Turning the tide on HIV and AIDS

28 November 2012
Thirty years ago AIDS emerged as a mysterious deadly disease with no known cure. It was a dark time for the world as humanity was faced with a threat for which there were few answers.
 
Fast forward to the present day and a very different picture is evident; it no longer is a death sentence and South Africa is seen as a beacon of success and hope in the global fight against this resilient pandemic.
 
South Africa’s massive nationwide rollout and availability of antiretroviral (ARV) drugs has given hope to millions, that they can live healthy and productive lives.
 
On Saturday, 1 December, we will again unite as a country for World AIDS Day under the 2012 national theme “Zero new HIV and TB infections”. This is always an emotional day when we show our support for people living with HIV and Aids and commemorate people who have died. It should also be the day of reflecting on our achievement as a country to reduce the new infections.
 
It was therefore humbling that the recently released UNAIDS World AIDS Day Report 2012 commended our commitment in the fight against HIV and Aids. The report states that South Africa’s increase in investment and treatment had contributed to a dramatic 41 per cent cut in the country's rate of new HIV infections since 2001, with new HIV infections falling by more than 50 000 in the last two years. It adds: “South Africa … invested US$ 1, 9 billion (in HIV and Aids) last year from public sources…. This strategic leadership is an example being echoed across the region”.
 
The World Aids Day Report confirms that Government is on track with the HIV treatment and prevention initiatives. Over 1, 7 million South Africans are now on antiretroviral treatment and we are on course to meet our target of 2, 5 million by 2014. Importantly, the rate of new infections has decreased from 1.4 per cent to 0.8 per cent in the 15-24 age groups.
 
Treatment is now also more widely available with approximately 2 948 public health facilities initiating patients on antiretroviral treatment compared to 495 in January 2010. The 41% reduction in new infections also suggests South Africans are heeding the message of responsible sexual behaviours.
 
However, one of our greatest successes is the remarkable 50 per cent reduction in mother-to-child transmission of HIV from about 8 per cent in 2008 to 3, 5 per cent in 2011. This ensures that annually over 30 000 babies are protected from infection.
 
Government’s decisive action, under the stewardship of President Jacob Zuma, led to policy changes in 2010 that ensured children younger than one year automatically receive treatment when testing positive. All patients with both tuberculosis (TB) and HIV were also placed on antiretroviral treatment if their CD4 count was 350 or less. Pregnant HIV positive women with a CD4 count of 350 or with symptoms regardless of CD4 count also started to get treatment.
 
According to the Department of Health, the scaling up of our antiretroviral treatment programme bore positive results with the Medical Research Council’s 2011 Rapid Mortality Surveillance Report showing that South Africans’ life expectancy increased from 56.5 years in 2009 to 60 years in 2011.
 
In 2010 Government also launched a nationwide HIV counselling and testing (HCT) campaign to encourage South Africans to familiarise themselves with their HIV status. This campaign proved extremely successful with 20.2 million people being tested for HIV thus far. We recorded almost a fivefold increase to pre-2010 HCT campaign numbers with 9, 6 million South Africans being tested in the last financial year.
 
It demonstrates how far we have come as a society in taking responsibility for our sexual behaviour. It also tells us that perceptions about the disease are starting to change. Knowing ones status is the first step to remain HIV negative or to make the necessary lifestyle changes if you are living with HIV.
 
Although we have made great progress, Deputy President Kgalema Motlanthe who also chairs the South African National AIDS Council (SANAC) cautioned: “The war is not yet over. We cannot declare victory yet - we are only just beginning to turn the tide! A comprehensive, robust, decisive and sustainable response to HIV is like climbing a mountain. Twenty years ago we were at the foot of the mountain. Our collective efforts, resilience and determination have brought us to within inches of the summit of the mountain. We dare not slide back!”
 
To ensure that we do not “slide back”, the National Strategic Plan (NSP) for HIV, Sexually Transmitted Infections and Tuberculosis (TB) for the period 2012 to 2016 sets out our strategy for the next four years. TB was included in the NSP, because of the high co-infection rate between HIV and TB.
 
The five goals of the 2012-2016 NSP campaign are as follows:
  • To initiate at least 80 per cent of eligible patients on antiretroviral treatment with 70 per cent alive and on treatment five years after initiation;
  • To reduce the number of new TB infections as well as deaths from TB by 50 per cent;
  • To ensure an enabling and accessible legal framework that protects and promotes human rights in order to support implementation of the NSP; and
  • To reduce self-reported stigma related to HIV and TB by at least 50 per cent.
 
Government is continuously examining new research, initiatives and treatments to ensure we meet our NSP goals. We will therefore soon move towards a one-tablet-a-day ARV treatment. Moreover, Government’s procurement system is being enhanced to ensure a continuous supply of antiretroviral drugs to all facilities.
 
Although the NSP is in place to steer us through the next four years, Government needs parents to assist by educating children on responsible sexual behaviour. President Zuma stated: “Government is still troubled that our young people are at risk of contracting HIV infection. Equipping girls and boys with information on how to prevent unwanted pregnancies can thus play an important role in ensuring that all learners reach their full potential."
 
Government will continue to invest in sustainable HIV treatment and prevention programmes as part of its commitment to fight new HIV infections. In moving forward there needs to be a shared responsibility and all South Africans must play their part.
 
Let’s start by educating ourselves and our children about HIV; know how to prevent infection; and ensure we get tested on a regular basis. In our communities we should fight the stigma about HIV. We need to create an environment where family, friends, colleagues feel comfortable to get tested, seek treatment, and provide a caring and supportive environment. Let us join hands in the fight against HIV to reach zero new infections.
 
Phumla Williams is Acting CEO of the Government Communications and Information System (GCIS)