SA moves closer to goal of an AIDS-free generation

Since HIV/AIDS was identified 30 years ago, governments, civil society, non-governmental organisations (NGOs), educational institutions and researchers from around the world have put local knowledge and expertise into action in prevention, treatment and care.

Through this co-ordination, combined with new scientific advances, we now have the tools that allow us for the first time to set the goal of achieving an AIDS-free generation - when virtually no children are born with the virus, we have effective and comprehensive education and prevention strategies that help to reduce risk; and those who are infected with HIV have access to treatment that helps prevent them from developing AIDS and transmitting the virus. Since 2003, through the US President's Emergency Plan for AIDS Relief (Pepfar), the US has committed itself to the realisation of an AIDS-free generation. The Pepfar programme is the single largest initiative by any government in history to combat a single disease.

In SA alone, the US has provided more than R25bn ($3,2bn) to support HIV/AIDS prevention, care and treatment. Today, as SA devotes additional resources, smart planning and more efficient strategies to management of the country's response, we are moving in the direction of an AIDS-free generation. At the beginning of the HIV/AIDS epidemic, South African and international NGOs responded to the call to fill the gap in service delivery in a climate in SA characterised by the government's HIV/AIDS denialism. Today, SA has prioritised the transitioning of ownership of the full HIV/AIDS national response to the government, including treatment and care of HIV-infected and affected patients.

Under the leadership of Health Minister Aaron Motsoaledi, Deputy President Kgalema Motlanthe and President Jacob Zuma, the government is now leading the fight. This is a profound transition. As part of this shift to South African leadership, there will be changes in partners and shifts in US funding in line with the government's National Health Strategic Plan. We must make smart investments.

We must identify, and support, the most effective interventions. We must ensure every dollar (and rand) is stretched as far as possible to help the greatest number of people with the highest level of service. For example, the US Global Health Initiative supports one-stop clinics that offer an array of health services while driving down costs, driving up effect and saving more lives. In another example, the US demonstrated that the cost of antiretroviral medication could be cut in half, leading to a doubling of the number of people who get these life-saving drugs for the same total expenditure - through a streamlined and efficient procurement system that used South African vendors, in line with South African Medicines Control Council and the US Food and Drug Administration rules.

Pepfar investments such as these have shown that when we work in partnership with the government we can put systems of care in place to improve citizens' overall health and at the same time maximise the effect of every dollar spent. The global HIV/AIDS response is a shared responsibility. An AIDS-free generation cannot be accomplished by one nation alone. The US stands beside SA as you continue to build your capacity to lead your national responses and increase your own HIV/AIDS funding. This is the only way these programmes are sustainable: South African-led, South African-managed, in partnership with civil society, including faith-based groups and groups of people affected by HIV/AIDS.  

Together, and driven by South African leadership, we are making huge strides across the prevention, education, treatment and care spectrum. Here in SA, the prevention of mother-to-child transmission serves as a global example. One in seven new infections worldwide occur through mother-to-child transmission, and by focusing on it, we cannot only eliminate new infections, we can also save the lives of mothers. Last year, globally, Pepfar provided HIV/AIDS counselling and testing to 8,3-million pregnant women and antiretroviral prophylaxis to 600 000 HIV-positive pregnant women. In SA, by September 30, more than 236 085 HIV-positive pregnant women had received antiretrovirals to prevent transmission. We are witnessing the first step of an AIDS-free generation, happening here, now, in SA.

Business Day, 30 November 2011
By: Donald Gips - US Ambassador to South Africa