Address by the Deputy President of South Africa, Kgalema Motlanthe, at the 5th International AIDS Society Conference
19 July 2009Thank you Programme Director;
Minister Aaron Motsoaledi,
Ladies and Gentlemen:
On behalf of the government of South Africa I welcome you all to our country and to the 5th International AIDS Society Conference being held in the Mother City, the beautiful city of Cape Town.
To our international guests I do hope that you will find the people of Cape Town warm and friendly, and have a wonderful time in this city, and that you will also be able to make time to visit other parts of our country during your stay in his country.
I wish to thank the organisers of this seminal event for inviting me to open this very important conference.
I would also like to welcome you as the chairperson of the South African National AIDS Council (SANAC).
HIV and AIDS is indeed a challenge that has distinguished the last two decades of the last century and unless we redouble our efforts to conquer this disease it will continue to define the 21st century as well for sub-Saharan Africa in particular.
This is one challenge we must overcome as soon as humanly possible in order to produce an HIV and AIDS-free generation.
Indeed, conferences such as this one do assist us to achieve this end.
The aim of this conference is to provide new insights into what exactly this disease is – or as scientists call it, its pathogenesis.
It has become clear as we struggle to find a vaccine and microbicides that we need to better understand the virus and how it functions.
But this is not enough. We must also understand the social dimensions of this disease.
This requires a comprehensive understanding of the virus, its epidemiology and the social implications of being infected and affected.
I am pleased that South African researchers are playing a vital role in trying to understand the pathogenesis of the virus as well as participating in clinical trials with respect to both vaccines and microbicides.
Equally I am pleased that many of these clinical trials are taking place in South Africa and under strict ethical rules.
In this context let me congratulate the South African AIDS Vaccine Initiative (SAAVI) which is partly funded by government and hosted by our Medical Research Council who will be launching two new vaccine trials in Langa ownship nearby tomorrow.
We wish them all the best in their attempts to find vaccines and microbicides that work.
As I am sure is largely well known by now, the South African response is guided by the National Strategic Plan for HIV and AIDS and STIs, 2007 to 2011.
The plan was drafted with extensive consultation and participation under the leadership of SANAC.
It therefore represents what all sectors of society want to achieve and will work towards achieving.
This plan sets ambitious targets of halving the HIV incidence by 2011 as well as providing care, treatment and support to 80% of people living with HIV & AIDS.
The Comprehensive Care Management and Treatment of HIV and AIDS Operational plan, which is largely run by the Department of Health, has been in effect since 2004.
Since its implementation, more than 780 000 people have accessed antiretroviral therapy in the public health sector, among them approximately 68 000 children.
This represents about half the number of people that we estimate need access to services.
It therefore means that this number should double by 2011 to enable us to reach our target of 80% coverage by 2011.
I am pleased to say that the private health sector, funded by private medical insurance and the business sector, has also played their part in funding and initiating patients on treatment.
I am sure that more can be done by the private sector and we shall work with them to find ways of doing this.
These numbers of patients on treatment have been matched with a massive scale up of access to laboratory services supplying CD4 tests, Viral load and Polymerase Chain Reaction or PCR.
For a middle-income country this is no mean feat and illustrates the commitment of this government.
It is also illustrative of the commitment of our development partners, both bi-lateral and multi-lateral to assist us to achieve our objectives.
I wish to publicly thank all our partners tonight for your sterling efforts.
Challenges, however, remain. These include: getting more of our people tested, starting treatment as early as possible, improving adherence, decreasing loss to follow-up, improving laboratory turn-around-times and strengthening drug supply management.
Every one of these challenges is receiving the necessary attention.
As I said we need a comprehensive approach to HIV and AIDS.
This means that as we invest in treatment we must also invest in prevention and care and support.
We have established Provincial and District AIDS Councils which parallel the national AIDS Council, SANAC.
They too have been doing good work in galvanising our efforts at provincial and local levels.
However, there needs to be greater synergy between our national, provincial and local efforts with more resources dedicated to efforts at the latter two levels.
This is where social mobilisation has the greatest traction and our prevention programme can achieve its objective of decreasing incidence by 50% by 2011.
We have a large number of very successful prevention programmes, some led by government but many by non-governmental organisations.
At the risk of not mentioning your favourite programmes allow me to single out the Government’s Khomanani programme, Soul City and LoveLife.
The latest HSRC community survey that has just released its report does indeed indicate that the penetration of these programmes is very high.
So we know that awareness of HIV is high in our country.
What we need in addition are programmes or re-programming to ensure that behaviour change follows.
In this regard the additional risks issues such as multiple concurrent partners are very important to highlight.
The Prevention of Mother To Child Transmission (PMTCT), given that it links HIV and mother and child health, can be used as a key catalyst to fast-track improvements in the health system and in health outcomes that the Millennium Development Goals commit us all to.
It can also be used to demonstrate that success can be achieved in the public sector.
We have begun work on strengthening our PMTCT programme and the Minister of Health will soon officially launch our accelerated Plan to ensure that we meet the targets set in the National Strategic Plan for HIV and STIs.
The importance of the virtual elimination of mother to child transmission of HIV was reinforced to me in my meeting with the Executive Director of UNAIDS, Dr. Michael Sedibe.
We agreed during our meeting that South Africa must ensure that we dramatically decrease the number of infants that are infected so that we can indeed have a generation free of AIDS.
We also know that there is a high degree of co-infection between TB and HIV.
We wish to stress that TB is curable even in the context of co-infection with HIV but additional measures to ensure that HIV patients are tested for TB and TB patients are tested for HIV must become the norm.
Our policy is to integrate these services with due regard to proper infection control.
On both accounts we need to accelerate progress going forward.
In this regard, I will be proposing to the plenary meeting of the SANAC to be held at the end of this month so that we also focus our attention as SANAC on TB.
With respect to the national TB programme I was briefed, last Thursday, on the results of the recent World Health Organisation/Stop TB Partnership led external review of the national TB control programme.
Whilst the review found that the programme has been strengthened since the last external review in 2005, with improved cure rates and decreased defaulter rates, they also found continuing challenges.
These include: the need for a more coherent strategy for TB/HIV integration; strengthened infection control; strengthening TB control in the mining industry as well as in the correctional services.
Additionally, the review team that briefed me reminded me about the relationship between poverty and TB.
To strengthen care and support programmes, the Department of Health and the Department of Social Development provide home and community based care services.
These Departments work in partnership with over 3 000 non-governmental organizations and community based organisations which provide services to households and communities.
More than 50 000 Community Care Givers have been trained to provide support to community members suffering from a range of chronic health conditions.
This programme contributes to the creation of work opportunities and currently has 1.3 million beneficiaries.
At the basis of all health programmes must be strong health systems.
In addition, we need strong social and equitable economic systems to underpin our health systems.
It is clear that health conditions and outcomes are related to a range of social determinants.
These include work opportunities, healthy working environments, access to educational opportunities especially for women and the girl-child, proper housing, access to safe water and proper sanitation etc.
The report by the Commission on the Social Determinants of Health released last year by the World Health Organisation makes it plain that as a society we need to improve social and economic circumstances for the poor.
I am happy to say that this is one of the priorities of our government for the next 5 years.
Together we can achieve this objective.
I would like to end by wishing you all fruitful deliberations, confident that this conference will achieve the objectives it has set itself.
With the dedication and wisdom of like-minded individuals and peoples I am sure that we will succeed in eliminating the scourge of HIV and AIDS.
I thank you for your attention.