SOUTH AFRICA’S COMPREHENSIVE HIV AND AIDS PROGRAMME

A Fact Sheet – May 2006

May 2006

The South African Government’s programme to address the challenges posed by HIV and AIDS is one of the most comprehensive and largest in the world

COMMITMENT OF RESOURCES

• Government expenditure on HIV and AIDS increased substantially over the years – it grew from R30 million in 1994 to over R3 billion in 2005/06.
• In the report to the previous United Nations (UN) General Assembly Special Session on AIDS (UNGASS), the UN Secretary General commended South Africa for tripling its resource allocation for HlV and AIDS programmes since the adoption of the UN Declaration in 2001.
• The World Health Organisation’s (WHO) progress report on the expansion of AIDS treatment, released in June 2005, noted that: ’South Africa has committed US$1 billion over the next three years to scaling up antiretroviral (ARV) treatment, by far the largest budget allocation of any low- or middle-income country.’

IMPLEMENTATION

These resources are being used effectively to curb the spread of HIV- infection and reduce the impact of AIDS:

• This is reflected in very high levels of awareness; stabilisation in recent years of the level of prevalence which had been rising fast and the creation of infrastructure to support and sustain counselling, testing, care and treatment across the country. Behaviour change is reflected in that secondary abstinence among females rose from 13,9% in 2002 to 20% in 2005 and the use of condoms among those with multiple partners increased from 48,6% in 2002 to 79,1% in 2005. Government will be scaling up the communication and social mobilisation campaign. The budget for the campaign over a two-year period has been increased from R160 million to R200 million. The department is currently finalising the specifications for the new communication tender, which will be advertised and awarded accordingly.
• The condom distribution programme cannot be compared with any in the world. Public health sector male condom distribution has increased from 270 million in 2003 to 346 million in 2004 while female condom distribution rose from 1,3 to 2,6 million during the same period. The Human Sciences Research Council's HIV-Prevalence, Incidence, Behaviour and Communication Survey of 2005 shows that there is nearly universal access (97%) to condoms, with government hospitals and clinics being the main sources of availability.
• There are now 231 accredited public health facilities providing HIV and AIDS-related services, including ARV drugs. These facilities are spread across the country’s 53 districts and cover at least two thirds of local municipalities. By the end of March 2006, at least 134 473 people had been initiated on ARV treatment in these facilities. Combined with an estimated 80 000 people initiated for private-sector ARV treatment, South Africa has the largest ARV treatment programme in the world. More than R3,4 billion has been allocated for procurement of ARV drugs for the period up to the end of 2007. Government is involved in ongoing initiatives to reduce the prices of relevant medication.
• Health facilities providing voluntary counselling and testing (VCT) have doubled from 1 500 in 2002/03 to 3 700 in 2004/05. The number of people counselled for testing in the public sector rose from 413 000 in 2002/03 to 691 000 in 2003/04 and 1,3 million in 2004/05. The total number of people tested during 2003/04 was 511 843 compared with 247 287 in the previous year.
• The prevention progamme includes prevention of mother-to-child transmission (PMTCT), with 2 500 facilities in operation and post-exposure prophylaxis (PEP) - almost all hospitals and trauma centres provide PEP for sexual assault survivors.
• On 11 April 2006, the Minister of Health launched the Accelerated Prevention of HIV and AIDS Initiative as part of an extensive initiative regarding prevention by the member states of the Africa Region of the WHO.
• More than 1 060 health professionals have been recruited to support the programme. Some 7 600 health professionals have been trained in the management, care and treatment of HIV and AIDS. Government is also improving working conditions so that it can recruit and retain more health professionals. This includes providing scarce skills allowance for certain categories of health professionals (doctors, pharmacists and specialist nurses) and a rural allowance for health professionals working in less
• developed parts of the country. This is in addition to the steadily improving salary packages.
• Nutritional supplements are provided to those who need them, as part of the comprehensive response to HIV and AIDS, as a complement to the appropriate forms of treatment. Some 90 000 people have accessed this service since April 2004. An amount of R7 million was made available for purchasing nutrition supplements in the 2003/04 financial year.
• Support and care for those affected by HIV and AIDS is expanding, through growing programmes such as home- and community-based care.

PARTNERSHIP

• Critical to successful implementation is an active partnership of all of society with government. The partnership is embodied in the South Africa National AIDS Council and expressed in action, which sees government, communities and non-governmental organisations (NGOs) working together to implement all aspects of the comprehensive plan.
• The Department of Health invited 14 members of civil-society groups to be part of South Africa’s delegation to the United Nations General Assembly Special Session (UNGASS) on HIV and AIDS. Government programmes are complemented by private sector, NGO and civil-society initiatives.
• In this partnership, there is appreciation that the role-players may agree on all or some of the elements of the comprehensive programme. What we seek to ensure is for the partners to work together on those issues on which they are in agreement.

There is still no known cure for AIDS.

We can overcome HIV and AIDS, working together in a partnership of all of society