Article for Independent regarding HIV prevalence - TAC and DA critique

28 September 2004

As usual, the Treatment Action Campaign and Democratic Alliance have chosen the easiest route and blamed everything on Government in their reaction to the Survey of Prevalence of HIV and Syphilis amongst Women Attending Public Sector Antenatal Clinic.

Popular lines have been repeated: "Government has the tools and policies to control this epidemic, but it seems not to want to use them." It has been argued that "the survey shows unequivocally that prevention efforts have been insufficient."

Although not justified, their criticism of the country's prevention might be an indication that these organisations are beginning to acknowledge the central role of prevention in addressing the major challenge of HIV and AIDS. Hopefully, they will widen their narrow view of this challenge and begin to appreciate the comprehensive nature of government's programme on HIV and AIDS.

Government has always maintained that, in the absence of a cure, prevention remains the mainstay of our response to HIV and AIDS. We have sustained our efforts to encourage particularly young people to abstain from sex. The life-skills programme in schools, partnership with loveLife and the broader healthy lifestyle programme are some of the initiatives that empower the youth and enable them to take care of their health. We cannot yet claim any victory, but the trends indicate a constant decline in the prevalence of HIV amongst teenagers since 1999.

We are also encouraging those who are involved in sexual relationships to be faithful to one partner. This is our contribution to moral regeneration and efforts to build strong families that serve as a foundation for human development.

Our condom distribution programme cannot be compared to any in the world. Public health sector male condom distribution has increased by 80% from 150 million in 1997 to 270 million in 2003. Condoms have been distributed to at least 3000 informal outlets, with an average of over 1 million condoms per month in spaza shops, taverns, hair salon etc.

The Department of Health has increased the number of sites to access female condoms from the initial 28 pilot sites in 2000 to over 200 sites in 2003 with 1.4 million female condoms distributed last year.

We have increased budget allocation for HIV and AIDS communication campaign - Khomanani, Caring Together - from R90 million in the past two years to R160 million over the next two years to support the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS.

This extensive mass communication initiative started with a below-the -line radio campaign and the production and distribution of printed materials.

In terms of radio:

• In April and May a total of 88 "live reads" by announcers outlined the basics of the Comprehensive Plan.
• In the same period, a total of 80 interviews took place with people undergoing antiretroviral treatment or clinicians that are providing it. The radio interviews slots which explained the basics of this therapy, would have appeared to be an editorial content - but in fact they were arranged and paid for by Khomanani.

The first round of printed information comprised the following:

• 2-million leaflets and 200 000 posters giving basic information about treatment, intended for distribution through clinics and hospitals.
• 10,6-million booklets on the Comprehensive Plan were printed in 11 languages targeted at readers with a low level of literacy. 80% had been distributed by May this year.
• Recently, another booklet (500 000 copies) has been produced for readers with a high level of literacy. It was distributed by insert in various publications, including business publications and nursing journals.

There was a short spurt of TV and radio advertising in April and May and this has been expanded more recently:

• Adverts on treatment for AIDS have been flighted on the SABC TV. It is estimated that they will reach 66% of the TV-viewing public an average of six times each.
• A set of radio adverts, in a range of official languages will also be broadcast for next few weeks.

The expansion of treatment has been an important part of the Khomanani Campaign over the past few months. However, Khomanani's brief is to undertake a comprehensive awareness and information campaign, supporting the goals of preventing HIV infection, promoting care and support for people living with HIV and AIDS, supporting treatment, and combating the stigma associated with HIV and AIDS. It also includes specific interventions on tuberculosis and sexually transmitted infections.

Khomanani works also through community mobilization. For instance, the sub-campaign on Positive Living involved the training of 555 community ambassadors who visited a total of 104 000 households.

Next week (October 09) we will be observing the Sixth Anniversary of the Partnership against AIDS which has mobilised almost every sector of our society into a response to HIV and AIDS since it was launched by the then Deputy President Thabo Mbeki in 1998. The majority of South Africans are pulling together towards with a common objective of curbing the spread of HIV infection and reducing impact of AIDS in our society.

TAC and DA who argue that we are not doing enough in our prevention programme need to tell us what they have to reduce HIV infections. We should remember that over the past years, the same organisations have only been campaigning about antiretroviral treatment and virtually nothing about prevention.

Addressing the challenge of HIV and AIDS is a collective responsibility of all sectors of our society. In an objective assessment of our performance as individual organisations, we need to ask how much we have contributed in ensuring that all elements of the response to HIV and AIDS are implemented including prevention; treatment, care and support; research; and issues of human rights.

Dr Manto Tshabalala-Msimang
Minister of Health