HIV/AIDS in South Africa

HIV and AIDS in South Africa are major health concerns, and around 5.5 million people are thought to be living with the virus in South Africa. [http://www.unaids.org/en/Regions_Countries/Countries/south_africa.asp UNAIDS South Africa] ] HIV (human immunodeficiency virus) is the retrovirus that causes the disease known as AIDS (Acquired Immunodeficiency Syndrome). South Africa has more people with HIV/AIDS than any other country. [http://www.radiodiaries.org/ radiodiaries] entry on "Just Another Day at the Biggest Hospital in the World"] Although progress has been made in South Africa - a country that has the resources to provide antiretroviral therapy for all of those with advanced diseaseFact|date=June 2008 - the majority of patients who require antiretroviral therapy in South Africa are still not receiving it. As a result, in most hospitals in South Africa it is still common to see patients without access to antiretroviral therapy dying of opportunistic infections including tuberculosis.

The South African National HIV Survey estimated that 10.8% of all South Africans over 2 years old were living with HIV in 2005. There is an average of almost 1,000 deaths of AIDS a day in South Africa. [http://www.avert.org/safricastats.htm HIV and AIDS statistics for South Africa] ] The ASSA2003 model estimates that 345,640 South Africans died of AIDS in 2006.

Effects

AIDS is affecting mainly those who are sexually active, which means the demographics of the country are slowly changing. Many deaths are people who are their family's primary wage earners. This is resulting in many 'AIDS orphans' who in many cases depend on the state for care and financial support.cite web |url=http://www.avert.org/aidsorphans.htm |title=AIDS orphans |publisher=Avert |accessdate=2006-10-08] It is estimated that there were 1,400,000 AIDS orphans in South Africa in 2007. Traditional orphan support systems are being overwhelmed by the large numbers of orphans, placing increased strain on carers, including elders. A recent study found that South African families who had lost members to AIDS were more likely to need to forage for firewood for fuel, and wild herbs and insects for food. [Citation | last = Marris | first = Emma | title = AIDS harms the environment | newspaper = News @ Nature.com | year = 2007 | date = July 4, 2007 | url = http://www.nature.com/news/2007/070702/full/070702-10.html]

Government action

The government has recently, after much delay, devoted substantial resources to fighting the epidemic. In 2000, President Mbeki publicly questioned the importance of HIV in causing AIDS, controversially suggesting that the main cause was "poverty". [ [http://news.bbc.co.uk/1/hi/world/africa/826742.stm BBC News: Controversy dogs Aids forum] ] In 2001 the government appointed a panel of scientists, including a number of AIDS denialists (who question the mainstream view on HIV), to report back on the issue. Following their report, the government stated that it continues to base its policy on the premise that the cause of AIDS is indeed HIV. [ [http://news.bbc.co.uk/1/hi/world/africa/1260941.stm BBC News: South African split over Aids] ] The controversy has not abated, and organisations such as the Treatment Action Campaign continue to mount political and legal challenges to what they claim is the government's slow response to the epidemic. Recently, drafts of a new five-year National Strategic AIDS Plan have come closer to being finalized. The new plans allocate about R45-billion (about 6 billion US Dollars) towards infection prevention, and says nothing of the previous governmental claims that malnutrition played a role in the spread of AIDS. The council, headed by Deputy President Phumzile Mlambo-Ngcuka, is expected to announce the finalized plan by the end of March 2007.cite web |url=http://www.southafrica.info/ess_info/sa_glance/health/aidsplan.htm |title=South Africa's Aids action plan |publisher=the International Marketing Council of South Africa |date=2007-03-15]

The effort to improve treatment of HIV/AIDS was damaged by the attitude towards treatments of many figures in the government. Manto Tshabalala-Msimang, former Health Minister of South Africa, advocated a diet of garlic, olive oil and lemon to cure the disease cite news
first=Fran
last=Blandy
title='Dr Beetroot' hits back at media over Aids exhibition
publisher=Mail & Guardian Online
url=http://www.mg.co.za/articlepage.aspx?area=/breaking_news/breaking_news__national/&articleid=280903
date=2006-08-16] . This led to President Thabo Mbeki sidelining the health minister to take focus away from her advocated treatment. Many leading scientists and political figures called for her removal from her post; however she was not removed from office until Mbeki himself was removed from office. [ [http://news.scotsman.com/topics.cfm?tid=460&id=1344522006 Garlic AIDS cure minister sidelined] 12 Sep 2006] President Mbeki and Health Minister Tshabalala-Msimang dismissed Deputy Health Minister Nozizwe Madlala-Routledge in early August, 2007. Madlala-Routledge has been widely credited by medical professionals and AIDS activists for energizing South Africa's response to AIDS over the last two years. [ [http://www.forbes.com/feeds/ap/2007/08/12/ap4011089.html Mbeki Gives Reason for Firing Minister] August 12 2007] Routledge reports of having clashed with her boss Tshabalala-Msimang, leading to allegations that her removal was a "setup". [ [http://www.int.iol.co.za/index.php?set_id=1&click_id=125&art_id=nw20070808223254301C831843 Madlala-Routledge was 'set up': De Lille] August 08 2007]

