Category Archives: Infectious Disease Control

HIV/AIDS: The HIV prevention agenda

JOHANNESBURG, 13 December 2012 (PlusNews) – If the world scales-up HIV treatment and prevention in the next two years, a critical tipping point – in which those on treatment outnumber those newly infected with the virus – could be reached, according to the global HIV prevention advocacy organization AVAC.

On the heels of AVAC‘s annual African Partners Forum, which was held in early December, IRIN/PlusNews breaks down the issues likely to top the HIV prevention agenda in the coming year.

1. End confusion over “combination prevention”. It may have been the catch phrase of 2012, but “combination prevention” – the use of complementary behavioural, biomedical and other prevention strategies – remains poorly defined. AVAC is urging activists to help guide focused discussions about combination prevention and how donors, policy makers and implementers can best develop combination prevention packages tailored to individual countries’ needs.

2. Start – and keep – people on antiretroviral (ARV) therapy. While the latest UNAIDS report charts increasing access to ARVs over the past decade, only about half of those who need ARVs are receiving them. Meanwhile, more health officials are starting to shift their focus away from treatment numbers and towards treatment quality to ensure that people who begin treatment stay on it, and to make sure this treatment is working. According to AVAC, more innovative strategies are needed to improve uptake and retention in treatment programmes.

Such strategies will be especially important in “treatment as prevention” programmes. In most treatment protocols, only people living with HIV who have relatively low CD4 counts – indicating weaker immune strength – are put on ARVs. With treatment as prevention, even HIV-positive people with higher CD4 counts will take ARVs in order to decrease the likelihood of transmitting the virus to their partners. “Treatment as prevention” has also been used to describe the use of ARVs by people who are HIV-negative but at a high risk of contracting the virus.

Although there are treatment as prevention pilot projects underway among high-risk populations, policymakers remain unsure how treatment as prevention will work in contexts of generalized risk.

3. Prepare for the next wave of non-surgical medical male circumcision (MMC) devices. South African activists continue to protest the use of the controversial, unapproved Tara Klamp, a non-surgical device used to perform MMC. Even so, the first non-surgical MMC devices are expected to receive UN World Health Organization (WHO) prequalification in 2013, according to AVAC. Prequalification allows 14 prioritized African countries, including Swaziland, Ethiopia and South Africa, to use the devices,
which could offer MMC in areas where surgical options are not safely available.

But AVAC cautions this new technology might not suit all countries and that policy makers need to be prepared to decide whether they’ll stick with the surgical “snip” or move towards new devices that allow lower cadre health workers to perform circumcisions, AVAC says.

4. Define and launch a core package of pre-exposure prophylaxis (PrEP) demonstration projects. Although the WHO issued guidance on the use of PrEP in July 2012, AVAC says that many global health agencies and national HIV programmes are hesitant to adopt the strategy of giving HIV-negative people at high risk of contracting the virus ARVs to prevent infection without first conducting more pilot programmes.

According to AVAC, the PrEP agenda will hinge on defining just what kinds of pilot projects or studies policymakers need in order to be convinced.

5. Safeguard HIV-prevention research funding. Finally, AVAC says research funding for new prevention methods – like vaccines or ARV-based microbicides – needs to sustained. Luckily, the US President’s Emergency Plan for AIDS Relief (PEPFAR) will likely continue to support research not only into vaccines but also into point-of-care HIV technology, according to its latest blueprint.

Meanwhile, South Africa has taken a keen interest in supporting its own national research into a microbicide using the ARV tenofovir.

http://www.plusnews.org/Report/97039/HIV-AIDS-The-HIV-prevention-agenda

HIV/AIDS: Uganda still behind on ARV target

Photo: M. Sayagues/PlusNews

Uganda - Government needs to scale up HIV treatment and halt new infections

KAMPALA, 7 January 2013 (PlusNews) – Uganda continues to fall short of achieving its goal of ensuring that 80 percent of people living with HIV receive antiretroviral drugs (ARVs) by 2015, according to the Uganda AIDS Commission (UAC).

Some 62 percent of those needing HIV treatment were on ARVs in March 2012, up from 50 percent in 2010. Uganda managed to enrol an estimated 65,493 new HIV cases on life-prolonging ARVs in 2012, bringing to 356,056 the number of those receiving ARVs, according to UAC statistics.

