Deputy President Paul Mashatile: Commemoration of World AIDS Day 2023

Co-Programme Directors - Health MEC Nomagugu Simelane and Provincial Civil Society Chairperson, Mr Patrick Mdletshe,
Our gracious host - KwaZulu-Natal Premier Nomusa Dube-Ncube, who is also the Chairperson of the Provincial Council on AIDS,
Minister of Health - Dr. Joe Phaahla,
Ministers and Deputy Ministers present,
SANAC Co-Chairperson and Chairperson of the SANAC Civil Society Forum - Ms. Steve Letsike,
Deputy Chairperson of the SANAC Private Sector Forum - Dr. Tshegofatso Gopane,
The UN Resident Coordinator - Mr Nelson Muffuh,
The Patron of Global Alliance South Africa Chapter - Ms Humile Mashatile
The United States Ambassador to South Africa - Dr. Reuben Brigety, and the rest of the esteemed US Government delegation,
Representative of COSATU - Mr Pat Mphela;
SANAC CEO - Dr. Thembisile Xulu,
Traditional and Religious leaders present,
All the children who have joined us today,
Members of the media,
Distinguished guests,
Ladies and Gentlemen,

Sanibonani eMandeni! Ninjani!

Today, we join the world to commemorate World AIDS Day. This day provides us with an opportunity to strengthen our solidarity and unity of purpose in the fight against HIV, to support those living with HIV, and to remember those who succumbed to AIDS-related illnesses.

This day also serves as a reflection on progress made in response to the HIV epidemic and raises awareness about the challenges remaining towards achieving the goal of ending AIDS by 2030.

The theme for this year's commemoration is "Let Communities Lead". This theme urges all of us as stakeholders, and communities to redouble our efforts and invest in community-led interventions and community-centred approaches in responding to the HIV epidemic.

This theme also encourages communities to address inequalities such as poverty, discrimination, and inadequate access to services, particularly for vulnerable communities like women, transgender persons, sex workers, persons with disabilities, and children.

Communities must actively participate in strategic interventions to combat stigma, discrimination, and human rights violations affecting individuals infected and affected by HIV/AIDS.

History demonstrates that when communities unite, any challenge can be overcome. Our combined strengths can help us achieve the goal of eliminating HIV/AIDS and tuberculosis as public health threats.

Active civil society participation has been crucial in the HIV response globally and in our country, leading to significant progress in areas like access to prevention, treatment, care, and support, as well as outreach for vulnerable populations.

An additional area that necessitates strong oversight from civil society is the pervasive problem of gender-based violence and femicide, the correlation of which is universally recognised with HIV.

In this regard, in the past two weeks, I had the opportunity to interact with men during the National Men’s Parliament in Limpopo Province on issues related to gender-based violence and femicide.

I stand here deeply encouraged by the efforts of the Takuwani Riime Men’s Movement which is coordinated by the SANAC Men's Sector, and has demonstrated commitment to establishing community men's parliaments in every village, township, suburb, and community in South Africa, thus ensuring a responsive men's movement.

This movement seeks to mobilise men and boys to stand up and be counted in the country’s efforts against mental health in men, gender-based violence and femicide, new HIV infections, and toxic masculinity, and for men to be drivers of the positive socialisation of the boy child.

We also recently launched the 16 Days of Activism for No Violence Against Women and Children in Mpumalanga Province. As government, we urge communities to work with us in eradicating the scourge of gender-based violence and femicide in our society. We should work together to get rid of patriarchy, economic inequality, insensitive social norms, and harmful cultural practices. The scourge of gender-based violence is detrimental to our efforts towards the achievement of the global Sustainable Development Goals, as well as to our very own National Development Plan.

Fellow South Africans,

One of the key build-up activities for this year’s World AIDS Day was the launch of the sixth South African National HIV Prevalence, Incidence, and Behavioural Survey done by the Human Sciences Research Council.

According to this survey, there are about 7.8 million people living with HIV in our country, which is a decrease from 14% in 2017 to 12.7% in 2022.

While the results clearly show that the prevalence of HIV is declining, there are some worrying patterns regarding the age group between the ages of 25 and 49 years. Among females, HIV prevalence was highest in ages 35 to 39 years at 34.2%, whereas among males, HIV prevalence was highest in ages 45 to 49 years at 27.1%.

Furthermore, there is reason for concern about the increased incidence of HIV infection among adolescent girls aged 15 to 19, since it is an indication that older men engage in unprotected sexual activities with girls and young women.

We must take extraordinary measures as a society to protect kids against immoral predators.

We must ensure that children have a safe environment to discuss the issues influencing their sexual conduct and the pressures they are under.

We must stand with them and educate them about their rights and sexual health.

Furthermore, while acknowledging the significant advancements in HIV treatment cascades at a broad level, our deepest concerns persist regarding the lack of access to treatment by HIV-positive children, young people, and men.

