HIV and AIDS

Finally, a World AIDS Day to remember

Written by Health-e News

President Jacob Zuma has announced the most significant government-led interventions to stem the AIDS epidemic since its emergence more than 20 years ago, stating that extraordinary measures are needed.

In accordance with international best practice All HIV positive children under one year of age will receive antiretroviral treatment, no matter what their CD4 count (a measure of immune system strength) is.

All HIV patients with tuberculosis will receive anti-retrovirals if their CD4 count is 350 or less. Present guidelines determine that treatment should be initiated at a cut off of 200, a directive which is outdated. We have taken this step, particularly on learning that approximately 1% of our population has TB and that the co-infection between TB and HIV is 73%, Zuma told a World AIDS Day gathering in Pretoria.

He also announced that all pregnant HIV positive women with a CD4 count of 350 or with AIDS-related symptoms (regardless of CD4 count) will have access to treatment. At present HIV positive pregnant women are eligible for treatment if their CD4 count is less than 200.

All other pregnant women not falling into this category, but who are HIV positive, will be put on treatment at 14 weeks of pregnancy to protect the baby.

Zuma said that in order to meet the need for testing and treatment, Government would work to ensure that all the health institutions in the country were ready to receive and assist patients and not just a few accredited ARV centres. ‘Any citizen should be able to move into any health centre and ask for counseling, testing and even treatment if needed,’ said Zuma.

He also announced that Government would be launching a massive HIV testing campaign to ensure that every South Africa knew their status adding that he knew his, but would be undergoing another test soon.

United States Ambassador Donald H Gips announced at the gathering that America would provide an addition U$120 million (approximately R900 million) over two years for anti-retroviral drugs.    

The US said the one-time extra funding to procure ARVs would help ensure that there were adequate stocks on hand to meet the growing demand for ARVs in South Africa.

‘This funding is over and above the R4.2 billion budgeted for the regular U.S. government contribution to the fight against HIV/AIDS in South Africa (2010 fiscal year).   It will assist the Department of Health and provincial governments to meet their goals for antiretroviral treatments and to help build capacity in the provinces for planning and forecasting ARV needs.   The additional funding is in direct response to a request from President Jacob Zuma,’ the statement said.

The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) support in South Africa from 2004-2009 has totaled over R10 billion.  

This is the full speech delivered by Zuma:

Today we join millions of people across the globe to mark World Aids Day.
We join multitudes who have determined that this epidemic cannot be overcome without a concerted and coordinated effort.
We join millions who understand that the epidemic is not merely a health challenge. It is a challenge with profound social, cultural and economic consequences.
It is an epidemic that affects entire nations. Yet it touches on matters that are intensely personal and private.
Unlike many others, HIV and AIDS cannot be overcome simply by improving the quality of drinking water, or eradicating mosquitoes, or mass immunisation.
It can only be overcome by individuals taking responsibility for their own lives and the lives of those around them.
Fellow South Africans,
As a country, we have done much to tackle HIV and AIDS.
In every sector of society, there are individuals and groups who have worked tirelessly to educate, advocate, care, treat, prevent and to break the stigma that still surrounds the epidemic.
Today, we wish to acknowledge their dedicated efforts.
As government we are ready to play our role of leadership, building on the foundation that has been laid over the past 15 years.
Under the leadership of Presidents Nelson Mandela, Thabo Mbeki and Kgalema Motlanthe, the democratic government has put in place various strategies to comprehensively deal with HIV and Aids, tuberculosis and sexually transmitted infections.
Working with other sectors through the South African National Aids Council, we have managed to harness unity in confronting this scourge.
The amount of resources dedicated to prevention, treatment and care has increased with each successive year.
But it is not enough. Much more needs to be done.
We need extraordinary measures to reverse the trends we are seeing in the health profile of our people.
We know that the situation is serious. We have seen the statistics.
We know that the average life expectancy of South Africans has been falling, and that South Africans are dying at a young age.
We have seen the child-headed and granny-headed households, and have witnessed the pain and displacement of orphans and vulnerable children.
These facts are undeniable. We should not be tempted to downplay the statistics and impact or to deny the reality that we face.
At the same time, the epidemic is not about statistics. It is about people, about families, and communities.
It is about our loved ones.
For many families, it is a burden that they have to bear alone, fearful of discrimination and stigma.
Dear Compatriots,
Now is not the time to lament. It is the time to act decisively, and to act together.
Our message is simple. We have to stop the spread of HIV. We must reduce the rate of new infections. Prevention is our most powerful weapon against the epidemic.
All South Africans should take steps to ensure that they do not become infected, that they do not infect others and that they know their status.
Each individual must take responsibility for protection against HIV. To the youth, the future belongs to you.
Be responsible and do not expose yourself to risks.
Parents and heads of households, let us be open with our children and educate them about HIV and how to prevent it.
Ladies and gentlemen,