But just 8 percent of these cases were children. A recent government survey has revealed that just 49 percent of infants in need of treatment are receiving it. (The government recommends that all HIV-positive infants under age two receive ARVs.) Some 20,000 to 24,000 children are infected with HIV each year, according to the Ministry of Health.

To improve the prevention of mother-to-child transmission of HIV, the government launched in September 2012 the UN World Health Organization’s “Option B+” strategy, which involves giving HIV-positive mothers triple-therapy ARVs as soon as they are diagnosed, and continuing treatment for life, regardless of their CD4 count.

Call for treatment scale-up

Civil society groups have called on the government to scale up treatment and halt new infections.

“We need to put all the people who are eligible on treatment, and move quickly to provide early treatment for those who are not eligible yet for prevention benefit,” Richard Hasunira, HIV/AIDS adviser for the health rights group Coalition for Health Promotion and Social Development (HEPS)-Uganda, told IRIN/PlusNews.

Recent statistics show that Uganda’s HIV prevalence has risen from 6.4 percent to 7.3 percent over the past five years.

Health facilities face frequent drugs stock-outs, inadequate CD4 count machines and understaffing. Additionally, Uganda’s HIV programmes have been hit hard by a funding crunch limiting its ability to operate HIV programmes.

Of the 700 health facilities listed as offering antiretroviral therapy (ART), only 532 were doing so by end of March 2012.

The government acknowledges more must be done, saying it will focus on HIV prevention and allocate more funds to fighting the disease.

“The majority of accredited sites [administering ART] are higher-level facilities such as hospitals and Health Centres IV [county level], while [ just] 8 percent of Health Centres III [sub-county] are active, thus limiting access for rural communities. The situation is worse in hard-to-reach areas, such as the fishing islands,” noted UAC in a recent report.

“There is need to accelerate accreditation of Health Centres IV and III to enable access of ART for eligible individuals, including pregnant women, and health facilities that are accredited and are not functional should be supported to become functional,” it said.
“We are going to initiate some 214,000 individuals on ART by 2013,” David Apuuli Kihumuro, UAC’s director-general, told IRIN/PlusNews, “We have set an annual target of enrolling a minimum of 100,000 patients on ART.”

“We are going to emphasize prevention in order to reduce new HIV infections. We are embarking on male circumcision, condom distribution and rolling out Option B+,” said Health Minister Christine Ondoa. “The government will continue to allocate funds to fight the epidemic. We shall also mobilize funds from our development partners for universal access, prevention, treatment and care.”

Additional revenue

The government has been urged to set up an “AIDS levy” to generate additional revenue for HIV prevention, treatment and care.

“Budgeting by government for the AIDS response must increase as a matter of urgency for the financial year 2013-14 and beyond, prioritizing recurrent costs such as health worker recruitment and retention and procurement of essential commodities rather than trainings, workshops and seminars,” civil society groups said in a statement.

The Ugandan government recently developed a draft working paper on establishing a US$1 billion HIV fund to explore alternative and sustainable sources of funding for its HIV/AIDS programmes.

Sources of funding listed in the paper, released in September by the Uganda AIDS Commission, include levying taxes on bank transactions and interest, airplane tickets, beer, soft drinks and cigarettes, as well goods and services traded within Uganda.

Small fees would also be levied on civil servants’ salaries. Corporate and withholding taxes would be increased slightly, and a small tax would be added to telephone calls and to each kilowatt of electricity consumed.

 

Uganda: NGO to Test 10,000 for HIV/Aids in Kampala

A Kampala-based non-government Organisation; Integrated Community Based Initiatives (ICOBI) has launched a festive season HIV/Aids testing campaign for Kawempe division.

ICOBI Executive Director Dr Elioda Tumwesigye, said the campaign would target 10,000 people. The campaign dubbed “A New Year: A new beginning! Know your Status this Festive Season” will target homes and religious places to increase HIV testing among residents.

Dr Tumwesigye, who is also the Chairperson of the HIV/Aids committee of Parliament, launched the campaign in Nsooba Lufula village Kawempe division over the weekend, explaining that the door-to-door testing and community outreach is free.

“I appeal to residents of Kampala and Wakiso to offer all the necessary support towards achieving this goal so as to make our society an Aids free generation.” Dr Elioda Tumwesigye said.

