Persistently high rate of HIV infections scares SA’s health minister

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The high rate of HIV infections in South Africa has left Health Minister Dr Aaron Motsoaledi “scared”. City Press reports that Motsoaledi was addressing a discussion on leadership for HIV primary prevention at the 22nd International Aids Conference (AIDS 2018), which is taking place in Amsterdam.

During his address, he spoke about the remarkable strides which have been made in the country’s fight against the Aids pandemic – an estimated 7.9m people are HIV positive. Motsoaledi highlighted the most vulnerable group within the South African population: girls between the ages of 15 and 24. According to the Health Science Research Council’s national HIV prevalence, incidence, behaviour and communication survey, which was released last week, this group had the highest incidence rate.

“We are still scared, very scared, when we compare these figures. There are two main challenges we are faced with in South Africa,” Motsoaledi said, after the survey also showed that there was a 44% reduction in the infection rate in South Africa.

The report says Motsoaledi explained the first challenge was that the group constituted 80% of all new infections. This needed to be addressed and reduced. He also explained the rollout of the She Conquers campaign. The campaign, which was launched in 2016 by then deputy president Cyril Ramaphosa, sought to alleviate social ills that affected young adolescent girls – such as teenage pregnancy and gender-based violence.

Motsoaledi said one of the main challenges was to address the men in the country and the relationship that young girls had with them – which was “to lead them to socioeconomic opportunities, so as to reduce their dependence on the man, who impregnated and infected them. “They are called blessers, these colourful but ugly names,” he told the delegates.

The report says Deputy President David Mabuza was meant to lead the South African delegation to Amsterdam but had seconded Motsoaledi to the role after joining President Cyril Ramaphosa at the 10th annual Brics summit, currently taking place in Johannesburg.

The conference is hosting about 18,000 delegates from across the world, which included a range of activists, researchers and government representatives but, the report says, the opening night of the conference did not go off smoothly. A group of female activists called for the resignation of UNAIDS director Michel Sidibe, who was accused of interfering with an investigation into former UN assistant secretary, Liuz Lourez, who accused of sexual assault in 2015. Lourez was accused by Martina Brostrom, UNAIDS external relations officer, of assaulting her in an elevator at the Dusit Tham hotel in Bangkok on May 8 2015.

The report says in May, Sidibe had visited South Africa during a five-day visit to southern African countries when civil society groups Section27, Sonke Gender Justice and the Treatment Action Campaign called for an inquiry into Sidibe’s handling of the assault claims.

 

The criminalisation of sex workers, injecting drug users and gay men in many countries battling to overcome HIV are key focuses of the conference, reports Health-e News.

In Amsterdam’s red-light district, sex workers are registered with the local chamber of commerce and pay up to 50% of their earnings in tax – including 21% VAT. And, the report says, speaking during a tour of the district, Kholi Buthelezi, the national co-ordinator of Sisonke, a South African sex worker organisation, called for the “complete decriminalisation of sex work in South Africa”. “We are being chased by the police, we are not safe. We reject the so-called Swedish model adopted by the National Council of Provinces, that criminalises sex workers’ clients not sex workers. That has the same effect as criminalising sex workers,” said Buthelezi.

Meanwhile, Eastern Europe and Central Asia are the only regions in the world where HIV infections and deaths are rising, partly because of laws that drive the virus underground by criminalising gay sex and injecting drug users.

Civil society delegates from these countries have organised under banner “Chase the virus, not people”, and have vowed to disrupt all the presentations by government representatives from these countries, particularly Russia which has some of the worst discriminatory laws and practices.

 

The ongoing spread of HIV is directly linked to the inferior status of girls and women globally, Academy Award winning actress Charlize Theron told the conference. “We know that HIV is linked to the second-class status of girls and women worldwide,” Theron is quoted in a Health-e News report as saying.

“We know HIV targets communities that our societies have exploited, discarded and shamed. Communities like sex workers, people who inject drugs, and our trans community and men who have sex with men.”

The report says Theron described Amsterdam as “a beacon of openness and acceptance in a world that feels consumed by isolationism” and “a rising tide of nationalism, nativism and dehumanising rhetoric all around the world”. But, she said, Dutch colonisers had played a destructive role in Africa, also treating indigenous people as second-class.

“As well as being an actor, an activist and a mother, I am also an Afrikaner,” said Theron. “My family descended from Dutch settlers…. who believed the lie of white supremacy. They did not recognise the indigenous people they met as full human beings, but as a resource to exploit.

