Briefing Notes 6

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March 2004

HIV and AIDS

During the first decade of freedom the ANC has created conditions to strengthen national efforts to fight HIV and Aids:

• The ANC-led government has worked together with social partners to significantly improve people's awareness about the Aids epidemic.
• The ANC-led government is pioneering efforts to ensure the rights of people living with HIV are upheld and protected.
• The government and the people of South Africa are making important strides in overcoming prejudice towards those infected and affected by HIV and AIDS.

What is the ANC doing to fight the spread of HIV and AIDS?

Prevention

• The ANC-led government, in cooperation with other people's organisations (like faith-based groups and trade unions) has developed a comprehensive five-year strategic plan on HIV, Aids and sexually transmitted infections (STIs). This strategy addresses prevention, treatment and care, research and human rights aspects. It is based on the premise that HIV causes Aids.
• Government has embarked on awareness campaigns, using mass media and community mobilisation under the theme, 'Khomanani - Caring Together', to step up efforts to prevent further spread of the disease. This campaign is focusing on prevention among youth, support for vulnerable children, living positively with HIV and Aids, effective STI treatment, control of tuberculosis (TB) and supporting health workers.
• Government distributed 350 million condoms free of charge in 2002 in an effort to encourage safer sexual practices. This distribution is increasing to 400 million for the year 2004.
• By the end of 2002, government had made 982 sites available throughout the country which provide voluntary HIV counselling and testing and prevention of mother-to-child transmission of HIV. Government has allocated R334 million for expansion of these programmes in the health system for the 2003/4 financial year.
• Following the Constitutional court ruling, which gives doctors working in the public sector maternity service a choice to offer the drug Nevirapine to HIV-positive pregnant women, provided that HIV testing and counselling facilities exist, this programme is being progressively expanded in the public health sector.
• It is estimated that by the end of December 2002, over 100,000 women had visited the 18 pilot research sites which implement the programme on prevention of mother-to-child transmission of HIV.
• Antiretroviral therapy is provided to survivors of sexual assault to diminish the likelihood of HIV infection as part of a comprehensive package of support which includes counselling.

Treatment

• Government's approach to treatment includes early and effective treatment of opportunistic infections, the use of antiretroviral therapy, improved nutrition and administration of complementary medicine which strengthens the immune system.
• Government has made TB treatment freely available in all public hospitals and clinics. Tuberculosis is the most common opportunistic disease and the Department of Health is prioritising the improvement of the management of TB.
• Government's food security and poverty alleviation programmes are part of the response to HIV, AIDS and TB. Poverty alleviation and improved nutrition contribute in strengthening the body's immune system.
• In April 2002, the government re-affirmed its position that antiretroviral drug treatment could improve the health of people living with AIDS if administered at the right time in the progress of the condition in accordance with international standards. After an extensive process of evaluation, government recently approved an operational plan to include antiretroviral therapy as part of a comprehensive treatment programme in public institutions.
• The introduction of antiretroviral treatment in public health institutions has been made possible by the reduced cost of drugs, improved and growing knowledge about this issue, and the availability of resources to introduce and sustain this enhanced response. The ANC-led government continues to work for a reduction in the cost of these and other drugs.

  Progress in the implementation of the comprehensive plan for management, care and treatment of HIV and Aids.

• Government has visited 110 facilities in all districts to assess their capacity and develop urgent action plans where necessary to enable these facilities to manage the disease, provide care and treat those living with HIV and AIDS. National and Provincial government are recruiting to strengthen personnel. Doctors who did community service and those who are currently in this programme are being targeted for recruitment to ensure that they are retained in the public service. Training guidelines have been developed and some provinces have started training.
• Government has increased voluntary counselling and testing sites to ensure that people get tested. Testing protocols have been developed and are in line with treatment protocols. Eighteen laboratories have been identified to service the 53 sites and these will be increased in line with demand and workload.
• Available interventions for people with a CD4 count - which measures the number of white blood cells - of above 200 include counselling and psycho-social support, encouraging healthy lifestyles and provision of nutritional support. Government has put out tenders for procurement of supplement meals for those without food security and an extra R4 million has been allocated to increase volumes.
• The plan also encourages the use of traditional medicine as an option. Government has invested more than R6 million to assist in research and development to ensure the quality and safety of these medicines.
• People with CD4 count of 200 and below will have an option of antiretroviral therapy and government has adopted treatment guidelines. To make these drugs available government has called on suppliers to express interest in supplying the drug. Proposals that have been submitted will be short-listed and qualifying suppliers will provide quotations that will form the basis for negotiating the best possible contract.
• Government is in a process of purchasing computer and information technology to enable health workers to track patients throughout the health system and ensure that appropriate services and correct treatment are provided. Government has also developed an integrated patient information system with electronic patient records and a paper-based backup system.
• Government is setting up a pharma-covigilance programme with support units in MEDUNSA and Free State University to ensure safe and effective of antiretroviral therapy and AIDS related treatment. These units will also assess the burden of drug related morbidity and mortality rates in patients living with HIV and AIDS.

Caring for those affected

• The broadening of access to the Child Support Grant is a major benefit to families affected by HIV and AIDS. The number of beneficiaries will rise as more eligible children are registered.
• By March 2002 a total of 466 home and community based programmes were in place and over 370,000 people were accessing these services.
• Through the 'Khomanani - Circles of Support' campaign the public has been mobilised to provide support for people affected by this pandemic and volunteers have been placed in suitable organisations.

Fighting discrimination against those living with HIV/Aids

• Government has embarked on a mass communication strategy which, among other things, aims to confront the stigmatisation of, and discrimination against, people living with HIV and Aids.
• The Department of Labour has launched a code of good practice to set guidelines for addressing HIV and AIDS at the workplace to prevent stigmatisation and discrimination.
• Government is working with people living with the disease in combating the epidemic.

Research for AIDS Vaccine

• Presently there is no cure for Aids. The ANC-led government is doing everything to prolong the period from when people are HIV positive until they have Aids-defining illnesses through counselling, encouraging positive living and safer sex practices, nutrition, nutritional supplements, traditional and complementary medicines, immune-boosters, regular exercise, and robust treatment of opportunistic infections, like TB and sexually-transmitted infections.
• Government increased its funding to the South African Aids Vaccine Initiative (SAAVI) to R20 million in 2003. Eskom contributed a further R15 million. SAAVI is coordinated by the Medical Research Council and involves a range of local research institutions

Our Messages

The government is making strides in fighting AIDS, the spread of HIV and the impact of Aids. However more needs to be done. Government will not win the battle against this disease alone.

There is no cure for HIV and Aids. We must therefore re-double our efforts as the people of South Africa to prevent the spread of this disease.

We must continue strengthening government efforts to lend a caring hand to people infected and affected by HIV and AIDS.

South Africans must build a people's contract - each of us with one another; government and each citizen, community and sector of society - together to fight HIV and AIDS and build a better South Africa.