KHOPOTSO: The new National Strategic Plan for HIV/AIDS is to be launched before Easter. It is probably the biggest project that will come out of the Department of Health in 2007 as it will determine how the country deals with the epidemic. Dr Nomonde Xundu, Cluster Manager of the HIV/AIDS, TB and STIs unit in the Department of Health says two broad aims underpin the plan.

Dr NOMONDE XUNDU: What it’€™s basically saying is’€¦ reduce the number of new infections and reduce the impact on individuals, families – society in general.

KHOPOTSO: Xundu says the implementation of the plan will be based on four priority areas, and there will be regular monitoring of programmes to see how they are working.

Dr NOMONDE XUNDU: Prevention; treatment, care and support; in an appropriate human and legal rights environment; what we’€™ve added onto that plan is targets and we now are busy with the costing; and we are finalising the monitoring and evaluation framework.

KHOPOTSO: A draft of the Plan shows an ambitious target to reduce by half the rate of new HIV infections in South Africa by 2011. But Xundu would not be drawn on specific targets.

Dr NOMONDE XUNDU: No, not at this stage because that is the work that is currently underway’€¦ What we’€™ve looked at is the estimates from statisticians and epidemiologists in terms of who will be requiring what kind of service. But also, we’€™ve drawn from the experience ‘€“ having implemented this programme for the past 9 to 10 years or so ‘€“ in terms of capacities and what is practical.                            

KHOPOTSO: The national Department of Health’€™s track record in addressing HIV and AIDS in the last 10 years is a blemished one. Disputes over AIDS treatment has led to a rift between the Health Department, activists and the medical fraternity. However, this year there is reason to hope that all that will change. Under the leadership of Deputy President Phumzile Mlambo-Ngcuka, government, business and civil society have equally contributed to the drafting of the new AIDS plan. Xundu says the plan takes into account the shortcomings of the past. For instance, while over 5 million South Africans are estimated to be living with HIV, most of these don’€™t even know it. How can government encourage more people to take HIV tests?  

Dr NOMONDE XUNDU: We are challenged to increase the uptake of VCT, as you correctly say. Certainly, I can quickly say to you that mandatory (testing) will not be considered, compulsory (testing) is out of the question, routine testing is out of the question. What perhaps we may consider ‘€“ and this is a national debate ‘€“ is routine offer of testing, not routine testing.  

KHOPOTSO: Routine offer of testing already takes place and is limited to certain groups of the population.    

Dr NOMONDE XUNDU: Pregnant women, for instance, TB patients, patients presenting with sexually transmitted infections and obviously, the ones that are presenting with one opportunistic infection or the other that is linked to underlying HIV infection and we don’€™t know what their HIV status is. Those should, in fact, be routinely offered testing ‘€“ which is what is called provider-initiated VCT’€¦ That is the approach that we’€™re planning to  take.                  

KHOPOTSO: Reaching people who need anti-AIDS treatment is also high on the plan’€™s agenda. Currently, almost 200 000 or 25% of South Africans who need antiretrovirals are accessing them. The last 10 years have been a challenge in South Africa’€™s response to the AIDS epidemic. The next five years will not be easy, but the spirit of co-operation that manifested at the close of last year offers hope for the future. Brad Mears is the Chief Executive Officer of the South African Business Coalition on HIV/AIDS.

BRAD MEARS: Government and, indeed, this country is facing an absolutely mammoth task in being able to manage HIV. The figures of having to test 50 million people in order to discover and find the 5 million people that are HIV-positive in this country means that we really need to be doubling and re-doubling and then re-doubling again our efforts to test people’€¦ We all recognise that government has shifted its position and is moving forward in a positive way towards dealing with HIV, and business is supportive of what they are doing.