It is estimated that 5.6 million South Africans live with HIV. In 2010, there was an estimated 380,000 new infections. Young women between the ages of 15 and 34 are disproportionately affected. Together, HIV and poverty are fuelling the tuberculosis (TB) epidemic (with a HIV/TB co-infection rate of 70%).
At the end of 2011 the South African National AIDS Council (SANAC) launched the National Strategic plan (NSP) for HIV, TB and STIs 2012-2016. The NSP aims amongst other things to treat three million people living with HIV by 2016 and to reduce vertical transmission of HIV (PMTCT) to below 2%. The leadership of SANAC has also changed. Previous CEO Dr Nono Simelela moved to the Presidency office and was replaced by Dr Fareed Abdullah. Mark Heywood, a TAC national executive member, resigned as the deputy chairperson of SANAC
TAC debated its continued participation in SANAC. It was felt that SANAC had become less relevant – because it is often silent when it needs to be proactive. There are concerns about the poorly functioning SANAC structures, lack of coordination, and insufficient direction from SANAC leadership.
We therefore resolved to only participate minimally at this national structure and increase our participation at provincial and district level. We took a conscious decision to focus its energy in helping to build provincial and local AIDS councils during the last two years because that is where implementation occurs. Even so, TAC is still represented in many SANAC structures, for example, our organisational leadership is participating in the SANAC trust and the country coordinating mechanism committee.
Notable country successes over the last two years include:
- The launch and continuation of the HIV Counselling and Testing Campaign ( HCT)
- The increased number of antiretroviral treatment sites (In the last two years it has increased from 490 to more than 3,000.)
- A decrease in the HIV transmission rate from mother to child from 8.5% to 2.7%,
- The number of people reported to have access to ART has increased to roughly 1.8 million
- In the 2012 ARV tender the Department of Health again negotiated much reduced prices for antiretrovirals
- The public sector will finally be providing three-in-one fixed-dose combination ARVs from April 2013
We also note progressive steps from Minister Motsoaledi to address health inequalities between public and private health care. We welcome the NHI pilot projects and are contributing in some of the pilot areas. We also support the revitalisation of primary health care and the integration of community health care workers and nurses – all of which forms part of the wider health reform strategy.
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