Stuart Hess
Next Tuesday millions of people will observe yet another World Aids Day in a bid to raise awareness about the epidemic ravaging African countries.
In South Africa, as in many developing countries, efforts to combat the spread of HIV, the virus that causes Aids, have failed.
South Africa is considered to have one of the fastest-growing HIV-positive populations in the world. A host of surveys bears testament to this alarming scenario.
Official Department of Health figures compiled from antenatal clinics across South Africa show a significant increase in the infection rate among pregnant women in most provinces. The latest figures, from 1997, show that 16,01% of all women tested at public antenatal clinics are HIV-positive.
Health officials estimate that 1 500 South Africans are infected daily. That means that in a few years more than 500 000 South Africans will be dying annually from Aids.
Rather than focusing scarce resources on attempting to cure those already infected, the government has chosen to emphasise prevention with an R80- million awareness campaign launched in October by Deputy President Thabo Mbeki.
The new campaign has drawn a lot of criticism from doctors and medical officials, especially after Minister of Health Nkosazana Zuma withdrew AZT treatment for pregnant women in early October. One study showed that AZT reduced the chances of mother-to-child transmission by 50%. But Zuma claimed the money could be better spent on other areas.
Provincial health authorities have welcomed the government’s new intersectoral Aids funding plan. The plan distributes the responsibility for Aids prevention across several departments. This will lessen the burden on provincial health.
KwaZulu-Natal
This province has the highest figures for HIV-positive pregnant women, despite virtually the entire provincial health budget being used to fight Aids- related diseases. The largest amount of money is consumed in the fight against opportunistic infections like pneumonia or tuberculosis.
MEC for Health Zweli Mkhize says the KwaZulu-Natal government is leading the fight from the front. “All the MECs must discuss Aids at rallies where they are speaking, and time is set aside during each Cabinet meeting to discuss the epidemic,” he says.
Still, antenatal tests in the province this year revealed that more than 25% of all pregnant women are HIV-positive, an alarming increase of more than 7% on the previous year’s figures.
Mkhize concedes that the province is losing the fight. And because so much money is dedicated to fighting Aids, the province is neglecting its other health responsibilities, he said.
Northern Cape
South Africa’s largest province has led a strong and concerted fight against the spread of Aids. The provincial health authorities have collaborated with a vast spectrum of groups, from large mining company De Beers to sex workers who walk the streets of Kimberley.
MEC for Health Modise Matlaopane said a number of campaigns have started, including the training of teachers who will be responsible for alerting pupils to the dangers of unsafe sex.
More than six million condoms have been distributed in the past two years, mainly at government clinics. All MECs have to produce results showing how they have made people aware of Aids.
In 1997, the percentage of HIV-positive women in the province was 8,63.
North-West
This is the only South African province to show a decrease in 1997 in HIV- positive mothers, compared to 1996 figures. The provincial government gave the epidemic priority status, and five minutes are set aside at each Cabinet meeting to discuss the disease. The MEC, Molefi Sefularo, believes the intersectoral collaboration between departments has played a significant role in reversing the spread of the epidemic.
In 1996, 25% of women tested in the province were found to be HIV-positive. That figure has dropped to 18%.
Northern Province
The tiny increase in HIV to 8,2% is of major concern to the MEC for Health, Hunadi Mateme. “Of particular concern is the number of Aids orphans we have,” said Mateme. “This will create another hole in the budget as we will have to train people to care for these children.”
The province’s 1996 HIV infection rate was 7,96%.
The province has launched a “very successful” campaign to distribute condoms freely throughout the province. The provincial Aids awareness programme runs throughout the year and involves various bodies including NGOs, schools and other departments.
Mpumalanga
Commentators believe Mpumalanga is on the brink of disaster. The province’s antenatal infection rate jumped to 22,5% in 1997 from 15,7% in 1996.
MEC for Health Candith Mashego said she has done everything in her power to limit the spread of the disease. “We requested that all departments set aside 1% of their budgets at the start of the next financial year to fund a campaign to fight Aids.”
The province drew up a four-point plan calling on people to use condoms and to inform their partners if they are HIV- positive. Health officials also asked Aids sufferers to visit clinics in order to treat any sexually transmitted diseases. Such diseases increase the spread of HIV.
Gauteng
The province is set to launch a massive campaign including concerts, vigils and selling T-shirts as part of its Aids- awareness campaign. With more than 17% of pregnant women tested in the province HIV-positive, the province has recognised the importance of raising awareness – especially among the youth.
Western Cape
The Western Cape had the lowest figures of any province in South Africa last year, with 6,29% of pregnant women infected.
The province has not allocated a specific Aids budget from its health purse. But this year the Western Cape will receive R150 000 from the national government for an Aids campaign beginning this year. This will include distributing bumper stickers, leaflets and pamphlets.
While noting that rates are low, the assistant director for reproductive health, Aids and sexually transmitted diseases, Sylvia Abrahams, said there are pockets of infection across the province. “In places like Khayelitsha and Guguletu, the epidemic is growing.”
Free State
The health authorities in the Free State are optimistic that the battle can be won. The campaign aims to include as many sectors of the community as possible in the project.
Various groups including the private sector, NGOs and the government have been included in the programme. At least 19,57% of pregnant women tested are HIV- positive.
Eastern Cape
The MEC for Health, Trudie Thomas, says it was unfortunate that the budget for Aids came only through the health department in the past. She said expertise from other departments should have been used.
More than 12% of women tested in the province in 1997 were HIV-positive. This represents an increase of more than 4% since 1996.