Hospices face a budget crunch

HOSPICES in South Africa are being forced to retrench staff and cut back on the numbers of patients they care for as US donor funding dries up, the Hospice Palliative Care Association of South Africa said on Wednesday.

The budget crunch meant that an increasing number of terminally ill people were at risk of spending their final days in pain, isolation and distress, and there was less support available for very sick HIV and tuberculosis patients who could be restored to health in the right hands, association CEO Lynn Gwyther said.

The organisation channels donor funding to nongovernmental organisations (NGOs) that provide palliative care.

"Our hospice numbers are dropping significantly, we are closing down satellite sites, and can no longer reach the deep rural areas," she said on the sidelines of a presentation to Parliament.

The funding crisis facing the association is the latest example of the harsh reality facing NGOs as the US scales back its historically generous support to South Africa through its Presidential Emergency Plan for AIDS Relief (Pepfar).

Tough economic conditions throughout the world mean there are few alternative sources of international donor funding. And provincial health and social welfare departments have been slow to plug the gap.

Although the Treasury said provincial departments could make payments directly to well-established NGOs that provided services they were unable to do so themselves, Dr Gwyther said.

Many provincial departments are telling palliative care NGOs that they need to tender, a lengthy and bureaucratic process.

T

he US is the single biggest HIV/AIDS donor to South Africa, providing $3.2bn since 2003. By 2017, its annual funding to South Africa is to fall to $250m, roughly half the $484m budgeted for last year. Some of this money has been channelled to NGOs providing palliative care.

Pepfar gave the association a $12m grant for the US fiscal year starting October 2011, with a grant extension provided from October last year to the end of March.

Despite an increase in funding from corporate backers, the association had been unable to secure sufficient donor support to counter the budget shortfall when the Pepfar funding comes to an end, Dr Gwyther said.

"Although the Pepfar grant … is scheduled to end at the end of March … we will continue to support South African government healthcare efforts in palliative care," the US embassy said.

Palliative care aims to improve and prolong life for people with progressive illnesses, and relieve pain and distressing symptoms for people who are dying. It also offers emotional and spiritual support to patients and families.

In South Africa, hospices have played an important role in HIV and tuberculosis care, restoring extremely ill patients to better health. Earlier Wednesday, Dr Gwyther told Parliament’s portfolio committee on health palliative care was in desperately short supply in the country, with few doctors and nurses trained in this field.

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