Demographics of HIV

According to the study of The South African Department of Health study, 13.3% of 9,950 Africans that were included in the poll had HIV. Out of 1,173 whites, 0.6% had HIV. [http://www.avert.org/safricastats.htm The South African Department of Health Study, 2006] ]

1985 First AIDS Advisory Group

In 1985, a State of Emergency was declared in South Africa as a result of riots and unrest that had arisen in response to Apartheid, the system of racial segregation that had been in place since the 1950s. In the same year, the government set up the country’s first AIDS Advisory Group in response to the increasingly apparent presence of HIV amongst South Africans. The first recorded case of AIDS in South Africa was diagnosed in 1982, and although initially HIV infections seemed mainly to be occurring amongst gay men, by 1985 it was clear that other sectors of society were also affected. Towards the end of the decade, as the abolition of Apartheid began, an increasing amount of attention was paid to the AIDS crisis.

1990 First National Antenatal Surveys

In 1990 the first national antenatal survey to test for HIV found that 0.8% of pregnant women were HIV-positive. It was estimated that there were between 74,000 and 120,000 people in South Africa living with HIV. Antenatal surveys have subsequently been carried out annually.

1993

In 1993 the HIV prevalence rate among pregnant women was 4.3%. By 1993 the National Health Department reported that the number of recorded HIV infections had increased by 60% in the previous two years and the number was expected to double in 1993.

1995 International AIDS Conference

The International Conference for People Living with HIV and AIDS was held in South Africa in 1995, the first time that the annual conference had been held in Africa. The then Deputy President Thabo Mbeki, acknowledged the seriousness of the epidemic, and the South African Ministry of Health announced that some 850,000 people - 2.1% of the total population - were believed to be HIV-positive.

By 1996 the HIV prevalence rate among pregnant women was 12.2%. By 1997 the HIV prevalence rate among pregnant women was 17.0%. By 1999 the HIV prevalence rate among pregnant women was 22.4%.

2000 AIDS 5 Year Plan

In 2000 the Department of Health outlined a five-year plan to combat AIDS, HIV and STIs. A National AIDS Council was set up to oversee these developments. But since then, President Mbeki and his administration have been repeatedly accused of failing to respond adequately to the epidemic. In April 2000 at the International AIDS Conference in Durban, President Mbeki made a speech that avoided reference to HIV and instead focused on the problem of poverty, fuelling suspicions that he saw poverty, rather than HIV, as the main cause of AIDS. President Mbeki defended a small group of dissident scientists who claim that AIDS is not caused by HIV.

Retrovirals

President Mbeki's government was applauded by AIDS activists for its successful legal defence against action brought by transnational pharmaceutical companies in April 2001 of a law that would allow cheaper locally-produced medicines.

AIDS advocates, particularly the Treatment Action Campaign and its allies, campaigned for a program to use anti-retroviral medicines to prevent HIV transmission from mother to child; and then for an overall national treatment program for AIDS that included antiretrovirals. In 2002 South Africa's High Court ordered the government to make the drug nevirapine available to pregnant women to help prevent mother to child transmission of HIV. Despite international drug companies offering free or cheap antiretroviral drugs, the Health Ministry remained hesitant about providing treatment for people living with HIV. In November 2003, the government finally approved a plan to make antiretroviral treatment publicly available. Until 2003, South Africans with HIV who used the public sector health system could get treatment for opportunistic infections they suffered because of their weakened immune systems, but could not get antiretrovirals, designed to specifically target HIV.

*The HIV prevalence rate in 2003 among pregnant women was 27.9%.
*By 2005 the HIV prevalence rate among pregnant women was 30.2%.
*In 2006 the HIV prevalence rate among pregnant women was 29.1%.

References

Further reading

* Pieter Fourie, "The Political Management of HIV and AIDS in South Africa: One burden too many?" Palgrave Macmillan, 2006, ISBN 0230006671

External links

* [http://www.aidsportal.org/overlay_details.aspx?nex=22 AIDSPortal South Africa page - latest research, guidelines and case studies]

See also

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*46664 (concerts)