Prof. Bheki Mngomezulu
Every year on December 1 the global community observes World Aids Day. The event is used to reflect on progress made in curbing the pandemic, identify lessons learnt and table proposals on what should be done.
Globally, the first Aids Day was observed on December 1, 1988, under the theme: “Join the Worldwide Effort.” At the time, South Africa was a pariah state and thus not part of the global community in many respects.
Following the advent of democracy in 1994, two years later in 1996, the South African Department of Health organised a special event called “The National World Aids Day.” The event was held in two cities: Bloemfontein in the Free State, and Pretoria in Gauteng. Since then, this has become an annual event.
In Africa, HIV/Aids treatment began in 2002. The first African country to take the pandemic seriously was Botswana which established a national HIV/Aids programme called “Masa,” a Setswana word for “a new dawn.” This was Botswanan government’s response to the highest HIV/Aids prevalence cases in the country at the time.
Other countries on the continent followed suit. The brief background means that the year 2023 marks the 35th anniversary of the World Aids Day event if we count from 1988. It was being organised under the theme: “Let communities lead, a clarion call to invest in and strengthen community-centred approaches in the management of HIV.”
The theme is relevant and timely, especially at a time when the call for Africanisation and decolonisation is gaining momentum. In the past, many decisions have been taken in the boardrooms while local communities were left out. The inclusion of communities in trying to address the HIV/Aids pandemic is a welcome development.
If HIV/Aids has divided nations, South Africa has had its fair share of those challenges. When President Thabo Mbeki was in office, there was an uproar following his statement that rather than addressing the pandemic medically, it was important to address some of the causal factors such as poverty and inequality. At times he was misconstrued, at other times he was deliberately contradicted for political expediency.
When Jacob Zuma became president, he took a different approach. His administration put resources into the treatment campaign. Public hospitals upped their game in testing patients and then providing them with antiretroviral treatment. However, for one to qualify, the CD4 count had to be less than 500 cells per mm3.
The year 2016 marked a new epoch in the fight against HIV/Aids in South Africa. During this year, new changes in the treatment guidelines were introduced. Key among them was that anyone who needed treatment had to get it immediately and not wait for the CD4 count to drop below 500 cells per mm3. Since then, South Africa’s response to HIV/Aids has improved significantly.
The results of a study conducted by the Human Sciences Research Council (HSRC) and other partners between 2017 and 2022 attest to the claim made above. The results show that in 2017, South Africa recorded 14.0% HIV cases. By last year, this figure had gone down to 12.7%. These figures translated to 7.9 million people living with HIV in 2017 compared to the reduced figure of 7.8m people in 2022.
A close analysis of the HSRC data presents interesting discussion points. For example, the report states that in South Africa, the availability of HIV treatment medication has resulted in those people who are 15 years and older being virally suppressed compared to 61% in 2017. According to this study, viral suppression was higher among women at 83% compared to men who recorded 79% – with men aged 25-34 years recording 66% of those who were virally suppressed.
HSRC researchers and their colleagues tried to understand the causal factors for this promising picture. Their observation was that there are few new infections within the population. There are more children who are born HIV-negative than has been the case before. Half of the men aged 15-24 were found to be medically circumcised in 2022 compared to only 43% in 2017. This was a huge improvement. The study concluded that South Africa is on the right track to meet the UNAids target of 95% of all people living with the pandemic being on Antiretroviral treatment ART and 95% of those infected knowing their status. The study also revealed that 90% of South African people living with HIV from 15 years and above know their status, 91% are on ART and of that number, 94% are virally suppressed.
While these results are encouraging, they should not lead to complacency. More work still needs to be done by everyone!
*Prof.Mngomezulu is Director of the Centre for the Advancement of Non-Racialism and Democracy at the Nelson Mandela University
**The views expressed do not necessarily reflect the views of Independent Media or IOL