We are still marking the 16 days of activism against violence on women and children. During this period, it is important that we also remember to uphold the rights of women and children, including their right to protection from infection with HIV.
Many women are unable to negotiate for protection due to unequal power relations in relationships.
As we mark the International Day of Persons with Disabilities on Thursday, the 3rd of December, let us remember the impact of HIV on persons with disability.
We have to tailor government programmes and messages to also speak to the needs of this sector.
Fellow South Africans,
To take our response a step forward, we are launching a massive campaign to mobilise all South Africans to get tested for HIV.
Every South African should know his or her HIV status. To prepare for a continuous voluntary testing campaign, we would like to announce a few new measures, to expand our response.
All children under one year of age will get treatment if they test positive. Initiating treatment will therefore not be determined by the level of CD cells.
This decision will contribute significantly towards the reduction of infant mortality over time.
All patients with both TB and HIV will get treatment with anti-retrovirals if their CD4 count is 350 or less. At present treatment is available when the CD4 count is less than 200. TB and HIV/Aids will now be treated under one roof.
This policy change will address early reported deaths arising from undetected TB infection among those who are infected with HIV.
We have taken this step, particularly on learning that approximately 1% of our population has TB and that the co-infection between TB and HIV is 73%.
All pregnant HIV positive women with a CD4 count of 350 or with symptoms regardless of CD4 count will have access to treatment. At present HIV positive pregnant women are eligible for treatment if their CD4 count is less than 200.
All other pregnant women not falling into this category, but who are HIV positive, will be put on treatment at fourteen weeks of pregnancy to protect the baby. In the past this was only started during the last term of pregnancy.
In order to meet the need for testing and treatment, we will work to ensure that all the health institutions in the country are ready to receive and assist patients and not just a few accredited ARV centres. Any citizen should be able to move into any health centre and ask for counselling, testing and even treatment if needed.
The implementation of all these announcements is effective from April 2010. Institutions are hard at work to ensure that systems are in place by the 31st of March.
What does this all mean? It means that we will be treating significantly larger numbers of HIV positive patients. It means that people will live longer and more fulfilling lives.
What does it NOT mean? It does not mean that we should be irresponsible in our sexual practices.
It does not mean that people do not have to practice safer sex. It does not mean that people should not use condoms consistently and correctly during every sexual encounter.
We can eliminate the scourge of HIV if all South Africans take responsibility for their actions.
I need to re-emphasise at this point that we must intensify our prevention efforts if we are to turn off the tap of new HIV and TB infections. Prevention is our most powerful and effective weapon.
We have to overcome HIV the same way that it spreads – one individual at a time. We have to really show that all of us are responsible.
The HIV tests are voluntary and they are confidential. We know that it is not easy. It is a difficult decision to take.
But it is a decision that must be taken by people from all walks of life, of all races, all social classes, all positions in society. HIV does not discriminate.

I am making arrangements for my own test. I have taken HIV tests before, and I know my status. I will do another test soon as part of this new campaign. I urge you to start planning for your own tests.
Ladies and gentlemen,
We are also mindful of the social impact of the epidemic, and continue to provide psycho-social support and home based care, through the Home Community Based Care and child care programmes of government.
Let me use this opportunity to salute all our caregivers including those neighbours who assist and support families in distress.
We also thank our international partners, who continue to provide material support to our campaign against AIDS.
On this day, our hearts go out to all South Africans who are in distress as a result of this epidemic. To families looking after sick relatives, we wish you strength. We understand what you are going through.
To those who have lost their loved ones to the epidemic we share your pain, and extend our deepest condolences.
Fellow South Africans,
At another moment in our history, in another context, the liberation movement observed that the time comes in the life of any nation when there remain only two choices: submit or fight.
That time has now come in our struggle to overcome AIDS.
Let us declare now, as we declared then, that we shall not submit.
We have no choice but to deploy every effort, mobilise every resource, and utilise every skill that our nation possesses, to ensure that we prevail in this struggle for the health and prosperity of our nation.
History has demonstrated the strength of a nation united and determined.
We are a capable, innovative and motivated people.
Together we fought and defeated a system so corrupt and reviled that it was described as a crime against humanity.
Together we can overcome this challenge.
Let today be the dawn of a new era.
Let there be no more shame, no more blame, no more discrimination and no more stigma.
Let the politicisation and endless debates about HIV and AIDS stop.
Let this be the start of an era of openness, of taking personal responsibility, and of working together in unity to prevent HIV infections and to deal with its impact.
Working together, we can achieve these goals!
I thank you.

About the author

Health-e News

Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews