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IKHALA TRUST A not-for-profit community micro fund operating in the Eastern Cape Province of South Africa

HIV/Aids in South Africa The facts: 

HIV/Aids in South Africa The facts At least 5,5 million people living with HIV in SA Estimated 1000 deaths per day 1 in 5 people infected A staggering 71% of deaths between ages15-49 caused by AIDS In parts of SA, cemeteries are running out of space for the dead In a recent survey it was found that S Africans spent more time at funerals, than they did having their hair cut, shopping or socialising

HIV/Aids in South Africa: 

HIV/Aids in South Africa Average life expectancy in SA – 54 yrs Over half of 15 year olds are not expected to reach 60 yrs 2006 estimated that 21% of teachers were living with HIV

History of HIV in SA: 

History of HIV in SA 1982 – 1st recorded case of Aids 1992 – Government’s 1st significant response came when Nelson Mandela addressed the newly formed National Aids Convention of SA. A free national Aids helpline was founded

History of HIV in South Africa: 

History of HIV in South Africa 1995 – The Ministry of Health announced that some 850 000 people – 2,1 % of the total population were believed to be HIV positive 1998 – Pressure Group – Treatment Action Campaign (TAC) was founded. 1500 new HIV infections were occurring every day

History of Aids in South Africa: 

History of Aids in South Africa 2000 – Dept of Health outlined 5 year plan to combat AIDS, HIV and STIs. A National Aids Council set up to oversee these developments.

History of AIDS of South Africa: 

History of AIDS of South Africa 2002 – South Africa’s High Court ordered the govt to make the drug nevirapine available to pregnant women 2003 – November – Govt finally approved a plan to make ARV treatment publicly available. 2004 – Treatment program began taking effect in Johannesburg in March.

History of Aids in South Africa: 

History of Aids in South Africa 2005 – At least 1 service point for AIDS related care and treatment had been established in all of the 53 districts 2006 – Jacob Zuma, former SA Deputy-President, went on trial for allegedly raping an HIV-positive woman. Govt announced a draft framework. Civil society groups claimed that this marked a turning point in the Government’s response

Why did SA’s AIDS epidemic go unchecked for so long?: 

Why did SA’s AIDS epidemic go unchecked for so long? Most rapid increase in SA’s HIV prevalence took place between 1993 and 2000 during which time the country was distracted by major political changes South African people and the world’s media was focused on the political and social changes occurring in the country, HIV was rapidly becoming widespread. Results of these political changes were positive, the spread of virus not given attention it deserved, impact of the epidemic not acknowledged.

HIV/AIDS Support Group: 

HIV/AIDS Support Group People living with Aids (PWAs) groups are established and functioning in almost all communities

HIV Treatment in South Africa: 

HIV Treatment in South Africa SA government only started in 2004 Around 33% of people in need receiving treatment at the end of 2006. Govt initially reluctant to provide drugs to prevent HIV-positive mothers Slow provision linked to unconventional views about HIV and AIDS Health Minister promoting nutrition rather than ARV drugs as a means of treating HIV.

HIV Testing in South Africa: 

HIV Testing in South Africa Voluntary Counselling and Testing sites has increased significantly in recent years with 4172 operational by November 2006 – concerns regarding quality of services. Women accessing testing more readily than men in SA. Researchers believe that this is due to fears amongst men that their HIV positive status will be disclosed through testing and that stigmatization will follow. Surveys also suggest that some men see no value in knowing their status, viewing this as a burden

HIV prevention campaigns in SA: 

HIV prevention campaigns in SA The issue of prevention in SA has attracted less controversy and debate than other aspects of the country’s response to AIDS. Some notable national efforts include:- However the prevailing high rates of HIV found across SA suggest that either the message isn’t getting through to many people, or that people are receiving information but not acting upon it. In December 2005 the Global Fund withdrew its funding from loveLife.

