Programme Director,
Minister of Health: Dr Aaron Motsoaledi,
Premier of Mpumalanga: David Mabuza,
Executive Mayor of Gert Sibande District: Cllr Mishack Nhlabathi
Executive Mayor of Mkhondo Local Municipality: Cllr Bhekabantu Mtshali
UNAIDS Country Coordinator, Dr Catherine Sozi,
SANAC Deputy Chairperson, Ms Mmapaseka 'Steve' Letsike,
Representatives of the diplomatic corps
Representatives of the Development Community,
Members of the community of Gert Sibande and Mkondo and other municipalities
Distinguished guests,
Fellow South Africans,
Good Afternoon.
It is an honour to address you on this special occasion to commemorate World AIDS Day.
Today marks the 25th anniversary of World AIDS Day, a day when people the world over stand together in solidarity to honour the memory of those who have succumbed to HIV infection and its related complications, to acknowledge the impact of the epidemic on individuals, families and communities, to note the gains that we have made and to recommit ourselves to doing whatever it takes to realise our collective vision of an AIDS-free world.
Whilst we have embraced the overarching global theme of: "Sharing Responsibility - Strengthening Results for an AIDS-Free Generation”, we have adopted our own context specific theme.
South Africa's theme for World AIDS Day 2013 is:
- Get Wise.
- Get Tested.
- Get Circumcised!
World AIDS Day 2013 is also special in that today represents nearly 10 years since Cabinet approved South Africa's first Comprehensive HIV and AIDS Treatment programme.
Our programme started in a number of pilot sites with a focus on the Prevention of Mother-to-Child-Transmission of HIV; this was followed by provision of prophylaxis to prevent transmission through needle-stick injuries among health workers and to survivors of sexual assault. As you know, our programme has since expanded to include provision of treatment to those who were eligible as determined by international guidelines and we continue to expand access in an evidence-informed manner.
Given the fact that we are faced with a huge burden of disease, due not only to HIV and TB but other non-communicable diseases, we have adapted and realigned our programmes to respond to the social determinants and many other structural factors that hinder our progress in realising a long and healthy life for every South African.
On World AIDS Day in 2009 we took a number of policy decisions to strengthen our response:
- We lowered the threshold for eligibility for anti-retroviral treatment- thus making it possible for many more South Africans to get access to life saving antiretrovirals;
- We made it possible for almost all health facilities to provide anti-retroviral treatment
- We recognised that it was necessary to train nurses to initiate those who are eligible, thus expanding access significantly;
- We launched a bold HCT campaign and provided screening for TB and other non-communicable diseases; and
- We committed to massively increasing domestic investment in the AIDS response;
Today,
- The anti-retroviral treatment programme is delivered out of more than 3,500 of the country's public health facilities;
- More than 2.4 million children and adults take antiretroviral medication on a daily basis;
- More than 1 million men and boys have been medically circumcised;
- Mother-to-Child-Transmission has been reduced to 2.7% at 6-weeks- from 8% in 2008 - this means that 70 000 new born infants are born HIV- free each year;
- 20 million people tested for HIV over 20 months during the HCT campaign; they now know their HIV status and are empowered to take appropriate steps to maintain their health.
- The GeneExpert technology has been put into all public health laboratories which has reduced the time taken to diagnose drug susceptible TB and drug resistant TB within two hours.
Providing anti-retroviral treatment on such a scale was thought an impossible task for our country, and yet today we are here to acknowledge the efforts of all of the health workers, sectors, the communities, people living with HIV, the development community and everyone who contributes to our national response. Collectively, we have brought our country closer to the attainment of our vision of an AIDS-free South Africa.
Programme Director,
It is comforting to note that not only are we as a country making progress, the region and the global community as a whole is moving forward. The 2013 UNAIDS report on the HIV epidemic in Eastern and Southern Africa tells us that between 2001 and 2011 the massive effort to reduce new HIV infections achieved a regional decline of 32% in new HIV infections. The report also highlights some of the gaps and the challenges that persist, thus requiring on-going global effort. Our work is far from done.
In South Africa, the epidemic has matured and the acceleration of our response since 2009 has moved us beyond the "tipping point” where the number of patients being enrolled onto treatment each year now exceeds the number who are newly infected. However, the number of new infections still remains unacceptably high, hence the importance of maintaining our focus on PREVENTION, PREVENTION, PREVENTION! Our response will not succeed unless we turn of the tap of new infections.
That we are here today is an indication that much more needs to be done, especially here in the Gert Sibande District. Through our annual surveys we have been able to identify that this district has one of the highest rates of antenatal HIV infections and therefore requires more support in the implementation of a wide range of programmes to address the burden of disease and the social determinants thereof.
Our National Strategic Plan elaborates a comprehensive prevention package which encourages that EVERY South African test for HIV annually. The starting-point for prevention will always be, knowing one's HIV status. That is why I am announcing the re-launch of the national HIV Counselling and Testing Campaign (HCT). You may have tested in 2010 or 2011, test again this year, and every year.
The HCT campaign will include screening for TB and other communicable diseases like diabetes and hypertension as well as eye examinations. We are emphasising this because 80% of the population has 'latent TB'. TB is preventable, treatable and curable - but if left untreated or if treatment is not completed, TB can be deadly.
We are also launching a national Medical Male Circumcision (MMC) campaign today.
Medical Male Circumcision (MMC) is a proven, effective component of our HIV prevention package. Once 80% of men have been medically circumcised, projections tell us that this will prevent half-a-million new HIV infections and 100,000 deaths over the course of the next decade. Our target is to circumcise 1 million men over the next 12 months and cumulatively, 4 million men by 2016.
Work has been underway in all the provinces to ensure that we reach the targets we have set.
The re-launch of the HCT and the launch of the MMC campaigns will enhance the medical interventions to strengthen our country's massive prevention effort. But bio-medical interventions are only one prong of our efforts. We also need to ramp up our efforts to address the social determinants that fuel the HIV & TB epidemic. Examples of the social determinants include: disempowered women and children - who are often the targets of violence; poverty; the migrant labour system; intergenerational sex; transactional sex; and many other structural issues.
These MMC and HCT campaigns and the effort to address the social determinants that fuel the dual epidemic will only succeed with the all-round participation of all stakeholders. The health system is a public health system. Every one of us has a role to play in ensuring its effective functioning. We need everybody to drive this vision and work towards the same goals. Many of our activist organisations help to ensure accountability of delivery across this public health system. We are not offended when civil society organisations raise issues. We need your help in bringing many of these issues to our attention and we remain committed to working with you to ensuring that the issues you raise are dealt with appropriately. Please continue to work with us in bringing these matters to our attention.
Programme Director,
Referring once more to the social determinants that increase vulnerability to HIV infection, as we move into the festive season it is important to maintain our focus on health and on responsible behaviour. Our theme for World AIDS Day may change every year but we continue to hold true to the theme of World AIDS Day under which we launched our accelerated response in 2009: I am responsible, we are responsible, and South Africa is taking responsibility. Over this festive period I encourage all of us to bear this theme of responsibility in mind.
In closing, it is prescient that we are commemorating World AIDS Day during the 16 Days of Activism for No Violence Against Women and Children. Women and girls bear not only the brunt of the HIV epidemic but the brunt of the violence in our communities. We remain committed to reducing the high levels of violence for the sake of our country and the future of our communities.
I leave you with the Theme for World AIDS Day 2013:
? Get Wise.
? Get Tested.
? Get Circumcised!
I Thank You all.
