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South Africa takes steps to tackle HIV

Government finally faces up to pandemic.

Cape town

South Africans face a brighter future now their government is set for serious action on HIV. Credit: C. DHARAPAK/AP

At last, the South African government seems to have agreed to tackle the AIDS pandemic in a whole-hearted manner. Admitting that “we all know that HIV and AIDS are among us”, deputy President Phumzile Mlambo-Ngcuka appealed to South Africans on 1 December, World AIDS Day, to “join hands to save our people, in the same way that we joined hands to fight and defeat apartheid”.

At a rally in Nelspruit, the capital of South Africa's Mpumalanga province, Mlambo-Ngcuka released a draft of the government's plan. The document contains only two targets: to halve the rate of infection, and to make antiretroviral treatment available to 80% of those who require it, both by the end of 2011.

Mlambo-Ngcuka also declared her intention to restructure the South African National AIDS Council to include representatives from the private sector, trade unions and non-governmental organizations. No information is available on how the targets will be met — the government plans to finalize the details by March. But the developments have been greeted with cautious optimism by AIDS activists and practitioners.

“If enough funds are provided, and if human resources problems — particularly relating to nurses — can be resolved, treatment targets are achievable,” says economist Nicoli Nattrass, director of the AIDS and Society research unit at the University of Cape Town.

South Africa has previously taken an ambivalent approach to HIV. President Thabo Mbeki has maintained a stony silence on the issue, and with no coordinated national strategy to provide antiretroviral drugs to patients, access to treatment has been patchy at best.

Many see the Worlds AIDS Congress, held in Toronto, Canada, in August, as a turning point. The government was embarrassed by health minister Manto Tshabalala-Msimang, who used it to extol the virtues of garlic, lemon and beetroot in the fight against AIDS. Mlambo-Ngcuka, who many see as a possible successor to Mbeki, quickly assumed responsibility for government policy on the issue.

She faces a tough task. A report released last week by the Actuarial Society of South Africa (ASSA) stated that 1.8 million people have died of AIDS in South Africa since the early 1990s. Between 800,000 and 1 million people need antiretroviral treatment but only a third of them — and a tenth of children — are getting it.

Slowing down rates of infection might be even more difficult. The ASSA estimates that half a million people became infected this year, down from 650,000 in 1998.

But the signs are promising. In 2005, 1.7 million people used government counselling and testing services, and this year the number of people treated for HIV nearly doubled. Last week the deputy health minister, Nozizwe Madlala-Routledge, became the first government minister to publicly undergo an AIDS test.

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