We've come a long way on HIV/AIDS - Jacob Zuma

President says HIV incidence rate dropped from 2.4% in 2001 to 1.5% in 2009

Address by President Jacob Zuma on the occasion of the 30th Anniversary of World AIDS Day and launch of National Strategic Plan for HIV and AIDS, December 1 2011

Honourable Deputy President
Ministers, Premiers, Deputy Ministers and MECs 
Executive Mayors and Councillors
Members of the South African National Aids Council
Traditional leaders,
Religious leaders
The People of the Eastern Cape province
Fellow South Africans

Good morning to you all.

On this day each year, the world gathers to reflect on progress made in the fight against HIV and AIDS, and to recommit to taking the battle forward.

Today is a special anniversary because it is 30 years since the virus that causes AIDS was discovered. The first documented case of what was later known as AIDS emerged on June 5, 1981 in Los Angeles, California.

It was a difficult and baffling moment for both ordinary people and the medical fraternity.

It has been a long, hard and painful road since then, with people battling to understand what was happening to them and their loved ones.

Finally, it appears that society worldwide has come to terms with HIV and AIDS.

In our own country, 30 years on, we can count some successes.

We are steadily overcoming fear and confusion. We have overcome divisions. We have stopped making HIV and AIDS a battlefield on which to fight one another.

Instead, we are now working together as government and all sectors through the South African National AIDS Council (SANAC). We have indeed come a long way.

The year 2009 was a turning point in our fight against HIV and AIDS.

On World AIDS Day 2009 we announced wide ranging changes to the treatment protocols of government.

We announced that all children under one year of age will get treatment if they test positive, and that treatment would not depend on the CD4 count.

We said all patients with both tuberculosis (TB) and HIV will get treatment with anti-retrovirals if their CD4 count is 350 or less.

We also announced then that all pregnant HIV positive women with a CD4 count of 350 or with symptoms regardless of CD4 count would have access to treatment.

HIV positive pregnant women were to become eligible for treatment if their CD4 count was less than 200.

All other pregnant women not falling into this category were to be put on treatment at fourteen weeks of pregnancy to protect the baby.

In the past this was only started during the last term of pregnancy.

We said in order to meet the need for testing and treatment, we would ensure that all the health institutions in the country were ready to receive and assist patients, instead of just a few accredited ARV centres.

The implementation of all these announcements was to be effective from April 2010.

I am pleased to report that we have made tremendous progress in all areas.

In April 2010, I launched a national HIV counselling and testing campaign which aimed to test 15 million people by June 2011.

More than 13 million people were tested for HIV and more than 8 million were screened for TB. This is a remarkable response by South Africans. It demonstrates how far advanced we have become in 30 years.

Knowing one's status is critical for both staying negative and living positively.

Besides knowing one's status, the testing campaign is important with regards to dealing with the stigma and discrimination.

The South African National AIDS Council, with the Department of Health as the lead department, are continuing to take testing to all corners of the country.

Regarding access to services and treatment, I am pleased to report that from January 2010 to September 2011, the number of public health facilities initiating patients on antiretroviral treatment has increased from 495 to 2 948.

In addition, while 290 nurses were accredited to initiate and provide treatment at the beginning of the campaign, we have now increased the number to nearly 10 542 nurses.

In addition, all public health facilities in South Africa now offer services to pregnant women, which includes HIV testing.

Where pregnant women are HIV positive, we offer CD4 testing, which determines whether the mother should go onto antiretroviral treatment.

Another landmark achievement is the 50 percent reduction in the transmission of HIV from mothers to children between 2008 and 2010.

The proportion of children whose mothers are HIV positive who were infected decreased from 8% in 2008 to 3.5% in 2010.

The availability of medicines has also improved considerably.

Government's procurement system is being improved to ensure a continuous supply of antiretroviral drugs to all facilities. These efforts have resulted in significant decreases in drug stock-outs from 33% in January to March 2010 to 4% by June 2011.

The reduction on the prices of anti-retrovirals by 53% will also contribute to increasing the number of people the government will be able to start on treatment.

Ladies and gentlemen, in another major achievement, between April 2010 and June 2011, more than 300 000 people were placed on preventive treatment to stop the activation of TB.

In 2009, only 23 000 people were on TB preventive therapy.


It is really encouraging that the work we have done as government, business, labour, religious sector and others is yielding fruit and is being recognised internationally as well.

The recently released World AIDS Day Report, 2011 of UNAIDS, entitled; ‘How to get to zero faster, smarter, better' has praised the work our country is doing.

The Report notes that the annual HIV incidence rate has dropped from 2.4 percent in 2001 to 1.5 percent in 2009.

The report also applauds South Africa for expanding access to treatment, referring to the measures that I have just outlined.

On the international front, the Report points out that the number of deaths due to AIDS has dropped from 2.2 million to 1.8 million.

It also states that 2.5 million deaths were averted in low and middle income countries, largely due to increasing access to treatment.

