When HIV Care Disappears, So Do Lives

Imagine being 23, HIV-positive, and living in a rural town in South Africa. You’ve done everything right—tested early, stayed on treatment, kept your viral load suppressed. But then the clinic stops calling. The meds run late. The nurse says funding is drying up. 

For thousands of South Africans, this is not fiction. It’s 2025.

A recent report by Reuters revealed a disturbing trend:

“HIV testing and viral load monitoring in South Africa have dropped by up to 20% in the wake of U.S. aid cuts under PEPFAR.” [Reuters, May 2025]

That means:

• Fewer people being diagnosed
• Fewer patients being monitored
• And far more people quietly slipping through the cracks. 

When Funding Falters, So Does Hope

South Africa has made heroic gains in HIV treatment. With over 8 million people living with HIV, it is the world's largest antiretroviral (ARV) program.

But what happens when testing clinics downscale, and support partners are replaced with low-touch alternatives?

What happens when digital health systems don’t scale fast enough, and value-based models aren’t used to hold service providers accountable?

What happens… is we start to lose.

“We’re watching the largest HIV treatment programme in the world unravelling in real time. We don’t need perfection, but we do need a combination of urgency, action, and strategy to save it”—comes from an opinion piece written by Professor Francois Venter and published by GroundUp on 23 April 2025.

Pharmacy Direct’s Case for Value-Based HIV Care

We need to stop treating digital health and value-based care as buzzwords—and start seeing them as lifelines.

Pharmacy Direct—a leading courier pharmacy in South Africa—has been working behind the scenes to ensure:

• Timely ARV delivery, even to remote or under-resourced areas
• Real-time patient engagement via SMS, WhatsApp & mobile tools
• Strong collaboration with leading HIV disease management partners to ensure continuity in HIV care
• Digital scripting and doctor portals to remove friction in access
• A commitment to Value-Based Care, measuring not just volumes dispensed—but lives impacted

Pharmacy Direct delivers over 1.2 million prescriptions monthly—yet behind every one of those is a person, a husband, a mother, a student, a patient who can’t afford to fall through the cracks.

Strengthening HIV Access through CCMDD

One of South Africa’s most successful public-private innovations is the CCMDD (Central Chronic Medicine Dispensing and Distribution) program which also forms part of Pharmacy Direct. Designed to decongest clinics and empower patients, CCMDD allows stable chronic patients—including those living with HIV—to collect their medication from convenient pick-up points like retail pharmacies, community centres, and lockers.

Yet, even this model relies on logistics precision, last-mile delivery, and reliable data systems—areas which are mission-critical. As one of the largest dispensing service providers in the sector, CCMDD ensures that:

• Patients receive timely notifications
• Delivery points are aligned with patient volumes
• Tracking and reporting are accurate and real-time

CCMDD is not just a supply chain—it’s a patient dignity chain. Let’s not break it.

Why This Needs Urgency, Not Bureaucracy

The South African National HIV prevalence sits at 13.7%, with young women aged 15–24 accounting for nearly 30% of new infections.

Disengagement in care disproportionately affects:

• Youth
• Pregnant women
• Undocumented migrants
• Rural populations

In other words: the people with the most to lose are being reached the least.

As health leaders, if we don’t respond with urgency—this crisis becomes irreversible.

A Call to Action for Every Health Leader:

• To medical aid funders: Tie payments to outcomes, not only processes. Embrace Value-Based Care.
• To pharma companies: Support digital access platforms and subsidize real-world patient engagement models.
• To clinics and NGOs: Invest in training, telehealth and patient navigation tools that bring people back into care.
• To patients and communities: Keep showing up. Keep advocating. Keep sharing your stories.

Because Access Is Everything

We don’t need more studies to know what works—we need collaboration, digital scale, and smart accountability models that ensure people stay in care.

Lives aren’t lost in big moments—they're lost in the quiet ones: the test not taken, the message not answered, the medicine not delivered.

Let’s not let that happen on our watch. 

Call to Action:

If you’re a health decision-maker, funder, or program lead—we’d love to collaborate. 

Let’s build a healthcare system where HIV care doesn’t pause because of politics, paperwork, or procurement.

Let’s build one that delivers—consistently, compassionately, and at scale.

#HIVCare #DigitalHealth #HealthcareTransformation #ValueBasedCare #PublicHealth #SouthAfrica #PharmacyDirect #PatientAccess