ICOBI has also pledged to link HIV-negative males to safe male circumcision centres, while those found to be HIV-positive will be referred to psycho-social support and spiritual counselling as well as Prevention of Mother to Child Treatment (PMTCT). According to the latest HIV/Aids Indicator Survey (2011), at least seven in 100 people in Kampala are HIV-positive and the prevalence is higher among women.

“Despite the fact that evidence has demonstrated overwhelming benefits of HIV counselling and testing for HIV prevention, less than 40% of adults have ever tested for HIV.” Tumwesigye said.

By Maxwell Ochan

27 December 2012

http://allafrica.com/stories/201212271574.html

 

Africa: New HIV Infections Are Falling Dramatically

Africa is pulling out all the stops in its race to curb the AIDS pandemic by 2015, a deadline set by UN member states.

From making anti-retroviral drug therapy (ART) readily available to the masses, to increasing consistent, correct condom use and voluntary medical male circumcision, everything has been tried and tested. And these efforts are paying off, according to the latest report of the Joint UN Programme on HIV/AIDS (UNAIDS), entitled Results.

Africa has cut AIDS-related deaths by one third in the past six years, the report says. Even countries with the highest HIV prevalence in the world have seen the number of new HIV infections decline dramatically.

Malawi has witnessed a 73 per cent drop in new HIV infections. Botswana, Namibia, Zambia and Zimbabwe follow. South Africa managed to reduce new infections by 41 per cent. Even Swaziland — the country with the highest HIV prevalence in the world — saw new HIV infections drop by 37 per cent. Meanwhile, in other regions of Africa, Ghana topped the list, followed by Burkina Faso and Djibouti.

Leaders in Africa have been funneling money into their national AIDS programmes. Last year alone, South Africa invested $1.9 billion from public sources for its national AIDS response. Kenya doubled its domestic investments for AIDS between 2008 and 2010, and Togo did the same between 2007 and 2010. International assistance has also been stable, with 26 of 33 countries in sub-Saharan Africa relying on donor support for their domestic programmes, Results adds.

‘From despair to hope’

The scaled-up response has been most effective in boosting the number of people on ART treatment and reducing the number of children born with HIV. Six African countries (Burundi, Kenya, Namibia, South Africa, Togo and Zambia) saw a 40 per cent reduction in the number of children newly infected by the virus between 2009 and 2011. “It is becoming evident that achieving zero new HIV infections in children is possible,” says Michel Sidibé, the UNAIDS executive director. “I am excited that far fewer babies are being born with HIV. We are moving from despair to hope.”

On the other hand, North Africa has not fared so well. The number of people newly infected with HIV each year has risen since 2001, although overall numbers are still relatively low.

On 1 December, World AIDS Day, Mr. Sidibé called on the world to renew its commitment to zero new infections, zero discrimination and zero AIDS-related deaths. At a UN high-level meeting on AIDS in New York in 2011, global leaders agreed to meet the ambitious targets of significantly reducing the sexual transmission of HIV, virtually eliminate mother-to-child HIV transmission and achieve universal access to treatment by 2015. Mr. Sidibé believes that with “political will and follow through,” the world can reach those shared goals.

Challenging the ‘rosy picture’

ONE, a global advocacy group fighting poverty and preventable diseases, begs to differ. The world is not on track to achieve the global AIDS targets, the organization asserts.

In its latest progress report, The Beginning of the End of AIDS? Tracking Global Commitments on AIDS, ONE remarks that anti-retroviral treatment for HIV-positive individuals has been the hallmark of the world’s response to the AIDS pandemic. But, the group warns, only 6.6 million of the 15 million who need the treatment have access to it, and 2.5 million continue to be newly infected every year.

According to the South African advocacy group Section27, such figures prove that the “end of the epidemic is no where near.” Section27 Director Mark Heywood challenges the “rosy picture” painted by UNAIDS. He argues that the “remarkable” gains of recent years have yet to be consolidated and entrenched, notes that people living with HIV/AIDS still need to secure their rights and warns that the global economic recession could redirect money away from AIDS.

