KHOPOTSO: Some see the focus on antiretroviral therapy in Africa as a threat to national and regional prevention efforts aimed at decreasing the rapid levels of HIV infection. This was said by Health Minister Dr Manto Tshabalala-Msimang, at last week’€™s launch of the Year of Accelerating Access to HIV Prevention in Africa programme.    

Dr MANTO TSHABALALA-MSIMANG: The unfortunate consequence of this engagement on treatment locally and internationally has been the downgrading of prevention as a central element in responding to this health condition, for which there is still no cure. Prevention became the forgotten child of the HIV and AIDS response.

KHOPOTSO: But Tshabalala-Msimang concedes that there are other factors – mostly social – that continue to feed the epidemic.

Dr MANTO TSHABALALA- MSIMANG: These factors include poverty, under-development, malnutrition and gender inequalities. And these make women more vulnerable to HIV and the impact of AIDS. The challenge of inappropriate human settlement and the lack of access to basic services such as water and sanitation, education and health increase the vulnerability of our people to diseases, including HIV and AIDS.                    

KHOPOTSO: Africa has both the highest poverty levels and the highest incidence of HIV and AIDS in the world. The World Bank estimates that 46 % ‘€“ 76% of Africans live below the poverty line. Southern Africa is at the epi-centre of the HIV epidemic. Remigious Makumbe is the Chief Director of the Southern African Development Community.

REMIGIOUS MAKUMBE: While the SADC member states constitute less than 4% of the global population, it carries about 40% of global HIV and AIDS cases. In many member states more than 20% of adults are living with HIV and AIDS. In almost all these countries, with the exception of Zimbabwe, new infections continue to increase. In some member states, the figures are even higher than 30%. In at least one member state, for example, HIV/AIDS prevalence amongst pregnant women attending ante-natal clinics now exceeds 40%. We believe that in the worst case scenario it could be possible that in the coming years more people will be living with HIV/AIDS than those living without HIV and AIDS.

KHOPOTSO: Reflecting on efforts to address prevention in the region, Makumbe says it’€™s less than satisfactory.

REMIGIOUS MAKUMBE: Statistics across the region reflect a depressing state of affairs’€¦ For instance, the regional picture reflects the following: Less than 40% condom use by young women; 80% of HIV and AIDS amongst the youth are women; 5% access to prevention of mother to child transmission, less than 10% of people have access to HIV voluntary counselling and testing.                    

KHOPOTSO: Several interventions, including the SADC Strategic Framework on HIV and AIDS and the Maseru Declaration to combat HIV and AIDS were adopted. But these have failed to halt the rampant infection rates.

REMIGIUS MAKUMBE: We certainly do not need more declarations and strategy plans. We indeed need more action on the ground.

KHOPOTSO: In April, the SADC Secretariat will convene a regional experts’€™ meeting to assess why prevention efforts have failed. Around the same time, African heads of state will hold a similar meeting in Abuja, Nigeria. Renowned singer and UNICEF goodwill ambassador, Angelique Kidjo, laments the impact that the rising HIV infection rates have on African children.

ANGELIQUE KIDJO: Unfortunately, after a year of high enrolment rates around the region, more and more girls are being forced to miss classes or drop out altogether to care for sick relatives or fend for their siblings when orphaned or because of the economic impact of the epidemic on their families or because they become pregnant. They are not supported to return to school. It is imperative to keep these girls and other vulnerable children such as orphaned boys, in school where they can learn the skill needed to gain greater control over their lives and so be better able to protect themselves in future.    

KHOPOTSO: In South Africa, the Year of Accelerating Access to HIV Prevention programme will focus on three main activities. First, it’€™s to re-enforce messages that go with the government’€™s massive condom distribution campaign to emphasise correct and consistent usage. Secondly, to include messages that direct people to service delivery points in the government’€™s communication programme. Lastly, to encourage more South Africans to take up voluntary counselling and testing and prevention-of-mother-to-child HIV transmission services.