HIV prevention campaigns in SA: 

HIV prevention campaigns in SA Difficult to carry out HIV prevention campaigns in SA: Population is highly diverse and divided by deeply rooted social inequalities. SA has a mixture of ethnic backgrounds: black people account for 75% of the population; whites make up around 13%; Asians make up about 3% and other people of mixed racial heritages account for 9%. There are 11 official languages and many dialects; around 86% of the population is literate Diversity has made it very difficult to carry out AIDS awareness campaigns that actually influence people’s behaviour


STIGMA AND DISCRIMINATION IN SOUTH AFRICA The prevalence of misinformation about AIDS in SA hampered efforts to increase access to treatment, but has also creates climate of confusion in which prejudice towards people living with HIV thrives. HIV is sometimes seen as a disease of the poor. In SA, there is some correlation between extreme poverty and high HIV prevalence, although HIV is prevalent in all sectors of society. By 1998, although people from more affluent, largely white society were starting to come out as being HIV-positive, stigmatization of the condition remained deeply rooted in township areas. In October 1998, the then Deputy President Thabo Mbeki made the Declaration of Partnership Against AIDS, in which he called for an end to discrimination against people living with HIV. Less than 2 months later, Gugu Dlamini an AIDS activist in Durban, was beaten to death by her neighbours after declaring that she was HIV positive on World Aids Day.


STIGMA AND DISCRIMINATION IN SOUTH AFRICA In 2000, Justice Edwin Cameron of the SA court announced in a speech that he was HIV-positive – public largely supportive A study in 2002 revealed that only 1/3 of respondents who revealed their HIV-positive status were met with a positive response in their communities – 1 in 10 met with outright hostility and rejection When Nelson Mandela’s son died in 2005 the publicized the cause of death in an effort to challenge the stigma that surrounds HIV infection.


GENDER EQUALITY AND SEXUAL ABUSE IN SOUTH AFRICA Women and girls in SA are often unable to negotiate safer sex and are frequently involved with men who have several sexual partners. They are particularly vulnerable to sexual abuse and rape and are economically and socially subordinate to men. Police reports in 2004-2005 suggest that there were at least 55,114 cases of rape in SA In a 2006 study of 1 370 SA men, nearly 1/5 revealed that they had raped a woman Rape plays a significant role in the high prevalence of HIV among women in SA.


GENDER INEQUALITY AND SEXUAL ABUSE IN SA Women often face more discrimination than men if they are known to be HIV-positive Since antenatal testing gives them a greater chance of being identified as HIV positive, women are sometimes branded as spreaders of the infection Govt acknowledged that women face “triple oppression” in South African society – oppression on the grounds of race, class and gender – and has been making efforts to address the problem through education and skills development schemes. In September 2007, rape laws were strengthened to stop judges and magistrates taking into account factors such as a rape victim’s sexual history, their apparent lack of physical injury, or the relationship between the victim and the perpetrator, when deciding on the length of the perpetrator’s sentence.


CHILDREN, HIV AND AIDS IN SOUTH AFRICA Antenatal surveys revealed around 260 000 children aged below 15 living with HIV in South Africa in 2006 Pediatric ARV treatment still a shortage in SA UNAIDS estimates that at the end of 2005, children accounted for 8% of those receiving ARV drugs in SA UNAIDS estimated that there were 1.2 million SA children orphaned by AIDS in 2006 compared to 780 000 in 2003.

Treatment in South Africa: 

Treatment in South Africa Aspen Pharmacare main factory in my city of Port Elizabeth – biggest pharmaceutical manufacturer in the southern hemisphere and the only generic company currently manufacturing and supplying ARV drugs to the SA state hospitals and clinics Received licences from 3 multi-nationals viz Bristol Myers, Boehringer Ingelheim and GSK – companies hold patent but rights and licence given to Aspen to manufacture.

Treatment in South Africa: 

Treatment in South Africa Situation changing has Indian players now tapping into SA markets due to licences granted and are more competitive than local manufacturers Locally produced drugs will prevent bureaucratic delays and cases were Aids drugs are expiring on shelves due to poor co-ordination between aid agencies and governments.

The way forward for South Africa: 

The way forward for South Africa The high level of new infections occurring in SA reflects failure of prevention and education strategies. The high number of AIDS deaths occurring in the country reflects the continuing lack of ARV treatment available The future of the epidemic at least partly depends on the direction of the government’s HIV and AIDS policies. New national framework to guide a national response to AIDS from 2007 – 2011 – suggests that Government is now more committed to improving the situation. The question for many “is a not a little too late for so many thousands who are already sick and infected”

Eastern Cape Context: 

Eastern Cape Context Population of 6,4 million 64% of population live below a dollar a day Unemployment at around 49% 96 000 people requiring treatment 110 000 receiving treatment in S.A.

Ikhala Trust: 

Ikhala Trust Thank you for the attention and for listening to our story

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