Disability grant cutoff threatens livelihoods

As the number of South Africans accessing antiretroviral (ARV) treatment steadily increases, AIDS researchers and activists are concerned that the government's drug rollout programme could have some unexpected social side effects. Many HIV-positive South Africans, whose CD4 count has dropped to below 200, are receiving a R780 (US $120) disability grant each month, to ensure that they can afford appropriate nutrition and medical check-ups. In practice, however, the grant is used to support entire families. To reduce the possibility of fraud, the health department has insisted that grant recipients undergo regular medical examinations to verify their health status and, in some cases, patients certified fit enough to work have had their grants discontinued. But health researchers argue that even though a patient's health may have improved as a result of ARV treatment, ongoing financial assistance remains critical to ensure drug adherence. Sister Sue Roberts, a nurse at the HIV/AIDS clinic at Helen Joseph Hospital in Johannesburg, told PlusNews that about 10 of her patients, who had recently applied for a grant renewal, had not returned to the clinic. Without the grant money, she added, many patients could not afford the transportation costs to the clinic to receive their monthly medication. Unemployment is currently around 35 percent in South Africa, and AIDS activists have said the likelihood of recovering patients re-entering the workforce was negligible. Chloe Hardy, a researcher at the Johannesburg-based AIDS Law Project (ALP) noted, "These are people who've got no prospect of finding work in the short term or even the long term, especially if they've been out of the labour pool for a long time because they've been sick." She pointed out that many of the grant recipients had been unemployed before they became too sick to work, and some had never held a permanent job. A major concern was that the loss of the monthly stipend was likely to have devastating consequences for poor households that depended on the financial aid. A recent study conducted in poverty-stricken Khayelitsha township on the outskirts of Cape Town showed that, on average, the grant made up 56 percent of total family income. The small sample of grant recipients interviewed for the study said that while they would choose the treatment over the grant, it would be a painful decision, as it would mean extreme hardship for their families. With only about 43,000 people currently accessing ARVs, many of whom have just started their treatment, the loss of the disability grant has not yet occurred on a large scale. Researchers said it was imperative that the government introduce a Basic Income Grant (BIG) for all unemployed South Africans, regardless of their HIV status. Several AIDS lobby groups have argued that South Africa's welfare system was inadequate and failed to address the needs of the most vulnerable. Connie Kganakga, Chief Director of the HIV/AIDS Unit at the Department of Social Development, acknowledged that there were problems with the disability grant, but said that the BIG was "not yet on the table, for reasons that the government can't afford it right now".