The survey shows that, in 2022, among the people aged 15 years and older who were living with HIV in South Africa; 90% of them were aware of their status; 91% of those who were aware of their status were on antiretroviral therapy, and 94% of those on treatment were virally suppressed.

We may not have met the 90-90-90 targets of December 2020, but we are confident that we will meet the 95-95-95 targets of December 2025, and be well on our way to fulfilling our commitment towards Agenda 2030.

In this regard, we launched the new National Strategic Plan for 2023 – 2028 earlier in March this year during World TB Day. This National Strategic Plan places people and communities at the centre of its efforts to overcome inequities in the country's response to HIV, TB, and STIs and to end AIDS.

Since the Districts of King Cetshwayo, Ugu, uMkhanyakude, and uMzinyathi were the first districts in the nation to achieve the 90-90-90 targets ahead of schedule in this province of Kwa-Zulu Natal, we are confident that this is a goal that is attainable.

It was in uMkhanyakude where we launched the new cost-effective and client-friendly HIV treatment regimen called "TLD”, which is one tablet once a day, with fewer side effects and highly efficient in achieving viral suppression. Our primary objective as a government is to integrate all facets of an individual's healthcare into a unified system, ensuring that everyone consistently gets quality medical care.

Another game-changer in our progressive treatment literacy efforts is the integration of the U=U (Undetectable equals Untransmittable) concept into our policy framework.

It simply means that, if a person takes their treatment consistently without fail, they will achieve ongoing viral suppression until the level of the virus drops to below 50 copies per millilitre. At that point, you are classified as having an undetectable viral load, indicating that you cannot pass the virus on to your sexual partner.

However, we advocate for safe sex since being undetectable will not prevent you from passing on a sexually transmitted infection to your partner or having an unplanned pregnancy.

As a country, we are struggling with retaining people on treatment, which is the second 95, however, U=U is one of the key interventions that will assist us with treatment initiation and retention.

It will also encourage people living with HIV to strive for an undetectable viral load status, thus enabling them to enjoy a longer, healthier life by combating stigma and discrimination against people living with HIV.

Stigma and prejudice can be as traumatic as the illness itself, leading to partner or family rejection, social marginalisation, school expulsion, denial of medical services, a lack of care and support, and violence.

We encourage our community leaders to engage our communities in order to alter societal attitudes and customs, some of which are influenced by our upbringing.

Fellow South Africans,

This year's World AIDS Day commemoration revolves around the launch of the South African Chapter of the Global Alliance to End AIDS in Children by 2030, which is led by the Alliance's national patron, Ms. Humile Mashatile.  

As I mentioned earlier, we are concerned with HIV treatment gaps in children. Children living with HIV aged 15 years and below are left behind in the global HIV response when compared to the general population.

Globally, only 52% of children who are living with HIV are on lifesaving treatment, compared to 76% of the adult population. This has resulted in children accounting for 15% of AIDS-related deaths on an annual basis, despite the fact that only 4% of the total number of People Living with HIV are children.

Stigma, discrimination, punitive laws and policies, violence, and gender inequalities in Eastern and Southern Africa remain some of the barriers that hinder access to treatment, care, and support for women, girls, and children.

Unfortunately, South Africa has the largest population of children living with HIV in the world, and as of June 2023, our treatment coverage for children is alarmingly low, coming in at 67%.

This statistic undoubtedly raises concerns and emphasizes the urgent need for increased efforts and resources to guarantee that every child who is HIV-positive receives the care and treatment they require.

In response to this challenge, and with governments in the lead, UNAIDS has coordinated United Nations agencies, including UNICEF and WHO, as well as other development partners such as PEPFAR and the Global Fund, together with civil society, in the establishment of the Global Alliance to end AIDS in Children by 2030.

The proclamation was first made at the 24th International AIDS Conference held in Canada in 2022. South Africa was among the first twelve countries to join this Alliance. As the South African government, we are determined to fulfill our commitment to end AIDS in children through:

● Strengthening case finding among HIV-exposed infants and children,
● Scaling up the initiation of the TLD regimen to pregnant and breastfeeding women as per the revised clinical guidelines.
● Strengthening regular retesting of pregnant and breastfeeding women,
● Scaling up access to social protection programmes, including; social grants, nutritional support, and early childhood development for eligible children, adolescents, and women living with HIV, and other priority populations for improved access to HIV treatment and other services, and
● Addressing gender-based violence and femicide, sexual assault, and abuse of infants, children, adolescents, and women, including scaling up advocacy for the enforcement of laws and the administration of justice.
I am happy to officially announce that the South Africa Chapter of the Global Alliance to End AIDS in Children by 2030 is duly launched today!

Collectively, we should strive to ensure universal access to treatment, eliminate mother-to-child transmission, and confront prevailing prejudice and discrimination in order to foster a society that accepts and supports all individuals living with HIV, including our children.

Together, we have the power to end the epidemic of HIV and AIDS.

I thank you.