Over 111,000 people living with HIV in the Western Cape have not accessed care in the past two years, according to Provincial Health Data Centre figures, as researchers and health officials warn that medicine alone cannot sustain treatment outcomes without addressing poverty, hunger, and access barriers.
A republished Health-e article carried by AllAfrica on 3 September 2026 argues that antiretroviral therapy (ART) success depends on far more than drug supply, pointing to food insecurity, transport costs, and unemployment as major drivers of treatment disengagement across South Africa.
Research published in the journal PLOS Medicine in May 2024 defined disengagement as interrupting ART or care for 90 days or more, in line with national guidelines, and found substantial drop-off across the HIV care cascade. Independent reporting by Daily Maverick and Spotlight, referencing South African researchers, estimated that on any given day about 130,000 people — roughly a quarter of all people living with HIV in the Western Cape — are disengaged from treatment.
A review article on food insecurity and HIV/AIDS found that inadequate food access is associated with decreased ART adherence, reduced baseline CD4 cell count, incomplete virologic suppression, and decreased survival. South African researchers, summarised by aidsmap in September 2023, reported that difficulty in balancing work commitments and clinic appointments, diverting resources towards substance use, and covering other basic household needs over ART-related costs all negatively affected adherence.
The Western Cape provincial government has acknowledged the scale of the problem, noting in an update that over 111,000 people living with HIV had not accessed care in the previous two years. The province said it is working to close the gap through differentiated service delivery models.
South Africa’s Central Chronic Medicine Dispensing and Distribution programme (CCMDD) allows clinically stable clients to obtain ART at external community pick-up points or clinic-based pick-up points, reducing clinic visits to one or two times annually instead of monthly. Research on the programme, published in PMC, found that longer refill intervals and community-based collection help reduce disengagement among stable patients.
The exact wording and authorship of the original Health-e article republished by AllAfrica could not be independently verified, and specific clinic gardens or named programmes cited in that piece are not confirmed by at least two independent sources. Cape Flats News journalist Nadia Adams will seek confirmation from the Western Cape Department of Health and Wellness on current programme figures by 10 September 2026.
What remains unclear is whether provincial interventions such as CCMDD expansion and food-support pilot programmes are reaching the people most at risk of disengagement in Cape Flats communities like Khayelitsha, Gugulethu, and Mitchell’s Plain, where unemployment and food insecurity remain acute.