As South Africa navigates the complexities of its 2025/26 Budget Vote, a critical dilemma is emerging: the reallocation of funds traditionally aimed at combating communicable diseases like HIV and tuberculosis could come at a grave cost to cancer patients.
With non-communicable diseases, particularly blood cancer, on the rise, experts warn that redirecting resources might further jeopardise the already fragile infrastructure for cancer screening, diagnosis, and treatment.
Palesa Mokomele, Head of Community Engagement and Communications at DKMS Africa, an international non-profit organisation dedicated to the fight against blood cancer - highlighted the dire situation faced by blood cancer patients in the country.
“Nearly 80% of South Africans rely on a system already operating at full capacity, with many left with little more than hope due to limited access to care.
“Even before these new funding shifts, resources for blood cancer detection and treatment were critically scarce, contributing to the loss of more than 4,000 lives each year.”
Mokomele illustrated how inadequate medical infrastructure creates insurmountable barriers to life-saving care.
“The survival rate for a stem cell transplant is up to 50% with a matched unrelated donor and 61% with a matched related donor. Yet many healthcare facilities don’t have the resources to perform these procedures. As a result, most patients receive only medical management, which may not be enough to ensure survival.
“Given our population size, transplant activity remains critically low—only 139 of the required 600 transplants are performed on adults annually, and just 18 of the 250 needed for children.”
Financial burdens compounding challenges
Mokomele noted, “One in five South African households delays seeking healthcare simply because they cannot afford it.
“While the state covers the cost of a stem cell transplant from a matching donor, other essential expenses—such as tissue typing, donor searches, and stem cell procurement—are not covered.
“These out-of-pocket costs place treatment out of reach for many, leading to heartbreaking decisions and poorer outcomes.”
She stated that socio-economic challenges also complicate access to care.
“Being the sole breadwinner means some individuals struggle to take time off work for necessary treatment. In other cases, mothers face the impossible choice between continuing their treatment or staying home to care for their children when no other support is available.”
Post-transplant survival challenges
According to Mokomele, even for patients fortunate enough to undergo a transplant, survival post-procedure remains precarious due to substandard conditions in some public healthcare facilities.
“Overcrowding and poor sanitation create dangerous environments for these highly immunocompromised patients. To safeguard their fragile health, they need access to clean water, proper sanitation, isolation, and balanced nutrition.”
She argued that long recovery periods pose significant hurdles for patients traveling from distant areas.
“Without proper housing at treating hospitals, many are forced to abandon treatment, putting their survival at risk.”
“No patient should be denied life-saving treatment due to funding constraints. We urge the government and the private sector to collaborate in strengthening blood cancer care, and we encourage the public to play their part by supporting fundraising initiatives that help bridge critical gaps in treatment access,” Mokomele concluded.
On Wednesday, the South African parliament passed Finance Minister Enoch Godongwana's 2025 budget, which included a boost to the health budget, increasing allocations from R277 billion in 2024/2025 to R329 billion in 2027/2028.
The Finance Minister described this as a response to the pressing health needs of the public sector, which serves more than 80% of the population.
Despite the increase in the health budget, concerns have arisen regarding the proposed 0.5% increase in VAT, which critics argue could negate potential benefits to the health sector.
The World Bank reports that approximately 60% of South Africans live below the poverty line, and the VAT increase may exacerbate these challenges.
The Budget was passed amid serious opposition from several parties, including the DA, MK party, and the EFF, highlighting the contentious nature of health funding in the country.
As the government moves forward, the fate of cancer patients hangs in the balance, emphasising the urgent need for a holistic approach to healthcare funding that prioritises all forms of the disease.
IOL