The 5th South African AIDS Conference, held from 7-10 June, 2011 in Durban, showcased the recent remarkable achievements of the country’s HIV/AIDS response. The conference was less concerned with groundbreaking clinical research, and more with the work of improving the care and health of the country’s millions living with and at risk of HIV.
South Africa’s accomplishments
1) Just under 12 million South Africans got tested in the last year for HIV — almost a quarter of population in less than a year.
2) The cost of antiretroviral therapy for the country has been cut in half in the last six months.
The conference chair Professor Francois Venter credited this to the Department of Treasury and some hard bargaining by the Department of Health. “Bringing down the cost of antiretrovirals just in the last six months by more than half is no small achievement. It has meant that treating HIV is getting to the stage where it’s one of the cheapest chronic diseases to treat, in the South African system,” he said.
3) South Africa’s own public expenditure on HIV and AIDS has increased by 40% per annum. “In the current financial year we have allocated US$1 billion to HIV and AIDS programmes,” the Deputy President said in an address to the UN.
4) The number of South African facilities providing ART is now about 1668.
5) 1.4 million South Africans are now on ART, 400,000 of whom started treatment in the last year. “That’s 1.4 million people who are alive and well on antiretrovirals who would be either dead or sick. Four hundred thousand people who would be dead in a year or two. Their families would be burying them,” said Prof. Venter. “There are not many things in medicine that save this number of people. And we have to thank a Department of Health, a donor, an NGO, an activist nation who have got together and have collectively made this happen.”
|Coat of Arms of South Africa|
“I really do think that is something to be proud of as a country. Coming from a situation where we weren’t doing particularly well or benchmarking ourselves against countries like Botswana and Namibia, we are starting to step up and show the leadership that is required. It’s going to require a lot more. We need to almost double that number by the end of 2012. It’s going to require a lot of effort on the part of all of us to actually get there,” said Prof. Venter.
6) Reduction in mortality: ART appears to have had a clear impact on survival. Several years back, before such rapid scale-up of ART was considered possible, modelling by the Actuarial Society of SA had predicted that, in 2010, there would be 388,000 deaths due to the HIV epidemic, up from 257,000 at last count in 2005. However, the number of AIDS-related deaths has clearly dropping over the last couple years. Last year, it is estimated to have dropped to around 194,000, about 60,000 less than in 2005 and half the number projected. This sharp decline is attributable to the ART programme, according to Professor Yunus Moosa, of the University of KwaZulu Natal.
7) TB is finally receiving more attention: “TB has been the orphan of the health world for decades. It hasn’t been given the resources it deserves but for the first time, it’s being regarded as the emergency that it actually is. For the first time, we’re seeing new drugs, new diagnostics. We need to now start making sure that our healthcare system is one that can tackle TB,” said Prof. Venter.
Two separate symposia focused on advances in TB diagnostics, in particular the roll-out of Gene Xpert for more rapid TB diagnosis, while another symposium focused on the government’s efforts to scale up TB infection control in health facilities. Other presentations would describe the decentralisation of multidrug-resistant TB care in KZN, and the development of tools, training and support to improve the implementation of basic TB infection control measures by clinic staff.
8) Strengthened prevention: “We are making continuous efforts to strengthen our prevention strategies,” said the Deputy President in his taped address, noting that more than 50,000 men have undergone medical male circumcision nationally, along with an increase in the numbers of both male and female condoms being distributed nationally.
Another highlight of the meeting was the performance of the programme to prevent parent-to-child HIV transmission (PPTCT), which has reduced the rate of transmission to 3.5% at around 6 weeks of age — a profound improvement compared to reports a few years ago.
South Africa - Partnership Against HIV and AIDS
South African National AIDS Council
Africa Centre contributions to the conference