Equally encouraging is the news that the number of new infections globally has also dropped by 15% between 2001 and 2010.

Indeed, we have achieved a lot in the fight against HIV and AIDS as South Africans, and also globally.

As South Africans, we have worked hard to implement our five year National Strategic Plan against HIV and AIDS, which guided us from 2007 to 2011.

We have learnt a lot from implementing that plan. We know what works and know what we must do differently.

Drawing from those lessons, South Africans working together in SANAC have produced this document that we can all be proud of (see here - PDF).

We are today proud to unveil to the South African people, the new National Strategic Plan, which will provide direction from 2012 to 2016.

The new National Strategic Plan consists of five goals and four strategic objectives.

The five goals are:

  • Reduce new HIV infections by at least 50% using combination prevention approaches
  • Initiate at least 80% of eligible patients on antiretroviral treatment with 70% 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 implementation of the NSP and
  • Reduce self-reported stigma related to HIV and TB by at least 50%.

The four strategic objectives are the following:

  • 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.

We have also adopted the three zeros agreed to at the United Nations High Level Meeting in New York, in June this year, as our vision for the next 20 years.

In addition, we added, as a country, a fourth zero which aims to eliminate HIV transmission from a mother to a child.

The four zeros are the following:

  • Zero new HIV and TB infections
  • Zero new infections due to mother to child transmission
  • Zero preventable deaths associated with HIV and TB
  • Zero discrimination associated with HIV and TB.

Ladies and gentlemen,

Let me address a few of the key issues that will characterise the implementation of the National Strategic Plan over the next five years.

Firstly, while government will have to lead the effort and play a significant role in both providing resources and implementation, the National Strategic Plan belongs to all South Africans and all sectors.

We therefore urge all sectors of society to commit to its full implementation.

Secondly, I wish to draw to your attention, that unlike previous National Strategic Plans, this Plan focuses on TB as well. This was done because the co-infection between HIV and TB in our country is very high.

We cannot afford to deal with HIV and TB separately. I called for all facilities that treat TB to also treat HIV in 2009 and I am therefore pleased that this call has been taken to the next logical level.

Thirdly, we must prevent new infections.

Fourth, we must commit to dealing decisively with the social and structural barriers to HIV, STIs and TB.

One of social barriers is violence against women. I am pleased that this issue is reflected in the National Strategic Plan.

Recent research in South Africa shows that we could prevent HIV infections in young women if they were not subjected to violence or intimidation by their partners.

Government is prioritising the fight against the abuse of women and children, through law enforcement as well as education and awareness.

We must also enhance our socio-economic interventions to deal with poverty, unemployment, food insecurity and inequality. These either contribute to the spread of HIV or worsen impact of the epidemic.

With regards to the social impact, we urge society to support orphans and vulnerable children who have lost their parents to the epidemic.

We must ensure that these children are protected and are given every opportunity to prosper, despite losing their parents.

The Departments of Social Development, Basic and Higher Education in particular will do everything possible to ensure that they are supported.

I call on business and civil society to partner with government in this endeavour.

Another key priority is to deal with the stigma, discrimination and human rights violations of the infected and affected.

I want to make a special request to all South Africans. Let us support our family members, neighbours, colleagues and friends who test positive for HIV.

When people test positive for HIV, they need the love, understanding and support of family, friends and relatives more than ever to enable them to live long and healthy lives. They must not be made to feel like lepers.

Siyacela kubantu bakithi ukuthi singabaxwayi futhi singabacwasi abantu abaphila negciwane eliyisandulela-ngculazi. Kufanele sibaxhase, sibamukele sibambisane nabo ukuze babhekane nesimo abakuso, njengezihlobo nabangani.

Imithi yokwelapha lesisifo, ukuze kuphileke naso njengezinye izifo isiyatholakala.

Okubalulekile ukuthi abantu baye emitholampilo bayohlola ukuthi banalo yini igciwane, ukuze bathole usizo isikhathi sisekhona.

Siyababonga kakhulu abantu baseMzansi Afrika asebesisukumele kakhulu lesisifo. Ngonyaka ka 2010 wodwa nje beqile ku 13 million abantu abahambe bayohlola ukuthi banalo yini igciwane. Kuyancomeka kakhulu lokhu.

Namhlanje sethula umqulu omusha wokulwa nalesisifo, i-National Strategic Plan for HIV, Sexually Transmitted Infections and TB ka-2012 kuya kunyaka ka- 2016.

Masibambisane singuhulumeni, abamabhizinisi nomphakathi wonke. Uma sibambisene, sokwenza lukhulu.

Ladies and gentlemen and honoured guests,

It is a great honour for me to launch the National Strategic Plan for HIV, Sexually Transmitted Infections and Tuberculosis, for 2012 to 2016.

Let us all embrace this plan, and make it work.

I thank you!

Issued by The Presidency, December 1 2011

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