us,” says Maimela, “so that even as we hold dialogues with the government, [those people] could be part of [the conversation] and step in and say how they want to help.”

To find out how to support organisations that provide HIV and TB related health services in South Africa contact Gloria Maimela at gloriam@foundation.co.za.

Published jointly by GroundUp and Spotlight.

Republished from GroundUp under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Categories : Ethics and LawTags :

Probe Clears Most Gauteng Care Organisations

On By ModernMedia

Handful of organisations remain under investigation

Photo by Scott Graham on Unsplash

By Daniel Steyn, Joseph Bracken and Raymond Joseph

Most of the non-profit organisations that were flagged in a forensic audit by the Gauteng Department of Social Development have been cleared of all findings and have started to receive subsidies from the department again.

The forensic audit, announced by Gauteng Premier Panyaza Lesufi during his 2023 State of the Province Address, was a key intervention by former social development MEC Mbali Hlophe and aimed to uncover fraud and corruption in the non-profit sector. The department pays about R1.9-billion in subsidies to more than 700 non-profit organisations every year.

In a list circulated to affected organisations on Wednesday by the department, which GroundUp has seen, 34 of the more than 50 organisations that had audit findings against them, have been cleared after they rejected the findings. The organisations, which include drug rehabs and women’s shelters, have had to endure three months without any funding since the start of the new financial year on 1 April.

Read the list

According to the list, six organisations are yet to receive the final outcome of their submissions. These include the training academies Daracorp and Beauty Hub, which collectively received R114-million in funding in 2022 and 2023. There are still unanswered questions about why these two organisations received so much in subsidies while budgets were cut for other organisations that care for people with HIV and older persons.

Social work organisation Kitso Lesedi Community Development, which has rejected the findings against them, is also still awaiting the final outcome of their submission.

The department has decided to “uphold” the decision not to fund two organisations, according to the list. These are Life Healthcare’s non-profit drug rehab in Randfontein and Tembisa Society for the Care and Welfare of the Aged. GroundUp understands that Tembisa is taking steps to appeal the decision.

Also, eight organisations are part of a Hawks investigation, according to the list. These include several foodbanks and Godisang Development, which has historically played a key role in the department’s Welfare to Work programme.

The department has not responded to GroundUp’s questions on the Hawks’ investigation, and the Hawks told us that it will be difficult to answer questions without a case number.

According to the department, 14 officials have been suspended since the forensic audit was launched, but their identities, the allegations against them, and the status of their disciplinary processes remain unknown.

Total Organisations on List51
Organisations cleared34
Hawks Investigation8
Organisations yet to receive outcome6
Organisations that did not make submissions
(But one of these organisations, Carroll Shaw,
claims it made a submission)		2
Organisations that remain unfunded due to
investigation (decision upheld after submissions)		2

The forensic audit caused catastrophic delays in this year’s funding adjudication process, forcing hundreds of organisations to survive the first two months of the 2024/25 financial year without any funding. Some organisations retrenched staff, scaled down services or even shut down.

The department decided to centralise the process of allocating funds and appointed external adjudication panels. The department claimed this was because of findings by the Auditor-General, but the Auditor-General told GroundUp no such findings or recommendations were made.

The centralisation delayed the allocation of funds and the whole process ultimately collapsed, with the department deciding to simply extend contracts with organisations already signed in 2023.

The department did not respond to GroundUp’s questions.

Organisations vindicated

Organisations that have been cleared and have received findings told GroundUp that they feel vindicated and relieved.

Derick Matthews, CEO of Freedom Recovery Centre, which provides in-patient drug rehabilitation, told GroundUp that they have started admitting patients again and ordering supplies.

“Crazy days, but super excited,” Matthews said.

Mpule Lenyehelo, director of A Re Ageng, which runs women’s shelters and gender-based violence care centers, says it will take time to repair the relationship with the department.

“I am very angry and disappointed with the department,” Lenyehlo said. “Their allegations were unfounded and could not be substantiated as we have always received positive feedback from their monitoring and evaluation team. What the department seems to conveniently forget is that the organisation is providing essential services to the most vulnerable people in the community as well as 114 staff members in terms of job creation.”

One organisation caught in the cross fire was MES. The organisation never appeared on the list of organisations under investigation but nevertheless received a letter saying that there was a finding against them and that they would not be receiving funding. The finding was that they had not spent their full subsidies.

Leona Pienaar, CEO of MES, said she was confused because there was no money left over. She wrote to the department asking for clarity but received no reply. She then wrote to FSG Africa, the forensic auditing firm that was appointed to conduct the probe. FSG Africa told Pienaar that they made no findings against MES. After meeting with the department, MES finally had their funding for 2024/25 reinstated.

Lisa Vetten, chair of the Gauteng Care Crisis Committee, which has led litigation against the department and organised pro-bono legal assistance for affected organisations, says that she appreciates recent efforts by the new MEC Faith Mazibuko and some officials in the department to resolve the issues faced by the nonprofit sector.

“Corruption deprives people of services and has no place in the social care sector. But serious questions should be asked about the value of this audit, which not only came at great cost to organisations and their beneficiaries, but also, up to this point, hasn’t yielded much of substance,” said Vetten.

Categories : General InterestTags :

Child Welfare NGO One of Many Defunded by Government

On By ModernMedia
Photo by Chayene Rafaela on Unsplash

Christelike Maatskappy Raad Noord (CMRN), an NGO in Gauteng which focuses on children’s welfare through the use of social workers, has been defunded by the government. This amounts to just over half of its funding, according to marketing manager Anya le Cornu. Other NGOs have also had their funding cut, she said, as heard via the Auditor General’s office.

This comes in the wake of the COVID pandemic as CMNR had to cope with continuing to deliver services amidst lockdowns. If other NGOs are similarly impacted, . Founded in 1936, CMRN aims to eradicate child abuse and neglect, providing a wide range of child protection service from its 16 centres.

The NGO assists a large number of families of children: 6000 beneficiaries received material or skill support in 2020–2021, its Child Protection Awareness campaign reached 14 500 people, 622 children were protected through the legal system, and 900 children received speech or play therapy.

However, these services are obviously under threat from the significant loss of provincial government funding, which at R7 million, accounted for 53% of its income.

In order to cope, CMNR has been forced to restructure, reducing costs wherever possible. Unfortunately, it has having to slash its social workers from 28 to 17 as of 1 July.

Due to the lack of subsidy and other challenges, areas such as statutory work may be impacted.

According to le Cornu, CMRN will try and secure funding through every means possible. “We will maintain and strengthen our relationship with the NG church, our other funding partner,” she says. “We will also continue with our marketing and fundraising initiatives. Professional fees will also be applied where possible. We will also reach out to schools and other institutions where part time social work services are needed and contract these services out to generate an income stream.”

The organisation remains hopeful despite these challenges. “We do wish to have a good relationship with the Department of Social Development and would apply for government funding in specific programs where the objectives of these programs are aligned to our own and the communities we serve,” says le Cornu.

“The CMR North believes that we will survive this crisis and hope to be a beacon of light for other NGOs who might suffer the same fate. It is our passion to continue bringing hope to the vulnerable and we see these events as an opportunity to re-invent our services so that they can have a broader and positive impact in the communities we serve.”

Hopefully, additional funding can be found so that CMRN can continue to provide its services, but if this is part of a wider pattern, people in South Africa who are most in need and depend on these services will suffer the most.