How South Africa’s fight against HIV stacks up

Treatment

About 2.5 million people in South Africa are on HIV treatment, making the country’s public HIV treatment programme the world’s largest. The UNAIDS report lauds government’s recent tender that introduced the country’s first three-in-one – or fixed-dose -ARV into the public sector. UNAIDS estimates that this tender, which negotiated an almost 40 percent price reduction for the fixed dose ARV, will save South Africa more than R2.6 billion.

Footing most of its own HIV treatment costs, South Africa relies on donors to fund less than 25 percent of its HIV response.

Malawi, Zambia, Zimbabwe and Mozambique rely on donors to fund at least three-quarters of their responses, according to the UNAIDS report.

HIV and Tuberculosis (TB)

 More than 75 percent of all people co-infected with HIV and TB live in just ten countries, including South Africa, Zimbabwe and Mozambique.

Zimbabwe, Malawi and Namibia have at least halved the number of TB deaths among people living with HIV. While South Africa has yet to reduce these kinds of deaths by even 25 percent, the report notes that the country has made huge strides in scaling up ARV access for co-infected patients – far outpacing other countries with similarly large epidemics like India and Nigeria.

South Africa has also become the world’s largest provider of preventative isoniazid TB therapy to HIV patients. An estimated 370,000 people living with HIV now receive the anti-TB drug to prevent the development of active TB. In South African studies, the provision of preventative TB therapy to people on ARVs halved their risk of death.

Globally, TB remains one of the leading killers of people living with HIV and a leading cause of death in South Africa.

Prevention

Zimbabwe leads the region in scaling up medical male circumcision, which has been shown to reduce a man’s risk of contracting HIV by as much as 60 percent. Zambia, Uganda and Swaziland are all out pacing South Africa on increasing uptake of the procedure.

With falling rate of mother-to-child transmission, South Africa joins most other countries from southern Africa in reaching at least 80 percent of all HIV-positive expecting mothers with ARVs to prevent mother-to-child HIV transmission. Malawi and Lesotho are close behind, extending this kind of prevention services to at least half of all such mothers while less than 20 percent of HIV-positive pregnant women will access these services in Angola.

New infections and deaths

An estimated 370,000 South Africans contracted the virus last year. While South Africa’s new infection rate has fallen by about half in the last decade, it remains the world’s highest. Second only to South Africa, Nigeria saw an estimated 260,000 new cases in 2012.

Both countries recorded 240,000 AIDS-related deaths last year – Health-e News Service.

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