In the chaos of Covid-19, we can’t ignore HIV: Ramaphosa

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This year marks 30 years since the world started commemorating World Aids Day. Picture: iStock/Gallo Images
This year marks 30 years since the world started commemorating World Aids Day. Picture: iStock/Gallo Images

NEWS


As South Africans continue their efforts to manage the devastating Covid-19 coronavirus pandemic, they cannot ignore the other public health challenges that our country faces – the ongoing struggle against HIV and AIDS, which has cost many lives and caused great hardship and suffering.

President Cyril Ramaphosa centred his newsletter to the nation on Monday morning on World Aids Day, which is on Tuesday.

“This year, World Aids Day is taking place under difficult conditions,” Ramaphosa said.

“Since the outbreak of Covid-19 in the country, with the nationwide lockdown and the pressure on our health facilities, many HIV, Aids and tuberculosis services have suffered. This has posed a challenge for people testing and starting antiretroviral treatment. Many people found it difficult to collect their medicines and fewer people accessed other services, such as voluntary male medical circumcision.”

Read: Covid-19 may lead to spike in Aids deaths, warns UNAids

Ramaphosa said that there are many lessons that have been learnt from our public health response to the coronavirus pandemic that can strengthen the fight against HIV and TB.

“South Africa continues to have the largest number of people living with HIV in the world. It is encouraging, however, that over the last decade we made progress in reducing the number of new HIV infections in the population by nearly 60%,” he said.

It is also encouraging, he said, that HIV infections in adolescent girls and young women have significantly declined in the last decade. This is a crucial group because they are much more likely to be at risk of getting HIV.

“Our treatment programme has contributed to a reduction in the number of deaths due to Aids by 60%. There has been a greater reduction in HIV-related deaths among young people,” Ramaphosa said.

This reduction in the number of deaths was due to the country’s extensive antiretroviral programme.

Although South Africa has reduced deaths and new infections, it is still far from reaching the goal it committed to in 2016 of achieving a 75% reduction in HIV infections by 2020

“At the beginning of the decade, our programme to prevent mother to child transmission of HIV had very low coverage. Now we have one of the highest rates of coverage in Southern Africa, which has substantially reduced rates of infection among children.”

Although South Africa has reduced deaths and new infections, it is still far from reaching the goal it committed to in 2016 of achieving a 75% reduction in HIV infections by 2020.

“If we succeed in doing so, we are likely to end Aids as a public health threat by 2030,” Ramaphosa said.

“Unfortunately, we are not there yet. We have to do far more to ensure that young people are empowered to prevent infections, including through changing behaviour, accessing condoms and testing regularly. We need to make sure that everyone who is infected has access to treatment and care.

“We need to work harder on HIV prevention among key populations, including sex workers, men who have sex with men, and people who inject drugs. We must end the stigma and discrimination towards these populations. We cannot hope to end HIV if we ignore the needs, concerns and rights of any part of our population.”

South Africa needed to increase efforts to medically circumcise young men to reduce their risk of acquiring HIV.

“Unsafe circumcision should not leave young men with lifelong health problems, and no one should die from circumcision. We must make sure that young men have safe circumcision,” he said.

Ramaphosa said he was encouraged by findings of a recent study on pre-exposure prophylaxis (PrEP). Unlike antiretroviral treatment that is given to people who are HIV positive, PrEP involves the regular use of antiretroviral drugs by HIV negative people to prevention infection.

Read: World Aids Day | A good year for PrEP, bad for sustained ARV treatment

“The study, conducted by scientists from the HIV Prevention Trials Network, found that long-acting injections once every eight weeks was better than the daily tablet used for HIV prevention. These findings have the potential to significantly strengthen our response to the epidemic,” Ramaphosa said.

If the country was to succeed in ending Aids as a public health threat within the next decade, it needed to combine these medical breakthroughs with fundamental changes in behaviour. It also needed to tackle the economic and social conditions that contributed to high rates of infection.

“One of our central tasks is to empower adolescent girls and young women, educationally, economically and socially. They need to be able to make their own decisions about every aspect of their lives, including their sexuality and sexual behaviour,” said Ramaphosa.

South Africa continues to have the largest number of people living with HIV in the world. It is encouraging, however, that over the last decade we made progress in reducing the number of new HIV infections in the population by nearly 60%
President Cyril Ramaphosa

Ultimately, we will achieve the end of Aids through the empowerment of young people, women and other people at risk, he said.

This includes empowerment through access to information, advice and support. It includes access to education and economic opportunities, especially for young women. Empowerment also means that every person must have access to testing, treatment and other health services.

“On this World Aids Day, which is taking place in the shadow of another devastating pandemic, let us intensify both our resolve and our actions to confront and overcome Aids once and for all,” Ramaphosa said.


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