Feature story

President heralds new era in South Africa’s AIDS response

01 November 2009

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(from left) President of South Africa, Jacob Zuma; UNAIDS Executive Director, Michel Sidibé; and Minister of Health South Africa, Dr Aaron Motsoaledi meet at the opening of the UN General Assembly in New York, 24 September 2009.
Credit: UNAIDS

South Africa’s response to AIDS received a powerful boost with President Jacob Zuma’s landmark speech to the National Council of Provinces on 29 October 2009. The speech heralds the beginning of a new movement to accelerate access towards universal access to HIV prevention, treatment, care and support in the country which has the largest number of people living with HIV. In his speech the President calls on all leaders to work together and use evidence to inform the country’s AIDS response.

Congratulating the President on his bold leadership, UNAIDS Executive Director Michel Sidibé said, “President Zuma has shown extraordinary vision in prioritizing AIDS as an issue of national importance. His call to end denialism and embark on a national mobilization campaign will saves thousands of lives.”

In his speech the President called for a major movement to cut new HIV infections by half and reach at least 80% access to antiretroviral treatment. UNAIDS will support the Government of South Africa in implementing this promise.

Here are some excerpts from speech of President Zuma of South Africa to the National Council of Provinces.

The full speech can be accessed online

President Zuma has shown extraordinary vision in prioritizing AIDS as an issue of national importance. His call to end denialism and embark on a national mobilization campaign will saves thousands of lives.

Michel Sidibé, UNAIDS Executive Director

“Our young democracy faces significant challenges. Though we have achieved much, there is much more that we need to do. Just as we cannot allow ourselves to be overwhelmed by these challenges, we dare not underestimate them. If we are to build the thriving nation for which we have worked so hard, and for which so many have sacrificed so much, we need to appreciate the extent and nature of these challenges.

I would like to highlight two critical challenges, both of which, in different ways, have the potential to undermine our efforts to achieve a better life for our people.

The first of these challenges relates to our economy. The global economy is going through a major economic crisis. The impact of this crisis has been felt by every section of our society. Businesses, both big and small, have been closed. Thousands of workers have lost their jobs. As more families lose their livelihoods and businesses risk collapse, they look to government for assistance….”

“The second challenge that I wish to highlight is no less grave. Indeed, if we do not respond with urgency and resolve, we may well find our vision of a thriving nation slipping from our grasp.

Recent statistics from the Department of Health, Human Sciences Research Council, Medical Research Council, Statistics SA and other sources paint a disturbing picture of the health of our nation. They show that nearly 6 out 10 deaths in our country in 2006 were deaths of people younger than 50 years. If we consider mortality trends over the last decade, we see that the age at which people die has been changing dramatically. More and more people are dying young, threatening even to outnumber in proportional terms those who die in old age.

Honourable Members, South Africans are dying at an increasing rate. The number of deaths registered in 2008 jumped to 756,000, up from 573,000 the year before.

At this rate, there is a real danger that the number of deaths will soon overtake the number of births. The births registered during this period were one million two hundred and five thousand one hundred and eleven (1, 205, 111). The Independent Electoral Commission had to remove 396 336 deceased voters from the Voters Roll during September last year and August this year.

What is even more disturbing is the number of young women who are dying in the prime of their life, in their child-bearing years. In 2006, life expectancy at birth for South African men was estimated to be 51 years. By contrast, life expectancy in Algeria was 70 years and 60 years in Senegal. These are some of the chilling statistics that demonstrate the devastating impact that HIV and AIDS is having on our nation.

Not even the youngest are spared. Some studies suggest that 57% of the deaths of children under the age of five during 2007 were as a result of HIV. This situation is aggravated by the high tuberculosis prevalence. The co-infection rate between HIV and TB has now reached a staggering 73%. Statistics indicate that the numbers of citizens with TB number at 481 584. These statistics do not, however, fully reveal the human toll of the disease. It is necessary to go into the hospitals, clinics and hospices of our country to see the effects of HIV and AIDS on those who should be in the prime of their lives.

It is necessary to go into people’s homes to see how families struggle with the triple burden of poverty, disease and stigma. Wherever you go across the country, you hear people lament the apparent frequency with which they have to bury family members and friends.

Let me emphasize that although we have a comprehensive strategy to tackle HIV and AIDS that has been acknowledged internationally, and though we have the largest anti-retroviral programme in the world, we are not yet winning this battle. We must come to terms with this reality as South Africans.

We must accept that we need to work harder, and with renewed focus, to implement the strategy that we have developed together. We need to do more, and we need to do better, together. We need to move with urgency and purpose to confront this enormous challenge.

If we are to stop the progress of this disease through our society, we will need to pursue extraordinary measures. We will need to mobilize all South Africans to take responsibility for their health and well-being and that of their partners, their families and their communities.

All South Africans must know that they are at risk and must take informed decisions to reduce their vulnerability to infection, or, if infected, to slow the advance of the disease.

Most importantly, all South Africans need to know their HIV status, and be informed of the treatment options available to them. Though it poses a grave threat to the well-being of our nation, HIV and AIDS should be treated like any other disease. There should be no shame, no discrimination, no recriminations. We must break the stigma surrounding AIDS.

In just over a month, we will join people across the globe in marking World Aids Day. Let us resolve now that this should be the day on which we start to turn the tide in the battle against AIDS. Let us resolve now that this should be the day on which we outline those additional measures that need to be taken to enhance our efforts.

Let World Aids Day, on the 1st of December 2009, mark the beginning of a massive mobilisation campaign that reaches all South Africans, and that spurs them into action to safeguard their health and the health of the nation. Though a considerable undertaking, it is well within our means, and we should start now, today, to prepare ourselves for this renewed onslaught against this epidemic.

We have very impressive awareness levels in our country, well over 95%. We should now seriously work to convert that knowledge into a change of behaviour. We have demonstrated in the past that, working together as a nation, we can overcome even the greatest of challenges. We can and will overcome this one.

But we must begin by acknowledging the true nature of that with which we are confronted. We should not be disheartened by what we find. Rather, we should be encouraged to act with greater energy and motivation to overcome.

I have instructed the Minister of Health, as we prepare for World Aids Day, to provide further detail to the nation on the impact of HIV and AIDS on our people. He will do so next week.

The important factor is that our people must be armed with information. Knowledge will help us to confront denialism and the stigma attached to the epidemic.

Informed by this understanding, we expect that the South African National AIDS Council, under the leadership of the Deputy President of the Republic, Mr Kgalema Motlanthe, will develop a set of measures that strengthen the programmes already in place. We must not lose sight of the key targets that we set ourselves in our national strategic plan.

These include the reduction of the rate of new infections by 50%, and the extension of the antiretroviral programme to 80% of those who need it, both by 2011. Prevention remains a critical part of our strategy. We need a massive change in behaviour and attitude especially amongst the youth. We must all work together to achieve this goal.

As we prepare for World Aids Day, and as we undertake the programmes that must necessarily follow, let us draw on our experience of mass mobilization and social engagement. The renewed energy in the fight against AIDS and in mobilizing towards World Aids Day must start now, by all sectors of our society. Working together, we cannot fail.

Whatever challenges we face, we will overcome. Whatever setbacks we endure, we will prevail. Because by working together we can and will build a thriving nation.