Funding remains crucial

UNAIDS maintains that high-income countries have continued to help even as they faced persistent economic problems. The agency admits though that international assistance is still a crucial lifeline for many low income countries.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, an international grant-making institution, has been instrumental in attracting funds for national programmes. It is currently preparing for its 2013 replenishment meeting. It has already received a donation of $200 million from RED (a division of the ONE campaign) to fight the AIDS epidemic in Africa.

Meanwhile, the President’s Emergency Plan for AIDS Relief (PEPFAR), a US government initiative and the largest funder of HIV efforts worldwide, has announced that its future focus will be on prevention, women and girls, as well as on reaching the most at-risk populations.

Together, the Global Fund and PEPFAR are supporting 5.6 million people on ART treatment globally, ONE notes. There are more than 5 million people on ART treatment in sub-Saharan Africa alone.

Moving forward, experts and policy makers agree that keeping people on treatment is as important as getting them the drugs. UNAIDS warns that adherence to these HIV treatment programmes can fall as people regain better health. The agency cites the example of a treatment centre in Malawi where nearly half the people who began ART are no longer in care five years later.

HIV treatment is for life, UNAIDS emphasizes, and people living with the virus need to take pills every day. It urges African countries to incorporate community support strategies to complement clinical services and to keep down programme management costs and drug prices. Basically, more people need access to treatment to live longer and more productive lives.

By Joselyn Sambira

21 December 2012

http://allafrica.com/stories/201212220035.html?viewall=1

South Africa: World Aids Day Targets Men, Youth

Pretoria — This year’s World AIDS Day will focus on urging young people and men to get tested so they know their HIV status.

The national event, which will take place at Potchefstroom in North West on Saturday, will be held under the theme ‘A re Dlale – Safe for Zero new HIV and TB infections’.

“We are trying to appeal to young people by making use of this theme that combines tsotsi taal, African Languages and English, because we really want our young people to play very safe for zero new infections,” Health Minister Dr Aaron Motsoaledi said on Thursday.

The global theme for World AIDS Day which was announced last year and will run till 2015, comprises of three messages, ‘Zero New HIV infection, Zero Discrimination and Zero AIDS related deaths’. Dr Motsoaledi noted that South Africa has subscribed to the global World AIDS Day target of getting to Zero by 2015.

He said that through the new National Strategic Plan on HIV and AIDS, STIs and TB that runs from 2012 to 2016, government is hoping that every South African, including the youth, will develop a tendency to test at least once per annum.

During this year’s World AIDS Day, Deputy President, Kgalema Motlanthe will be joined by Motsoaledi and the Minister of Sport Fikile Mbalula, as the event aims to target sports.

He said they were concerned about older men and wanted to encourage them to get tested, therefore this year’s main event will be celebrated through soccer.

Dr Motsoaledi added that from this year onwards, they will be running soccer matches in their campaigns and hoping that through soccer, men will be encouraged to go and get tested.

“We want to target Confederation of African Football (CAF) and we are happy that CAF, together with UNAIDS have agreed to work together to make sure that next year when the Afcon is in South Africa. One of the many events you’ll see is the issue of HIV and AIDS. All soccer stars of the world will be supporting us,” Dr Motsoaledi said.

In terms of people getting tested and wanting to know their status, he said 65% of them were women, 5% children and only 35% were men.

South African National Aids Council Chief Operations Officer, Reverend Zwo Nevhutalu stressed that this year’s World AIDS Day would be about prevention.

“If we don’t put more effort on prevention, we might not be able to win the battle of HIV and AIDS,” the minister said.

The campaigns will include testing to be done in malls, more activations messages in store fitting room, messages to cell phones, mobi sites and advertisements on buses.

The event on Saturday will kick off with a 4km walk followed by testing with the main event to be followed by a soccer match.

Reverend Nevhutalu also thanked the Premier Soccer League for allowing them to use the Telkom challenge which takes place in Durban, to send messages.

“Thousands of condoms would be distributed on the day and the testing sites will be stationed at the parameters of the stadium.”

Government has exceeded the target of testing 15 million to 20 million people for HIV since the launch of the HIV, Counselling and Testing Campaign in April 2010.

In South Africa, over 1.9 million people are on treatment through government increasing the number of HIV treatment sites.

“In Feb 2010, there were only 490 testing sites. Today we now have 3000 facilities, which are well equipped in initiating HIV treatment. We have also increased the number of nurses who are certified and trained to initiate HIV treatment from 215 in February 2010 to 10 000 in April 2012.

