Good progress made in SA’s HIV/Aids programme

The South African government and the ruling African National Congress (ANC) are frequently criticised for a variety of perceived failures, non-delivery or a lack of political will to implement promised actions and policies effectively. However, very recently most of its critics – and its supporters – seem to have missed an important statement by Deputy President Kgalema Motlanthe regarding one of the government’s biggest successes.  

This success revolves around perhaps South Africa’s biggest challenge – the fight against HIV/Aids. The fact that the government’s massive HIV/Aids programme is becoming increasingly successful is all the more remarkable given the extreme level of denialism and the chaotic situation that prevailed only a few years ago under ex-President Thabo Mbeki and his infamous Health Minister, Manto Tshabilala-Msimang.

It seems a complete turnaround from that tragic era is rapidly being achieved. A reply to questions put to Deputy President Motlanthe in the National Council of Provinces (NCOP - South Africa’s Upper House of Parliament) just over a week ago provided some  insightful statistics. It showed the government has been doing some excellent work in combating HIV/Aids and its programmes have started showing very positive results.

Molanthe told the NCOP that government had invested “a large amount of resources into its HIV response” and that a number of HIV-combating programmes have started having an impact. The number of deaths due to HIV-related causes “is beginning to show a decline due to the intensification of anti-retroviral treatment". Despite this, however, he said the rate of new HIV infections continues to outpace prevention. Consequently government will prioritise prevention programmes in the new national strategic plan being drawn up for the period 2012-2016, he said.

There were now an estimated 5.38 million people with HIV in South Africa, translating into an HIV prevalence of 10.6% for the overall population, and 16.6% for the 15-to-29  age group. Apart from the infection/prevention ratio, the picture Motlanthe presented looked good in all other areas.

Among pregnant women tested for HIV, the rate of infection has gradually come down to just below 30%. According to data from the Department of Health's 'National Antenatal Sentinel HIV and Syphilis Prevalence Survey in South Africa, 2009', published in 2010, 29.4% of pregnant women (aged 15-49) were living with HIV in 2009. This estimate was based on a study sample of 32,861 women attending 1,447 antenatal clinics across all nine provinces. Until 1998 South Africa had one of the fastest expanding HIV/Aids epidemics in the world, but since 2006 HIV prevalence among pregnant women has remained relatively stable, now having settled at just under 30%.

And, the programme for prevention of mother-to-child transmission of HIV has yielded remarkable results, he said, with transmission rates having declined from 10 to 3.5% over the past three years. KwaZulu-Natal, once the worst HIV-inflicted province, has reported a further infection rate decline down to 2%.

After years of government denialism under Mbeki’s rule, when alternative Aids activists seemed to have a hold over government’s thinking, South Africa now has the world's largest anti-retroviral programme, with over 1.3 million people currently receiving treatment. The number of deaths from HIV-related causes is beginning to show a decline due to the intensification of antiretroviral treatment, says Motlanthe.

He added that research by the Human Sciences Research Council (HSRC) had shown that young people are also increasingly engaging in safer sex practices by using condoms, leading to a slight decrease in new infections among young people.

Over the past 15 months, the country had embarked on the world's largest HIV counselling and testing campaign, which had resulted in more than 14 million people being tested, of whom two million were found to be HIV positive. Motlanthe says the impact of current interventions will bear fruit over time.

Following South Africa’s massive HIV/Aids counselling campaign launched last year that saw more than 15 million people tested for HIV and other chronic diseases, Motlanthe expressed his concern about the number of men who go for HIV testing. He told a South African National Aids Council (Sanac) plenary session held in Bloemfontein recently that Sanac will embark on a targeted campaign to encourage more men and people at a high risk of contracting HIV to present themselves for counselling and testing. He also said that there are still important sectors such as the religious and private sectors that need to demonstrate visible leadership in testing for HIV.

As part of the campaign to test more men, health workers will intensify visits to factories, farming areas, construction sites, hostels, and various institutions of learning, Health Minister Aaron Motsoaledi told the same conference. He said the government had increased its capacity to take care of people living with HIV and that Sanac has endorsed the National Health Council Policy to initiate treatment for all those who tested positive with a CD-4 count of 350 or lower.

He was happy with the reduction of mother-to-child transmission.

For a country with the highest HIV infection rate in the world – with nearly one in t10people being infected – the success rate of the government’s current HIV/Aids programme is very encouraging and deserves praise.