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South Africa reflects on battle to curb HIV and Aids

10 June 2015

South Africa had turned the tide on HIV, Deputy President Cyril Ramaphosa said in opening the seventh SA Aids Conference yesterday.

"That is an undeniable fact. The advances we have made, have been made together. Many emanate from public programmes, but still others have been made by grassroots activists. Many of whom are present in this room today."

The conference is running from 9 to 12 June at the Inkosi Albert Luthuli Convention Centre in Durban. Discussions centre on the latest developments regarding the treatment and prevention of HIV, Aids and tuberculosis in the field of scientific research, vaccine development and human rights issues, with a particular focus on the epidemic in the country.

Global leader

South Africa was acknowledged by UNAids and others as global and continental leaders in the HIV response, Ramaphosa said.

"We have the right policies in place and the political will to see them implemented. South Africa has the biggest HIV treatment programme in the world, with more than 3 million people on life-saving antiretrovirals, moving on to 5 million," he added.

"Thanks to the progress we have made, thanks to partnerships we have forged, thanks to the resources we have mobilised, we now know that the fight against Aids and TB can be won."

However, the question to be answered at this conference was whether "we have the means, the will, the knowledge and the courage to prevail".

He called on people to renew their commitment to fighting the diseases: "We renew our commitment, we renew our determination, we renew what I would call our social compact, which has been forged over many years of shared struggle.

"We renew our commitment to the achievement by 2030 of a generation of under- 20s that is largely free of HIV," Ramaphosa said.

In unpacking the successes in South Africa so far, he said that in 2010, the country launched a national HIV counselling and testing campaign in which 20 million tests were conducted over 20 months; more than 700 million male condoms were distributed in 2014, and over 1.6 million medical male circumcisions had been conducted in public facilities since 2010.

"The results have been significant… People are living longer and fewer people are dying of Aids and TB. Life expectancy as attested by a few speakers before me, increased from 53 years in 2006 to 62.2 years in 2013. This is a great achievement."

In addition, HIV associated deaths in pregnant women, infants and children under five had also declined, as had new HIV infections since its peak in 2004, especially among those under 15.

"We have reduced mother-to-child transmission dramatically, to less than 2.6% in 2012."

More work to be done

These statistics were encouraging, Ramaphosa said, but there was still more work to be done.

"Our country has more than 6.4 million people living with HIV. That by any number is a huge number. That is where the challenge is. More than 1 in 5 people with HIV in the world live in our country.

"We have about 450 000 new HIV infections and 360 000 new TB infections each year. That is a challenge that lies ahead of all of us… We need to find the resources to expand further what is already the largest HIV treatment programme in the world and ensure better adherence to treatment. Then we need to be able to sustain it for many years to come."

South Africa had ambitious goals to have at least 90% of HIV-positive South Africans on treatment, and 90% of those on treatment to be virally suppressed.

"Simply put, as a country we cannot afford not to invest in HIV prevention, treatment and care."

However, new infections also needed to be stopped.

"We need a massive HIV prevention campaign that begins with the promotion of condom use and the reduction of multiple concurrent partnerships, but that also addresses sexual coercion, transactional sex, intergenerational sex, risky sex linked to the use of alcohol and drugs, lack of access to work for young women, ignorance, powerlessness and poverty."

Behaviour change in men

Most importantly, there needed to be behaviour change among men. One in four new infections occurred among young women and girls between the ages of 15 and 24.

"We must confront the reality that the astonishingly high infection rates among young South African women has much to do with the behaviour of men. It has much to do with how men of that age – and older – relate to women. It has much to do with the forms that social interaction takes and how sexual relations are conducted.

"It calls for greater awareness, greater respect and greater responsibility."

Stigma index

The theme of the conference is Reflection, Refocus and Renewal. Held every two years, it is a barometer of the advances made in confronting and controlling HIV infections, in South Africa and in the regional states.

On the first day, South Africa's first national HIV stigma index was launched. It found that 7% of HIV-positive women surveyed reported being sterilised against their will and about 40% reported contraception was a pre-requisite of accessing antiretrovirals.

The index, commissioned by the South African National Aids Council, also found that 5% of respondents did not seek health services at their local clinic because of stigma. It surveyed about 10 500 people with HIV across the country in what is the world's largest survey of its kind.

SAinfo reporter