“We have also reduced the rate of Mother To Child Transmission, from 8% in 2008 to 3.5% in 2010 and down to 2.7% in 2011. Our Medical Male Circumcision Programme is also doing very well,” Motsoaledi highlighted.

By Gabi Khumalo

30 November 2012

http://www.sanews.gov.za/news/12/12113009251001

Stigmatisation slows Kenya’s efforts to avert mother-to-child HIV transmission!

Many pregnant women in Kenya are giving birth to HIV positive babies because of stigmatisation and discrimination.

Health experts noted that the two vices make pregnant women who are living with the disease or who do not know their status shun hospitals.

The women end up seeking services of traditional birth attendants or deliver in poor-equipped health centers thus exposing their children to HIV.

Dr William Maina, Head of National AIDS/STD Control Program (Nascop), said that despite Kenya making great strides in fight against the disease, stigmatisation remains a great challenge.

“Some people still treat HIV as a ‘special’ disease. Those who are living with it are frowned upon. Great awareness about the disease has helped to reduce this but the cases still persist. Fear of stigmatisation prevents pregnant women from giving birth in hospitals,” said Maina at a recent forum on mother to child HIV transmission in Nairobi.

When pregnant women avoid hospitals, chances of them infecting their children with HIV at birth are high.

“It is important for the HIV status of a pregnant woman to be known. This helps in determining whether the mother will transmit the disease to her baby or not. The status is central for the survival of the baby,” noted Maina.

In Kenya, it is estimated that approximately 13,000 pregnant women give birth to HIV positive babies annually, which has dropped from about 23,000 cases in 2007.

Experts note the cases have reduced significantly because of government efforts to strengthen Prevention of Mother to Child Transmission (PMTCT) services offered across the country.

The services are available at nearly 5,000 private and public health facilities across the East African nation. In public hospitals, PMTCT services are free due to government and its partners’ subsidies, making them accessible to many pregnant women.

“We have ensured that any pregnant woman who visits hospital for delivery or antenatal clinic undergoes a HIV test. Once they know their status, we counsel and encourage them to attend clinics, ” said Maina.

However, he observed that only about 67 percent of pregnant women, who know their status, fully attend antenatal clinics.

“Where do the rest go to? This is where fear of stigmatisation comes into play. The women keep off clinics for fear of discrimination or perhaps they refuse to acknowledge their status. Thus, they increase their chances of passing the disease to their children,” said Maina.

According to the HIV expert, babies can acquire HIV from their mothers at three stages.

“Mothers can pass the disease to their children when they are still in the womb, while giving birth or when they are breast- feeding. This is the reason why PMTCT is very important since once doctors know a pregnant woman’s status, they will keep the baby safe from HIV,” he said.

Mercy Achieng, who works at a public hospital in Nairobi as a mentor mother for HIV positive pregnant women noted that stigmatisation is still a major hindrance in the East African nation’s quest to eliminate mother-to-child infection.

Achieng, who is HIV positive, recounted that many people in the Kenyan society still view HIV as a curse.

“About three decades since HIV was diagnosed in Kenya, people do not treat the disease as any other. They have not fully accepted those living with the disease and talk about it,” she said.

Discrimination, according to Achieng, is worse for pregnant women since they are carrying life in their wombs.

“When a pregnant woman is diagnosed with HIV, discrimination starts, particularly in the family. Her husband sees her as immoral yet many women get the disease from their spouses,” she recounted.

At the hospital, she noted, some nurses make it hard for HIV pregnant women.

“They will abuse them or talk about them negatively. This becomes nightmarish for many pregnant women, who end up not attending antenatal clinics. The women later give birth to HIV positive babies,” she noted.

Besides stigmatisation, she noted that violence against women and poverty also contributes to mother-to-child HIV infections.

“Most HIV pregnant women give birth to healthy babies, but end up infecting them with the disease because they cannot afford formula or other foods they should feed their babies. The women breast-feed their newborns increasing chances of passing HIV to them,” noted Achieng.

On the other hand, Achieng and Maina noted that violence against women makes them vulnerable to HIV.

“Many married women are diagnosed with HIV during antenatal clinics visit. Most of them blame their status on their husbands. The women get infected because they have little choice to make when it comes to using contraceptives or telling their men to go for HIV test,” said Maina.

