SA's big HIV/Aids 2030 plan

Wednesday, July 23, 2014

Pretoria - Health Minister Dr Aaron Motsoaledi says government has big plans to turn the tide on HIV/Aids by 2030, in line with the target set by delegates at the International Aids Conference in Australia.

“The conference took a very far-reaching decision to add to the already existing international goals … that we need to bring an end to HIV/Aids by 2030.

“The conference defined what is meant by bringing an end to HIV/Aids by 2030. It means 90% of people know their status; 90% of those that are HIV positive are on treatment; 90% of those on treatment are virally suppressed,” said the minister.

He was speaking during his department’s Budget Vote in Parliament on Wednesday.

The 2030 goal coincides with the deadline for targets set out in the National Development Plan.

“So this international target agreed to in Melbourne coincides with this important date on our calendar,” he said.

The minister said while tremendous progress has been made in fighting HIV/Aids, it remained one of the biggest problems and much still needed to be done.

“We have 15 years to achieve these targets globally … Like elsewhere in the world, there are leakages in the HIV/Aids cascade. This needs to be fixed to ensure that those that are prioritised for HCT [HIV Counselling and Testing] are indeed tested, and those eligible for treatment are initiated on treatment and stay on treatment.

“Our next step is to increase coverage in the manner proposed by the 90% approach. This means testing most, if not all, of the population annually, initiating everyone who is positive on treatment regardless of CD-4 count and supporting all those that are on treatment.

“In summary, it will mean mass testing in every possible setting: schools, universities, workplaces, churches and communities,” said Minister Motsoaledi.

Early intervention

In a bold step towards achieving this goal, the minister announced that in January next year, the department will move all HIV positive pregnant women to the World Health Organisation’s option B+, as opposed to the current option B that is operational in the country.

“Option B+ simply means every pregnant HIV positive woman goes on  lifelong treatment, regardless of their CD4 status; whereas option B is that they stay on treatment only while breastfeeding and stop after termination of breastfeeding if their CD4 count is >350.

“Option B+ is lifelong treatment regardless of CD4 status,” said the minister.

Also, as from January next year, the department will start HIV positive patients on treatment at the CD4 count of <500, as opposed to the present CD4 count of <350.

Minister Motsoaledi said this was a milestone in the country’s fight against HIV/Aids.

He said the treatment of as many people as possible has been found by research to be also a form of prevention.

This massive treatment programme will be accompanied by a wide range of prevention techniques, including:

-             massive condom distribution;

-             HIV Counselling and Testing (HCT), preventing mother to child transmission (PMTCT), sexually transmitted infections (STI) management;

-             a massive medical male circumcision campaign, where the department will target four million men by 2016;

-             the provision of safe blood transfusion, and

-             mass education and communication, as well as social mobilisation.

Minister Motsoaledi said keeping girl children at school until matric decreased their chances of pregnancy and contracting HIV/Aids.

He acknowledged that this was a major goal, and government and civil society -- as represented by the South African National AIDS Council (SANAC) -- would have to be a well-oiled machine.

“The task ahead in the next 15 years is huge, and we cannot afford to be flat-footed at this period in the history of the pandemic.”

TB

The minister announced that government will be undertaking a massive campaign to decentralise the management of multi-drug-resistant TB (MDR-TB).

“Presently, we have 100 such decentralised cites, and we intend to increase them to 2 500. This will happen through a rapid establishment and scale-up of nurse-led MDR-TB treatment management teams at municipal ward level,” said the minister.

He said the department will also aim to screen all 150 000 inmates in correctional services facilities, all 500 000 miners and the 600 000-strong peri-mining communities in the six districts that have a high level of mining activity. – SAnews.gov.za