World Aids Day, Mokopane
1 December 2007
Programme Director
Honourable Deputy President
Premier of Limpopo Province, Sello Moloto
My colleague, Health MEC Seaparo Sekoati and all MECs present
Members of the Provincial Legislature
Executive Mayor and councillors present
South African National AIDS Council (SANAC) members representing various
sectors
Distinguished guests
Ladies and gentlemen
It is a pleasure for me to be part national event marking the World AIDS Day
here in Limpopo. I have participated in many events marking the World AIDS Day
in the past, but I feel this one is different. It marks an end of year during
which we have witnessed great progress in our response to HIV and AIDS as a
country. Of course, there have also been some few, but difficult, setbacks.
The most difficult of these setbacks have been in the area of research with
two clinical trials one on HIV vaccine and another on microbicide, conducted in
the country being stopped because of the potential risk of HIV infection to
participants. These incidents requires that we move forward with caution and
ensure that people are exposed to unnecessary risk in the process of seeking
new interventions against HIV and AIDS.
The other difficult situation we had to engage in was the recalling of
condoms that were approved by South African Bureau of Standard (SABS) while
they were not conforming to the quality standards. While we note the media
reports about muted legal action relating to the use of these condoms and I can
indicate that by yesterday, there were no records of any legal correspondence
from the parties said to be intending to take legal action on this matter. The
department will respond accordingly once such correspondence is received.
It is important that we work together to encourage correct and consistent
use of condoms as the best barrier available to those who are sexually active
to protect themselves against sexually transmitted infections and unwanted
pregnancies. The SABS, which is responsible for assurance of the quality of
condoms, reported to the Department of Health that extensive controls and
verifications have been implemented throughout the testing and certification
process to ensure that all Choice condoms comply with the standards set by the
World Health Organisation (WHO).
Besides all these challenges affecting particularly our prevention
interventions, we received for the first time, a piece of good news regarding
the prevalence of HIV in the country. The report of the 2006 antenatal survey
results released this year showed a decrease in the prevalence of HIV amongst
pregnant women who use public health facilities. It is down to 29.1% in 2006
compared to 30.2% in 2005.
The report further indicated that this decline is mainly amongst people between
the ages of 15 and 24 years. The decline in the under 20s from 15,9% in 2005 to
13,7% in 2006, in particular suggests a possible reduction in new infections
(incidence) in the population. Let us use this World AIDS Day to commit
ourselves to work together in sustaining this trend in the coming years.
Prevention should remain the cornerstone of our response to HIV and AIDS.
An important component of prevention is the programme to prevent mother to
child transmission of HIV. With regard to the implementation of this programme,
we note the 2007 Report Card on prevent mother-to-child transmission (PMTCT)
and Paediatric HIV Care and Treatment in Low-and Middle Income countries
released by United Nations Children's Fund (Unicef) released last week.
The report card listed South Africa amongst 17 low-and middle-income
countries that are set to achieve the United Nations (UN) 2010 target of
reducing mother to child infections. It also acknowledged that South Africa and
Kenya were the only two of the countries with the high burden of HIV that were
reaching 40% of HIV positive mothers in need of antiretrovirals for prevention
of mother to child transmission (PMTCT) by 2006. The uptake for the programme
has since risen to between 50 and 60%. We acknowledge the limitations of this
programme including the need to strengthen the capacity to follow up on the
babies that have been part of the programme.
We will be conducting an extensive evaluation of the programme and the
findings of this review should inform the further strengthening of the
programme in an effort to achieve universal access targets. The other concern
has been the use single drug nevirapine (mono-therapy) for PMTCT. Our concern
has always been the limited effect and drug resistance associated with this
approach. To try and address this challenge, the Department of Health initiated
a process of consultation with experts and stakeholders in this area which has
led to the development of draft treatment guidelines on using dual therapy for
PMTCT.
The draft guidelines have been considered through the policy formulation
processes of the Department of Health which includes consultation with all
provincial health departments. They are now being considered for endorsement by
the National Health Council. The implementation of the new treatment guidelines
is going to be phased in taking into consideration expansion of training of
health professionals on the new protocol and mobilisation of additional
resources for procurement of the additional stock of drugs.
Programme Director, we continued this year to encourage voluntary
counselling and testing (VCT) by expanding this service to more than 4 000
centres, covering about 90% of clinics across the country. Our data indicates
that between April 2004 and December 2006, 4,5 million people received pre-HIV
test counselling and 3,3 million (76%) of them actually tested. Encouraging VCT
is crucial in assisting those who test negative to remain that way and to
enable those living with HIV to access the comprehensive package of care,
support and treatment that government has made available.
This package of care includes promotion of healthy lifestyles including good
nutrition which is important in maintaining optimal health and prolonging
progression from HIV infection to development of AIDS defining conditions.
Nutrition also forms a solid foundation for the effectiveness of treatment when
this becomes necessary. With regard traditional medicine component of our
response to HIV and AIDS, I can report that a directorate has been established
in the Department of Health to develop national policy on traditional medicine.
This directorate is also responsible for promotion of research and development
of African traditional medicines including those that show a potential to
alleviate conditions relating to HIV and AIDS.
Other encouraging developments this year were the review of the South
African National AIDS Council with the aim of strengthening partnerships and
the adoption by all stakeholders of the National Strategic Plan for HIV and
AIDS and sexually transmitted infections (STIs) for 2007 to 2011. The latest
National Strategic Plan provides an extensive analysis of the nature, dynamics
and character of the challenge of HIV and AIDS as it manifest itself in our
environment. It also identifies appropriate responses with targets that are
aligned with our commitment at the United Nations with regard to addressing HIV
and AIDS.
These targets are adapted by each sector according to their means,
particularly the availability of resources and in line with the provisions of
our Constitution. Progress is being made in the implementation of the National
Strategic Plan. We can say with pride that the awareness about HIV and AIDS is
high. Condom distribution and reported use continues to increase. All hospitals
now offer Post Exposure Prophylaxis for sexual assault clients and they manage
opportunistic infections. Screening and treatment of tuberculosis (TB) has been
improved considerably.
We can also proudly say that we have enrolled the largest number of people
on anti-retroviral (ARVs) worldwide. More than 370 000 people had been
initiated on antiretroviral therapy by September 2007. More than 32 000 of
these patients are children under 14 years. The annual budget allocation for
HIV and AIDS increased from R200 million in 2000 to R2,1 billion in the current
financial year for the Health Department only and its rises to R4 billion when
other government departments expenditure relating to HIV and AIDS.
Programme Director, HIV and AIDS remains a major challenge facing us as a
country. However, we have equally launched a major programme to respond to it.
It should be emphasised that the success of our interventions is dependent on
forging of strong partnerships. We therefore have to work together as
stakeholders and complement each other in a multi-sectoral and comprehensive
response to HIV and AIDS. Let us work together to stop HIV and AIDS and keep
the promise.
Issued by: Department of Health
1 December 2007
Source: Department of Health (http://www.doh.gov.za)
