Fighting Aids through policy 20 years on

Tuesday, March 11, 2014

A young South African woman tells Gabi Khumalo that there is life after HIV.

It’s been two weeks since Thabisile Majola* came back home after spending almost five days in hospital. Her parents and her younger brother are relieved to have her home.

But a week later, at about 10pm, as her mother prepares to go to bed, she hears screams coming from her daughter’s bedroom. At this stage, everyone knew it was time.

Thabisile’s condition has suddenly deteriorated. And as her father speeds off to hospital, everyone in the car wonders in silence whether she would come back home alive.

This was seven years ago, when Durbanite Thabisile, 34, was in a “war” with HIV.

She was a regular visitor to hospitals as the disease would from time to time try its luck on her life. At that stage, she was not eligible for Antiretroviral (ARV) treatment because her CD4 count was still at 300.  The lifesaving treatment was only available to patients with a CD4 count of less than 200, at the time.

Thabisile’s family had given up hope that she would ever recover. But her situation was to change in 2009, when during World AIDS Day, President Jacob Zuma had announced life changing policies for HIV/AIDS and the country was taking a new direction in the fight against the pandemic.

Like many of others, Thabisile had seen a number of people, including friends and her own family members, succumb to HIV. This, she says, was mostly due to lack of access to treatment and information about the disease.

“My brother contracted HIV in the early 90’s and at the time, we didn’t know much about the disease except that one would get it by sleeping around with multiple partners.

“Because of the stigma attached to the disease, he never disclosed his status. Only my parents knew but they were in denial and chose to believe that he had been bewitched by our neighbour.”

In 2003, the HI virus hit the family again. This time, it was Thabile’s sister. She tried to fight the disease by taking various immune system boosters. But without access to ARVs, she became weak and ill. By the time she was finally eligible to take the treatment, it was already too late. She lost the fight the following year, at the tender age of 20.

Since 2009, government has turned the tide in the fight against HIV. People like Thabisile say the ART and the prevention of mother-to-child transmission (PMTCT) programmes have had the most profound impact on the health of South Africans living with the virus.

Among the policies the current administration announced include that HIV positive people with a CD4 count of 350 or less start to receive ARV treatment - while pregnant women who have the virus regardless of their CD4 count - now have access to treatment. Women are also put on treatment at 14 weeks to protect the baby.

The number of people on ARV treatment has increased from 923 000 in February 2010, to a staggering 2.4 million in 2013, according to the 20 Year Review, released by the Presidency on Tuesday. The Review depicts the strides the country has made since the dawn of democracy, and also illustrates the challenges that have been faced.

Health facilities providing ARVs increased from 490 in February 2010, to just over 3 500 public facilities in 2013, says the report.

And government seems to have realised that the stigma which is still associated with HIV is probably the greatest danger in the fight against the virus.

This explains why the state launched the biggest HIV Counselling and Testing (HCT) campaign in April 2010, which has reached over 20.2 million South Africans.

Perhaps the good news is that HIV prevalence amongst the youth between the ages of 15-24 has declined from 9.7% in 2009 to 8.5% in 2013.

The country has also made progress in the Prevention of Mother-to-Child Transmission (PMTCT) Programme. The report says nationally, there has been a significant reduction in mother-to-child transmission of HIV from about 8% in 2008 to 2.5% in 2012. As a result, over 100 000 babies were protected from HIV infection.

Without the programme, people like Thabisile, and her child would not have survived.

She knew about the programme because the health professionals at the clinic where she collects ARVs, always encourages people  to  come out immediately when one suspects that she is pregnant.

“The minute I became aware of my condition, I informed them and was put on the programme and my boy was born HIV negative and he is very healthy.

“I followed all the instructions I was given after giving birth to my son and that saved his life….. the experiences I went through at  the time made me appreciate life more and now.  I know that HIV will never destroy me, not as long as I have my treatment. It ended with my brother and sister; I refuse to be the next statistic.” .

As is the case with TB, some HIV patients default in their medication as they complain about the amount of pills they have to take per day.

In April last year, the national department of health introduced the Fixed-Dose Combination (FDC) of ARVs. The FDC is a combination of all three antiretroviral pills - namely emtricitabine, efavirenz and tenofovir. It allows those on treatment to take one ARV pill on a daily basis instead of three or more tablets.

It was first administered to all newly diagnosed patients that were eligible to be put on ARV treatment, pregnant women and HIV positive breastfeeding mothers, and later rolled out to all patients on ARV treatment.

Thabisile started the FDC in November last year and says it’s much better than taking three pills. Her CD4 count is now over 400 and she says she feels stronger each day.

Thabisile has now intensified her fight against the disease.

She is speaking to young people about the importance of abstinence and safe sex and is looking forward to the years when she believes this country would have a zero new HIV infection rate.  –



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