How is the South African government dealing with the AIDS epidemic?

Tragically, South Africa has failed to manage and control the spread of HIV. Although a comprehensive national plan to fight the epidemic was formulated by a range of organisations before 1994, this has not been put into practice effectively.  

The plan revolved around education and prevention; counselling; health care; human rights and law reform; welfare; and research. Its objectives include preventing HIV transmission, caring for people infected and affected by HIV/AIDS and alleviating the impact of HIV/AIDS on communities. Government’€™s approach hinges on “ABC”: abstain from sex; be faithful to your partner; use a condom.

How many South Africans live with HIV/AIDS?

On average, 1 500 South Africans are being infected with HIV every day, in addition to the 4,2-million South Africans who were estimated to be living with HIV by the end of last year. One in every eight adults is estimated to be living with the disease. The highest infection rate is among women between the ages of 20 and 29.

Do you die of AIDS?

No, infected people die of opportunistic infections that their bodies cannot fight as the HI Virus has destroyed their bodies’€™ immune systems. So people with AIDS often suffer from infections in the intestinal tract, lungs (tuberculosis), brain, eyes and other organs, as well as weight loss, diarrhea, neurological conditions and cancers such as Kaposi’s sarcoma and lymphomas. Once their immunity has broken down to such an extent, they are said to have AIDS rather than being HIV positive. It is estimated that the infection takes 10 to 12 years to develop from HIV to full-blown AIDS.

What about the children whose parents are living with HIV/AIDS?

By 2005, nearly a million children under the age of 15 will have lost their mothers to AIDS. Care for orphans will become one of the greatest challenges facing this country. Many orphans will end up in child-headed households while others will end up on the streets.

Is it going to get worse?

Projections show that the country will be in the most devastating throes of the AIDS epidemic by the year 2004. It is estimated that more than six million South Africans will be infected by 2005 while 2,5-million people will have died of AIDS-related illnesses in the same year.

Why has there been controversy around President Thabo Mbeki’€™s involvement in the debate around how to deal with HIV/AIDS?

In his search for strategies to deal with HIV/AIDS, President Mbeki has consulted with “AIDS dissidents”, a small group of scientists who insist that HIV doesn’t cause AIDS, and that antiretroviral (anti-Aids) drugs such as AZT are poisonous. Mainstream scientists have condemned Mbeki’€™s consultations, saying that the “dissidents” claims have long been disproved. The controversy has been brewing since last October when, under pressure to provide AZT to pregnant HIV positive women, Mbeki asked Health Minister Dr Manto Tshabalala-Msimang to investigate the alleged toxicity of AZT. Mbeki then contacted Dr David Rasnick, a prominent California AIDS “dissident”. Tshabalala-Msimang recently set up an international panel of experts, including dissidents, to look at “AIDS in Africa: The way forward”. Mbeki has since written to US president Bill Clinton and other international leaders, defending his right to question established theories about HIV/AIDS.

Are we going to stem the tide of HIV/AIDS?

Yes:

1. Government initiatives such as the National AIDS Council, the Partnership Against AIDS and the vaccine trials are starting to gather momentum.

2. The latest antenatal survey (an annual anonymous HIV test of pregnant women at public health facilities countrywide) shows some stabilisation in the number of women who are HIV positive. Perhaps people are getting the message.

3. We have the expertise and the will the stem to the tide.

No:

1. Although everybody knows about AIDS ‘€“ 98% know that it’€™s sexually transmitted and incurable ‘€“ 40% of people don’€™t think they are personally at risk. Of this 40%, one fifth are already infected.

2. The stigma around the disease and around talking about sex is barring many people from seeking counselling, medical care or education. The disease will always remain an escalating statistic until people feel safe enough to stand up and say: “I am living with HIV” or “I am dying of an AIDS-related illness”.

Government is unwilling or unable to provide drugs to pregnant mothers to reduce the chances of HIV positive mothers giving birth to HIV positive babies.

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