Most men, according to the two, do not go for HIV tests or when they know their status, they do not inform their wives.

Kenya hopes to eliminate mother-to-child HIV transmission by 2015. The East African nation recently launched a program known as Elimination of Mother to Child Transmission of HIV to help in the course.

By Agencies

19 November 2012

http://www.globaltimes.cn/content/745231.shtml

Condom distribution in SA stops 20 000 HIV infections

A year after launching its condom distribution programme, the South African Breweries (SAB) has delivered more than 10 million condoms to taverns across South Africa, using its infrastructure, delivery trucks and extensive distribution network.

SAB launched the programme late last year as a public private partnership with the National Department of Health (NDoH), the South African Business Coalition on HIV/Aids (SABCOHA) and the Society of Family Health (SFH). SAB joined the national condom distribution programme to assist government extend its distribution reach to non-traditional outlets, namely taverns.

SAB is well positioned to undertake the task of delivering condoms owing to its efficient and reputable distribution logistics solution and extensive reach. SAB’s 40 distribution depots are used as primary distribution sites where condom stock is stored and collected by SAB truck drivers for distribution during their scheduled delivery run.

Millions of condoms distributed

The aim is to reach 16 000 local  taverns over the next five years, distributing more than 845-million condoms to these in total and averting 1.6-million new HIV/Aids infections.

To date, SAB has reached 7303 taverns and distributed 10 456 600 condoms to them over a period of a year. This has assisted in averting 20 914 new HIV/Aids infections. Taverns each received 400 condoms per month and additional stock delivered if needed. Twelve SAB depots have implementedthe programme and are operating as Primary Distribution Sites.

The HIV/Aids aversion rate is calculated according to a John Stover (founder  and president of Futures Institute) study which claims that for every 500 condoms distributed, at least one new infection is averted. This indicates that condoms are highly effective in protecting individuals against contracting HIV and sexually transmitted infections (STI’s).

“Challenges facing society are best tackled through the combined efforts of individuals and groups. Working with government and expert organisations within the HIV/Aids space, we believe that we can make a difference in the fight against the pandemic which has a devastating impact on communities and economic development,” says Hepsy Mkhungo, SAB Head Enterprise Development and Community Partnerships.

 

8 November 2012

Press Release November 2012

By Health 24

http://www.health24.com/news/HIV_AIDS/1-920,77742.asp

South Africa: Census Findings On Health

Government’s HIV/AIDS programme is bearing fruit, with fewer deaths now than in 2006. And older people are now dying, not young people in the prime of their lives, according to the Census released yesterday.

The majority of the deaths recorded by the Census were due to natural causes, with just 9.6% of them attributed to unnatural causes. However, the number of people dying in South Africa has decreased since 2006. Statisticians believe that the majority of deaths prior to 2006 were related to the AIDS epidemic and that the onset of the government’s AIDS treatment programme has reduced the mortality figures.

“It looks to me that we have turned the corner, probably, in the face of availability of anti-retrovirals and Nevirapine and all these other things that are causing life to be longer. And, of course, recent studies did indicate that new infections of HIV and AIDS have actually declined, particularly amongst the youth”, according to Pali Lehohla, Statistics South Africa’s Statistician-General.

Deaths are now increasing in older age groups as opposed to among younger people. It is hard to state that AIDS was the cause of the majority of deaths prior to 2006 because AIDS was not a notifiable cause of death, says Stats SA. But tuberculosis, a close ally of HIV infection, has been the number one killer of South Africans, accounting for more than half the country’s mortality.

“When you look at the sex and age structure of the deaths when mortality was increasing, it was particularly increasing in the reproductive ages – 20 to 40. That is where we see most of the decrease”, says Stats SA’s Maletela Tuoane-Khase, explaining the changes in the death patterns.

“A lot of people attributed the increase to the number of deaths as a result of HIV/AIDS, which could be possible. But we have a number of other causes of death, like if you look at the causes of death statistics, the leading cause of death will be Tuberculosis. But when we see the decline we see the decline in the specific age groups where there was an increase. Now when you look at where the number of deaths is increasing, it’s increasing at older ages, which is where you expect people to die. But the decrease is mainly at the young reproductive ages – 20 to 40 – and, particularly among females. You see a lot of decrease in mortality among females”, she adds.

