A South African initiative has been praised as having the potential to break ‘the trajectory of the Aids epidemic’
THE RECENT launch of a new testing programme by the South African government, which aims to persuade 15 million people to know their HIV status by mid-2011, is the biggest the world has ever seen, according to the United Nations.
The initiative launched by South African president Jacob Zuma and senior government ministers has been widely praised by civil society groups and health experts, who say it is a vital undertaking that has the potential to break “the trajectory of the Aids epidemic” around the globe.
The campaign, which will travel the country over the next 14 months in the form of a health fair, aims to increase the number of people who know their HIV status and tackle deeply rooted social ills that have hampered attempts to halt the spread of the disease.
Sexual violence against women, older men bribing young girls for sex, and the difficulties women have in persuading men to use contraception have all been listed as contributing social factors to South Africa’s extremely high rates of HIV.
The testing campaign is part of the new prevention and treatment strategy announced by the government on World Aids Day last December as part of its efforts to tackle the disease.
The latest government figures estimate that 5.2 million people were living with the disease in 2008, and more than 250,000 people died from Aids or related illnesses that year.
Also included in the revised policy is the introduction of treatment for all children under the age of one, all patients with both TB and HIV, and for pregnant HIV positive women.
Michel Sidibé, executive director of the UN’s programme on HIV/Aids, has been upbeat about the new programme and its chances of success, saying the South African government was now showing leadership and taking responsibility.
While conceding testing for HIV was not going to stop the transmission of the disease, he maintained it was an essential first step.
"It can break the log jam in starting difficult conversations around HIV treatment and prevention. Such conversations are necessary to achieve universal access to HIV prevention, treatment, care and support," he wrote in South Africa's Mail Guardianlast month.
“This is why the country’s new campaign to test nearly 15 million people for HIV by 2011 is courageous and must succeed. And the international community should do all it can to support this effort.”
The new HIV policy by the Zuma-led government contrasts greatly to the manner in which the disease was addressed by his elected predecessor, former South African president Thabo Mbeki.
Both Mr Mbeki and his health minister, Dr Manto Tshabalala-Msimang, disputed the causes of Aids, and were slow to embrace the HIV/Aids policies advocated by international experts.
Infamously, the recently deceased Dr Tshabalala-Msimang advocated the use of lemon, garlic and beetroot as a treatment for Aids over anti-retroviral (ARVs) drugs.
Although president Zuma’s extra-marital affairs and polygamist lifestyle are said by many people to be undermining the country’s efforts to combat the disease, his decision to make public his HIV status – which he said was negative – at the programme launch was received positively.
“After careful consideration, I have decided to share my results with all South Africans . . . to promote openness. I’m sure South Africans will know I am very open,” he said at the launch of the initiative.
“We have to work harder . . . to make all South Africans understand that people living with HIV/Aids haven’t committed a crime. We have to expand the knowledge and understanding of the epidemic to protect affected individuals and families.
“The stigma arises from fear, and fear from ignorance. Let us fight ignorance. The greatest benefit from the HIV-testing campaign should be the education of our people, and the promotion of the rights to human dignity and privacy of those living with HIV.”
Prominent support and lobby group, the Treatment Action Campaign (TAC), has welcomed the government’s expansion of its HIV and Aids programme, but has expressed concerns over the state’s ability to sustain its initiatives due to the scarcity of resources.
TAC senior researcher Catherine Tomlinson said the plan to increase the number of accredited treatment and testing facilities from 466 to 4,000 over the coming 12 months would be a difficult task.
“There is a shortage of resources and manpower especially in the rural areas. We hope to see nurses trained to initiate treatment to improve access for rural people,” she said.
Mr Sidibé told reporters last week that one way the government could optimise resources was to review its policy on purchasing drugs locally. “The government pays 25-30 per cent more for ARVs than the average international price,” he said.