“… South Africa is struggling to dismantle the racist society that was founded on this belief. The fight against HIV is linked to centuries’ long fight for equality, dignity and human rights and the only way to win this war is by shifting power to the people who have been shut out, by elevating local leadership especially young people, by spreading opportunity and access,” the report says Theron told the 15,000 delegates.

“I saw South Africa brought to its knees by the Aids epidemic. I grew up in apartheid South Africa and saw my country tear itself apart with prejudice and then rebuild with Ubuntu, a belief in a common humanity and that we are all bound to one another. I can feel this spirit here in this room.”

 

The International AIDS Society (IAS) will present the premiere Prudence Mabele Prize to Duduzile (Dudu) Dlamini at the conference. Dlamini, a long-time advocate for the rights and health of sex workers, is the founder of Mothers for the Future (M4F), a network striving to reverse the factors that make sex workers and their families particularly vulnerable to stigma, discrimination and HIV. She is also an ambassador for The Coalition for Children Affected by AIDS.

The Prudence Mabele Prize aims to promote global attention to the remarkable work of gender justice and health equity activists. The $25,000 cash award, endowed by the Ford Foundation and the Open Society Foundations in partnership with the Positive Women’s Network of South Africa, is the largest monetary prize ever given at an International AIDS Conference.

“Duduzile (Dudu) Dlamini is helping change the future for sex workers in South Africa,” IAS president Linda-Gail Bekker said. “Her work truly embodies the values, spirit and activism of Prudence Mabele.”

As part of the Sex Workers Education and Advocacy Task Force (SWEAT), Dlamini has worked tirelessly to protect the health and human rights of the often abused and overlooked sex worker’s community. With her vision and leadership, M4F has grown from an informal support network into a powerful social welfare system for mothers who are sex workers throughout South Africa.

In 1992, Prudence Mabele became the first black woman in South Africa to publicly reveal her HIV-positive status. A trailblazer for the rights of women and people living with HIV, Mabele helped found the Treatment Action Campaign and the Positive Women’s Network before her death in 2017. The new prize, endowed in her honour, recognises and celebrates those who carry on the fight in her name.

Duduzile Dlamini said, “I am honoured to receive this recognition, named for a great South African activist who spoke truth to power, on behalf of all of the women and families we serve at M4F.

“I know their struggles first-hand and have seen how abuse of sex workers by governments, police, health systems and other institutions has made sex workers and their children exceptionally vulnerable to HIV, poverty and exploitation. We also know that sex workers united are a powerful force for health and social justice. This recognition advances that march toward justice for all the women and children we serve.”

The Prudence Mabele Prize will be awarded a high-level special session honouring the life and work of the award’s namesake in the Amsterdam RAI Exhibition and Convention Centre on Thursday, 26 July.

 

The prevalence of HIV among people in South Africa has risen to 13.1%. Polity reports that this is according to figures released by South Africa’s statistician-general Risenga Maluleke, who said: “People living with HIV in 2018 are estimated to be sitting at 7.52m persons. Of course, we are looking at people in South Africa living a lot more healthier. With the proliferation and availability of ARVs, there are more people (with HIV) living so it’s not a question of the numbers just increasing. Certainly, we still have new infections, but the fact is that the people are living a lot more longer with ARVs. Over time, HIV prevalence among adults aged 15 to 49 is increasing while declining among youth 15 to 24 (years).”

The report says the number of Aids-related deaths has been on a consistent decline from 276,921 in 2007 to 115,167 in 2018.

The total number of people living with HIV in South Africa has however increased from an estimated 4.25m in 2002 to the 7.52m by 2018. For 2018, approximately one-fifth of women in South Africa in their reproductive ages (15 to 49) are HIV positive, according to StatsSA.

The report says earlier, Maluleke revealed that South Africa’s population has risen to 57.7m.
“We are talking about mid-year population estimates which use the latest fertility, mortality and migration data to estimate the size of the population of the Republic of South Africa. Now, the mid-year estimates for 2018, we are sitting at 57.73m people that are living in South Africa,” said Maluleke.

“In 2017 we were sitting at 56.8m. We had 1.2m births, a 0.2 net migration and we had about half a million deaths.” Approximately 51% (about 29.5m) of the people in South Africa are female.

About 29.5% of the population is aged younger than 15 years, and approximately 8.5% (4.89m) of the population is 60 years or older.

City Press report
Health-e News report
Health-e News report
AIDS 2018 material
Polity report
Stats SA material


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