Accepting the findings of the census, President Jacob Zuma admitted that the country has to do more to provide basic services such as access to electricity, water and housing. These have a direct impact on the safety and quality of life of people.

“The usage of electricity as a main source for cooking has increased from 45% to 73%. However, the use of paraffin still remains at 7.5% of all households as their main source of energy. We know the dangers of this type of energy, especially for those of us who live in shack settlements, constituting almost 13% of households in South Africa. The use of the bucket toilet system has been halved from 3.9% in 2001 to 1.9% in 2011. Much effort still needs to go into providing toilet facilities to some communities in the Eastern Cape, Limpopo, Mpumalanga and KwaZulu-Natal.

The Eastern Cape showed an increase in households residing in formal housing from 47.6% in 1996 to 61.8% in 2011. However, the province still lags behind the rest of the provinces”, Zuma said in his acceptance speech.

It is hoped that the findings of the census will help government to forecast and plan better in allocating financial and other resources to improve the living conditions of South Africans. In other key findings, the population of South Africa has increased to over 51 million from 40.5 million people in 1996. This means the government must increase resources accordingly to cater for the resultant growth in needs such as health and other services. The largest growth in population figures is in Gauteng, which has overtaken KwaZulu-Natal as the most populous of the nine provinces.

“The growth is largely in Gauteng where we see two million people higher than in KwaZulu-Natal. In the last 10 years, Gauteng has gained in the region of about four million people. There has been a phenomenal population growth there due to migration, particularly from other provinces and from outside the country. KwaZulu-Natal is at 10.2 million. It has grown marginally by about 500 000”, explains the Statistician-General, Pali Lehohla.

Nationally, it has been found that there are 10.9 million children under the age of five. Statistics for the under fives are how a country’s performance in child health is measured.

31 October 2012

By Khopotso Bodibe

http://allafrica.com/stories/201210311339.html?viewall=1

SOUTH AFRICA: Revamped AIDS council makes its debut

JOHANNESBURG, 9 October 2012 (PlusNews) – After a troubled past, a revamped South African National AIDS Council (SANAC) was recently unveiled, coinciding with the announcement that the country has achieved universal access to HIV treatment. South Africa must now ramp-up prevention, new SANAC CEO Fareed Abdullah said.

The newly reformed body is now undergoing a wide range of initiatives to improve its effectiveness and the country’s HIV prevention efforts, including increasing national funding for prevention activities, reinvigorating provincial AIDS councils and broadening representation within the body’s leadership.

In 2010, SANAC released a mid-term review of the country’s national strategic plan on HIV, which found that the national AIDS body was not user-friendly, failed to coordinate provincial HIV responses, and faced shortcomings in provincial monitoring and evaluation. The report proposed a new SANAC structure to make it “fit for purpose”.

Responding to these recommendations, and to criticism by civil society, SANAC was reformed over the last 18 months. The body will now hold a new, annual meeting comprised of representatives from the research community, labour unions and people living with HIV. At this meeting, participants will discuss major policy issues and review progress on the country’s current national plan to address the twin epidemics of HIV and tuberculosis.

SANAC leaders, representing diverse groups including women, sex workers and businesses, approved the restructuring on 17 August 2012. New leaders, following nomination and selection, will undergo an orientation at the end of October, according to South African Deputy President Kgalema Motlanthe, who, as deputy president, chairs the body.

The body recently held the inaugural session of this plenary body in Pietermaritzburg, the capital of South Africa’s KwaZulu-Natal province, which Motlanthe has described as the epicentre of the country’s HIV epidemic.

Treatment grows as prevention lags

At the meeting, SANAC announced new figures showing that two million South Africans are now on antiretrovirals; this figure covers about 80 percent of those estimated to need treatment in the country, surpassing the country’s 2006 universal access target, according to a UNAIDS report.

The country funds about 80 percent of its HIV response domestically, and about 70 percent of this is earmarked for treatment – leaving less than 20 percent for prevention. In the first quarter of 2012, the country only met about 30 percent of its condom distribution target, handing out 84 million condoms – about one condom per month for each of South Africa’s estimated 24 million males.

