The HIV epidemic in South Africa has in the last six years shown stabilisation and the country is on its way to reaching the Aids Millennium Development Goal of reducing the HIV prevalence rate to 25% by 2015.
According to the 2011 National Antenatal Sentinel HIV Prevalence Survey, 29.5% of pregnant women attending state clinics in 2011 were HIV-positive. The survey estimated that about 5.6-million people living in South Africa were HIV-positive in 2011.
Government has made major changes to its HIV and Aids policy - including Cabinet's approval of the rollout of anti-retroviral treatment (ART) in 2005 to those who need it - and the results are beginning bear fruit.
Linking various interventions such as behaviour change communication and HIV Counselling and Testing (HCT) with the Prevention of Mother-to-Child Transmission (PMTCT) and the Antiretroviral Therapy, has created a continuum of prevention and care services.
Through the PMTCT, the country is moving closer to its goal of less than 2% transmission by 2015. The rate of infection of mother to child transmission has dropped from 8% in 2008 to 3.5% in 2010 and 2.7% in 2011.
During World Aids Day on 1 December 2009, President Jacob Zuma announced bold and life changing policies for people living with HIV and AIDS. He directed that as from April 2010 patients infected with TB and HIV and Aids would be able to receive ARV treatment when their CD4 count was at 350 or less.
Prior to the announcement treatment was only available when one's CD4 count was less than 200.
Another government intervention was to have TB and HIV and Aids being treated under one roof to address early reported deaths arising from undetected TB infection among those infected with HIV.
Thanks to the new change in policy, all pregnant HIV positive women with a CD4 count of 350 or with symptoms regardless of their CD4 count now have access to treatment, unlike before when HIV positive pregnant women were only eligible for treatment if their CD4 count was less than 200.
All other pregnant women not falling into this category, but who are HIV positive, are now being put on treatment at 14 weeks of pregnancy to protect the baby. In the past, this only started during the last term of pregnancy.
All children under the age of one now receive treatment if they test positive and initiating treatment is no longer determined by the level of CD cells.
In 2010, Zuma launched the HCT campaign which aims to have more people know their status, among other things. By September 2012, more than 20 million South Africans had come forth to be screened and tested for various diseases, including HIV.
The President also launched the new National Strategic Plan (NSP) for HIV and Aids 2012 - 2016, on World Aids Day in 2011, which proposed to deal with HIV, sexually transmitted infections and TB by adopting a holistic approach which includes preventative and therapeutic measures.
The NSP brings together five succinct goals and four aims, whose combined purpose is to quash new HIV infections. The five goals are:
- Reduce new HIV infections by at least 50% by using a combination of prevention approaches;
- Initiate at least 80% of eligible patients on antiretroviral treatment with 70% being alive and on treatment five years after initiation;
- Reduce the number of new TB infections as well as deaths from TB by 50%;
- Ensure an enabling and accessible legal framework that protects and promotes human rights in order to support the implementation of the NSP, and
- Reduce self-reported stigma related to HIV and TB by at least 50%.
The NSP also has four goals, which are address social and structural barriers to HIV, STI and TB prevention, care and impact; prevent new HIV, STI and TB infections; sustain health and wellness, and increase the protection of human rights and improve access to justice.
The country had also adopted the 'three zeros' approach agreed to at the United Nations high-level meeting in New York as a vision for the next 20 years. A fourth zero - which aims to eliminate HIV transmission from mother to child - was also added by South Africa.
The four zeros are: zero new HIV and TB infections; zero new infections due to mother to child transmission; zero preventable deaths associated with HIV and TB, and zero discrimination associated with HIV and TB.
To date, 1.9 million people are now enrolling onto the anti-retroviral programme. This has lead to a decrease of more than 41% in new HIV infections in the past two years.
A report recently released by the Joint United Nations Programme on HIV/Aids (UNAIDS)'s 2012 World Aids Day notes an increase in South Africa' sustained investments on HIV treatment, such as antiretroviral therapy, which have led to many lives being saved in the past six years.
It noted that South Africa was on track to reach its target of supplying of ARVs to 2.5 million people by the year 2014.
Deputy President Kgalema Motlanthe, who was speaking at the 2012 World Aids Day celebrations in Potchefstroom, attributed the increase in life expectancy from 56 to 60 years between 2008 and 2011 to expanding access to ARV treatment.
Single dose treatment
The Department of Health recently announced the introduction of a single dose of the triple combination of tenofovir, entricitabine and efavirenz for people living with HIV, expected to start from April next year.
The new drug will enable people living with HIV to take only one pill a day to maintain their health, this will help government to save up to R2.2 billion over two years with a 38% reduction in drug costs.
South Africa has also used best practice and evidence to guide its interventions such as the home-grown circumcision programme which has reached 619 000 medical male circumcision.
This year's World Aids Day focused on urging young people and men to get tested so they know their HIV status.
The event was held under the theme 'A re Dlale - Safe for Zero new HIV and TB infections', through this theme, government is trying to appeal to young people by making use of the theme that combines tsotsi taal, African Languages and English, as it wants young people to play very safe for zero new infections.