It is indeed a very rare opportunity that the International Aids Conference is held in one country for a second time.
Whilst we warmly embrace the opportunity to host again, we are fully cognisant of the fact that South Africa is home to the largest concentration of people living with HIV in the whole world. To be specific, almost 20% of all HIV-positive persons globally live within our borders, according to STATS SA, this total to 6, 19 million people recorded in 2015.
Whilst South Africa carries the world’s largest HIV epidemic; the KwaZulu-Natal Province carries the largest burden in the country with prevalence rate of 17 % in the general population and 37.4 in pregnant women.
Having this conference in our shores again is a blessing in disguise as it allows us to reflect on the Conference that was held in the year 2000 which was a watershed moment for our national response to - and global action on - the AIDS epidemic.
Actually, the return of the Conference to Durban is an opportunity to take stock of the progress we are making in the fight against HIV and AIDS which includes improving access to prevention, treatment and eliminating stigma associated with HIV and AIDS.
We are happy that we will be joined by the international community in recalling the impassioned and poignant plea of the child activist, Nkosi Johnson, who in the year 2000 bore the distinction of being the longest-surviving child born with HIV in the country.
Nkosi Johnson brought home the impact of the AIDS epidemic with a self-written address, which was broadcast globally, carrying his call for treatment and care for people living with HIV. Sadly, several months later, Nkosi Johnson died at the age of 12.
Indeed our country, with its current political leadership has made great strides in the fight against AIDS. South Africans are no longer dying and are living longer. We are thus excited to host again as we will utilise the opportunity to communicate milestones that have been achieved since the 13th International AIDS conference that was held here in Durban.
Turning point
At the 21st International Aids Conference, we will thus be able to report that our turning point came on 22 April 2009 when Jacob Zuma was elected as the President of South Africa.
Upon ascendancy to power, Zuma immediately acknowledged HIV as among the most important challenges facing the country and wisely appointed Dr. Aaron Motsoaledi as a Health Minister.
The same year of his appointment, President Zuma declared the World AIDS Day, 2009 as ‘the day on which we start to turn the tide in the battle against AIDS’.
This was not just a slogan as the President called upon all children under one year of age to get treatment if they test positive and that this not be determined by the level of CD cells.
He also called upon all South Africans to get tested for HIV. Over and above that he announced the following:
- All patients with both TB and HIV will get treatment with anti-retroviral if their CD4 count is 350 or less, moving away from when treatment was available when the CD4 count was less than 200
- All pregnant HIV positive women with a CD4 count of 350 or with symptoms regardless of CD4 count to have access to treatment
- All other pregnant women who are HIV positive, to be put on treatment at fourteen weeks of pregnancy, doing away with maxim that called for initiation during the last term of pregnancy.
- TB and HIV/Aids to be treated under one roof
On behalf of Government, the President then apologised for all the mistakes of the past saying:
‘To those who have lost their loved ones to the epidemic we share your pain, and extend our deepest condolences.
At another moment in our history, in another context, the liberation movement observed that the time comes in the life of any nation when there remain only two choices: submit or fight.
That time has now come in our struggle to overcome AIDS.’
Under President Zuma’s leadership, on the 1st of December 2011, we also saw a third National Strategic Plan (NSP) on HIV, STDs and TB released for 2012-2016 realised. It specified clear and implementable objectives, amongst others calling for:
- Halving the number of new HIV infections;
- Ensuring that at least 80 percent of people eligible for HIV treatment are receiving it;
- Halving the number of new TB infections and deaths from TB;
- Ensuring that the rights of people living with HIV are protected; and
- Halving stigma related to HIV and TB
As earlier indicated, KwaZulu-Natal, is the Province that carries the largest burden of HIV in the country, we were privileged that it had Dr Zweli Mkhize as its Premier, who in 2013 during his State of the Province Address, declared:
“It is important to acknowledge that the burden of disease that is affecting South Africa has its epicentre in this province. Similarly, to improve the overall health outcomes in South Africa, Kwazulu-Natal must first improve.’’
As a Province we are thus able to report on the remarkable successes achieved that include:
- The Prevention of Mother to Child Transmission (PMTCT) that has been reduced to very low levels of 1. 2 %, in our Province whilst our country has also made its own notable strides at 1, 5%.
- The wise call by His Majesty the King that Medical Male Circumcision be revived as means to curb the spread of HIV. We are happy to report that in response to that call, we have circumcised more than 750 000 men and boys without a single loss of life since 2010.
- Millions of citizens are coming forward for voluntary counselling and testing
- To date, more than 1, 3 million persons have been initiated on lifelong antiretroviral therapy in this Province alone whilst the national tally is 3, 4 million on treatment. This in its own means that our people are now healthier and living longer.
- We have also rolled out the GeneXpert technology, which consist of 38 GeneXpert machines that are able to provide a faster diagnosis of TB and most importantly the Drug resistant TB
- Our life expectancy has increased from 49 years to 60 years.
It is indeed undeniable that the above mentioned efforts produced the desired results as was confirmed by the Old Mutual Report published in the Business Day of 10th January 2013, which stated:
“The death rate among employees of companies that bought risk cover from Old Mutual fell almost 20% between 2008 and 2011 – a decline that came as the Government’s drive to get more HIV patients on treatment gathered pace. …”
Dear colleagues, we made these strides because as Government, we constantly review our programmes.
It will be remembered that initiation to ARVs was previously a doctor driven programme but because of the big numbers of people being dealt with, we introduced the Roving Teams. Indeed the roving teams themselves couldn’t cope and we resorted to training nurses under the programme known as the Nurse Initiated and managed Anti- Retroviral Programme. With these nurses deployed even at Primary Health Care Clinics, we successfully initiated more than 1, 2 million people on ARVs, just in this Province alone.
Our successes are also borne out of the initiative to partner with Taxi Associations which led to a programme of taking Health Services to Taxi Ranks.
We are also where we are because of Operation Sukuma Sakhe responsible for creation of War Rooms in all Wards which assist in ensuring early attendance of ante natal care services by pregnant mothers. It also monitors the adherence to medication to those on treatment.
We have also launched Dual Protection Campaigns targeting all Institutions of Higher Learning including TVET colleges in the Province to promote safe sexual and reproductive behaviour and also curb unwanted and unplanned pregnancies.
I have to say that we are now more optimistic especially with the announcement by Minister Aaron Motsoaledi during his 2016 Budget Speech where he announced that all HIV positive South Africans will qualify for anti-retroviral treatment from September regardless of their CD4 count. We are moving to Test & Treat. In simple terms, this means that as soon as a person tests HIV positive they would start treatment.
According to the World Health Organisation, the research has shown that people who start ARV treatment earlier get less sick and are likely to live longer and that people on treatment correctly stop the virus replicating are therefore not infectious to other people.
We acknowledge that while a diagnosis of HIV used to be understood by many as a death sentence, today it is increasingly seen and accepted as a treatable and manageable condition.
That is the progress we have made and we are determined to continue on this trajectory going forward.
An AIDS free generation is indeed possible.
I thank you.
