They were talking about a revolution in Benoni this week — a revolution in health and social care that may finally stem the tide of HIV/Aids in South Africa, reduce the human pain and even regain some of the ground that has been lost to the epidemic.
This week, the national consultation conference on the draft HIV and Aids and STI Strategic Plan for South Africa 2007-2011 revealed the long awaited plan, which provides a blueprint for a cohesive national strategy to prevent further infections and alleviate some of the impacts of the epidemic.
The R14-billion plan shows that, for the first time, there has been real collaboration between government departments, business, scientists, doctors and activists in devising a holistic strategy that addresses the social, cultural and infrastructural drivers of the HIV/Aids epidemic.
There have been previous declarations and calls to arms against the disease, but the new National Strategic Plan (NSP) sets annual targets, which will measure the successes and failures of the plan. Unlike the previous five-year plan, the new version also has an extensive monitoring and evaluation system to feed that information back into planning and implementation.
The NSP also wants the large amounts of local and international funding for HIV/Aids to be leveraged to improve the healthcare system as a whole. Among the proposals in the NSP is a shift towards primary rather than tertiary initiation of antiretroviral (ARV) therapy, and a similar move towards nurse- rather than doctor-based routine supervision of treatment. Both changes have been mooted as a cost-effective and safe method of expanding the ARV programme despite South Africa’s shortage of healthcare workers. The target is to provide ARVs to 80% of HIV-positive adults needing the treatment.
Referring obliquely to the controversies that have dogged responses to HIV/Aids in the past, Deputy President Phumzile Mlambo-Ngcuka told conference participants that it was time to learn from mistakes and to manage differences better.
Transport Minister Jeff Radebe, who is the acting health minister, said that this week he had visited clinics that provide antiretroviral therapy. Each one was providing the treatment to about 2 000 people and achieving a 94% compliance rate. He also said that 100% of clinics would be providing specific care by the end of this year to prevent mother-to-child transmission of HIV.
Speaking for civil society was Cosatu leader Zwelinzima Vavi, who applauded a new era in the fight against HIV/Aids in which denialism and ‘chest-beating†had given way to partnership and unity. Vavi also challenged the business community to help, calling for the establishment of a fund to support the NSP. ‘It is clear that the cost of the plan and the amount allocated by the treasury so far creates a huge funding gap. However, this is not a reason to blink. Business must now come to the party.â€
Directing his words to the head of African Rainbow Minerals, Patrice Motsepe, who also addressed the conference, Vavi said: ‘Mr Motsepe, you and your colleagues — must come to the party — Money is not more important than people’s lives.†His call was matched by Mlambo-Ngcuka, who said that business may want to match the R14-billion government has committed — although she also pointed out that spending the government’s allocation is ‘not child’s playâ€.
Fully 40% of the NSP funds is expected to be spent on adult ARV treatment. The hope is that the greater the number of people on ARVs, the lower will be other medical costs — especially hospitalisation — related to the epidemic.
Given that education and behavioural intervention programmes have not been very successful so far, one of the most ambitious targets in the strategic plan is to cut the new infection rate by half by 2011.
This week, the Human Sciences Research Council released new research showing that there are about 1 500 new HIV infections per day in South Africa.