SA’s HIV epidemic still requires an emergency response

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The 9th SA National Aids Conference in Durban ended on Friday of last week with the eThekwini Declaration: “A Radical Call to Action – Reinvigorating and Revolutionising the HIV Response”. The declaration handed to deputy president David Mabuza at the close of the conference was to reawaken the urgency of HIV and Aids as a devastating public health crisis still requiring an emergency response.

The Times reports that 10 points to come out of the conference are: South Africa has 7.9m people currently living with HIV and at least 4.4m on treatment, but there is inadequate progress towards the UN 90-90-90 global targets; 90% of people will know their HIV status, 90% with HIV will get sustainable antiretroviral therapy, 90% on treatment will have viral suppression;
New HIV infections in South Africa are declining but the infection rate among young people, particularly teenage girls and young women, is still shockingly high;
Almost four women per 100, aged 16 to 35, are getting HIV every year, a study on the safety of three contraceptives including Depo-Provera found. The contraceptive is safe. Nearly 8,000 women from South Africa, Kenya, Zambia and Swaziland took part in the clinical trial, and the results were announced by Professor Helen Rees, one of the trial leaders and director of the Wits Reproductive Health Institute (WRHI);
Professor of medicine Francois Venter, head of Ezintsha, a WHRI sub-syndicate, says of the ECHO trial results: “If ever there was a wake-up call for the family planning sector, this is it: we should be treating women accessing these services as an emergency for access to HIV prevention, especially PrEP –pre-exposure prophylactic treatment”;
Key vulnerable populations, such as sex workers, need to be prioritised for better care and treatment, researchers and activists urged. They have higher infection and death rates. All groups on treatment in the public health system are at risk of antiretroviral drug stockouts, which are common;
The good news is that South Africa is at the forefront of HIV vaccine research. Four large-scale HIV vaccine efficacy clinical trials are taking place at research sites across the country, says Professor Glenda Gray, president of the SA Medical Research Council and director of the HIV Vaccine Trials Network Africa Programmes;
HIV/Aids donor funding to South Africa has reached a high point says Dr Fareed Abdullah, director of the Office of AIDS & TB Research at the South African Medical Research Council. PEPFAR has pledged about $730m for the current year and for the next year, following uncertainty about whether they would, and The Global Fund has increased its allocation to $369m to South Africa for the next three-year cycle;
Despite this, HIV/Aids activists and clinicians raised concerns on and off stage at the conference that service delivery by some organisations, or “implementing partners”, is threatened following unforeseen shifts in donor funding. They called for greater transparency and participation in the awarding of grants; and
The theme of the conference was Unprecedented Innovations and Technologies: HIV and Change and more than 3,000 delegates attended, about 25% of them from other countries.

 

Mabuza said at the closing plenary of the conference that the main contributing factor for South Africa not reaching its targets in combating HIV remains the challenge of stigma and discrimination, reports The Times. Mabuza said South Africans should stop stigmatising and discriminating against people living with HIV.

Mabuza said the government would be focusing on the transmission of the virus in women and children. “Our learners, especially adolescent girls and young women, will be getting focused attention from our government. This entails a holistic approach to sexuality, starting from age-appropriate life skills education in schools, so that young people have an understanding of their own bodies.

“We are approaching this work with utmost care and caution, so that we do not prematurely sexualise our children. It’s important to gradually gravitate to that point where we talk about these things with our young people.”

He said the government had recently made all menstrual products VAT-free. “We believe that every girl should have the power to decide her future. Our responsibility as government, together with parents, is to ensure that girls are equipped with education in order to lead independent and productive lives. Our responsibility is ensure that they are healthy, and that they are safe from any form of abuse and gender-based violence.”

According to the report, he said equal attention needed to be paid to young boys to prevent early exposure to HIV and other sexually transmitted infections. “Of concern is that the age of the first sexual debut among young boys is decreasing, thereby making them vulnerable to this epidemic. We must ensure that young boys do not become fathers without planning.”

He said the country’s premiers and mayors would be held accountable for the performance of HIV/Aids councils in the provinces and municipalities they lead.

The report says earlier, the CEO of the SA National Aids Council, Dr Sandile Buthelezi, said that gender-based violence, unemployment and substance abuse were some of the main reasons South Africa had not been on target to reach its 2020 goal of reducing HIV infections.

The Times report
The Times report


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