Johannesburg – While South Africa has made significant inroads in reducing HIV related deaths and new infections, the country is far from reaching the 2016 goal of a 75% reduction in infections by 2020.
The concession was made on Monday by President Cyril Ramaphosa in his latest weekly newsletter.
He made the remarks as the country prepares to join people across the globe in marking World AIDS Day on 1 December.
“If we succeed in doing so, we are likely to end AIDS as a public health threat by 2030,” wrote the President.
As the Chair of the South African National AIDS Council, Deputy President David Mabuza will lead the national commemoration with an address on progress in the country’s response.
With this year’s event taking place amidst the COVID-19 outbreak lockdown, President Ramaphosa reflected on how the pandemic has exerted pressure on health facilities.
“Many HIV, AIDS and Tuberculosis services have suffered. This has posed a challenge for people testing and starting antiretroviral treatment. Many people found it difficult to collect their medicines and fewer people accessed other services, such as voluntary male medical circumcision,” he said.
However, the public health’s response to the Coronavirus pandemic can strengthen the country’s fight against HIV and TB, said the President.
Reducing new infections
While South Africa continues to have the largest number of people living with HIV in the world, he said it was encouraging that over the last decade progress had been made in reducing the number of new HIV infections in the population by nearly 60%.
“It is also encouraging that HIV infections in adolescent girls and young women have significantly declined in the last decade. This is a crucial group because they are much more likely to be at risk of getting HIV. Our treatment programme has contributed to a reduction in the number of deaths due to AIDS by 60%. There has been a greater reduction in HIV-related deaths among young people,” he wrote.
He said it was possible to reduce the number of deaths as government and its partners had already rolled out an extensive antiretroviral programme reaching millions of people living with the disease.
At the beginning of the decade, the country’s programme to prevent mother to child transmission (PMTCT) of HIV had very low coverage.
“Now we have one of the highest rates of coverage of PMTCT in Southern Africa, which has substantially reduced rates of infection among children. While we have reduced deaths and new infections, we still are far from reaching the goal we committed ourselves in 2016 of achieving a 75% reduction in HIV infections by 2020. Unfortunately, we are not there yet.”
President Ramaphosa said more work on HIV prevention among key populations, including sex workers, men who have sex with men, and people who inject drugs is needed.
“We must end the stigma and discrimination towards these populations. We cannot hope to end HIV if we ignore the needs, concerns and rights of any part of our population,” he said.
South Africa, he added, needs to increase efforts to medically circumcise young men to reduce their risk of acquiring HIV, saying unsafe circumcision should not leave young men dead or with lifelong health complications.
He said government was encouraged by the findings of a recent study on pre-exposure prophylaxis (PrEP) by HIV Prevention Trials Network scientists. It was found that long-acting injections once every eight weeks, was better than the daily tablet used for HIV prevention.
“These findings have the potential to significantly strengthen our response to the epidemic,” said the President.
“If we are to succeed in ending AIDS as a public health threat within the next decade, we need to combine these medical breakthroughs with fundamental changes in behaviour. We also need to tackle the economic and social conditions that contribute to high rates of infection.”
Government’s central tasks he said, is to empower adolescent girls and young women, educationally, economically and socially. He said adolescent girls and young women need to be able to make their own decisions about every aspect of their lives, including their sexuality and sexual behaviour.
Addressing gender-based violence
As the country marks 16 Days of Activism for No Violence Against Women and Children, he said the country needs to work even harder to address the unequal relations between men and women – which contribute both to gender-based violence and to the spread of HIV.
Ultimately, said the President, “we will achieve the end of AIDS through the empowerment of young people, women and other people at risk”.
“This includes empowerment through access to information, advice and support. It includes access to education and economic opportunities, especially for young women. Empowerment also means that every person must have access to testing, treatment and other health services,” he said.
He urged the public to intensify its resolve and actions to confront and overcome AIDS once and for all.
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