According to CEO Abdullah, SANAC has begun negotiating with the treasury department to try to allocate more money towards prevention.

Resurrecting provincial AIDS councils?

Provincial AIDS councils have been historically ineffective, but SANAC will be helping to strengthen these, Motlanthe said in a statement.

“Each province has unique economic, social, infrastructural and cultural characteristics. There are population dynamics, health and community systems, and human resource issues that determine the impact of programmes, thus requiring context-specific approaches… for success,” he said. “This underpins the importance of having functional and efficient Provincial Councils on AIDS to better monitor the provincial responses.”

According to Abdullah, SANAC will now be providing resources to provincial AIDS councils and has been advocating for high-level politicians to join these groups. Already, KwaZulu-Natal Premier Zweli Mkhize has begun taking an active role in his province’s council, drawing the attention of several other premiers, Abdullah told IRIN/PlusNews.

By IRIN Plus News

9 October 2012

http://www.plusnews.org/Report/96492/SOUTH-AFRICA-Revamped-AIDS-council-makes-its-debut

Africa: South Africa Gets Ready for HIV Vaccine Trial

 

A vaccine candidate which showed that it can protect against HIV infection by up to 31% when tested in Thailand three years ago will be further tested in South Africa as soon as next year.

South Africa is the first country outside of Thailand to test the vaccine candidate that made worldwide headlines three years ago. Results of the RV144 Thai study gave hope that it is possible to find a vaccine to prevent HIV infection when it was found that the study vaccine had a 31% efficacy. Co-principal investigator for the HIV Vaccine Clinical Trials Network, Dr Glenda Gray, says the South African leg of the trial will be a Phase III clinical study, which will look into the efficacy of the vaccine in the South African population.

“In our first study, what we will do is take the exact regimens used in Thailand and test it in South Africans to see whether the response that the Thai people got is equivalent to the response our South Africans will have”, Dr Gray says.

She says the vaccine would have to be modified to fit the circulating strain in South Africa. There are different circulating HIV strains in the world. The Thai vaccine was manufactured to fit strains E and B. In South Africa, the prevalent strain is C.

“The first thing you need to do when you try to adapt a study to the local conditions is you change the gene inserts of the vaccine… There was a B and E insert. So, when you make a vaccine you want to match your gene inserts as closer to the epidemic happening in your country to maximise the effect”, says Dr Gray.

In parallel to the South African study, more trials are to be done in Thailand, specifically looking at men who sleep with men.

“The idea in Thailand would be to test it primarily in men who have sex with men and the reason is that the Minister of Public Health in Thailand did an analysis and it looks like commercial sex workers, perhaps, but MSM, definitely, would be a cost-effective intervention, given the expected level of efficacy that we hope to have in that series of vaccine trials… roughly 50 percent”, says Colonel Jerome Kim, of the US military.

Kim says the initial Thai study whose results came out three years ago involved 16 000 people who were mainly heterosexual. The idea now is to use small populations who are at most at risk of HIV infection, such as homosexuals and commercial sex workers.

“Right now what we’re doing in Thailand is do small studies designed to look much more intensively at the kind of immune responses that the vaccine induces because when you do a Phase Three trial with so many people you can’t collect enough information. So, now, we’re getting key and smaller populations and we hope to get information without having the cost and organisational difficulties associated with a trial of 16 000”, says Kim.

Having the RV144 HIV vaccine trial in South Africa is an exciting opportunity.

“It will mean a lot because South Africa will be the first country in the world where we test this vaccine and if it is successful it will be the first country where we will license it. We have been doing stakeholder engagement with government to find out what should this vaccine cost. If it works, how do we scale up local production and how do we roll it out? Who is our target population? So, it’s exciting and frightening because there is a still lot of work to do. Obviously, we don’t plan for success – and now, for the first time, we’re actually planning for success”, says Dr Gray.

 

Relevant Links

Scientists Plan New HIV Vaccine Tests

Nation Gets Ready for Trial of Successful Thai Vaccine

Community Involvement Key in Hunt for HIV Vaccine – Living With Aids # 534

Aids 2012: High Hopes for Vaccine, Progress for Mothers, Children

HIV Vaccine ‘Still a Decade Away’, Say Researchers

 

By Ayanda Mkhwanazi

1 October 2012

http://allafrica.com/stories/201210011025.html