Thursday, June 9, 2011

Brief Historical outline of HIV and AIDS – South Africa.


An estimated 5.6 million people were living with HIV and AIDS in South Africa in 2009, more than in any other country. It is believed that in 2009, an estimated 310,000 South Africans died of AIDS. Prevalence is 17.8 percent among those aged 15-49, with some age groups being particularly affected. Almost one-in-three women aged 25-29, and over a quarter of men aged 30-34, are living with HIV. HIV prevalence among those aged two and older also varies by province with the Western Cape (3.8%) and Northern Cape (5.9%) being least affected, and Mpumulanga (15.4%) and KwaZulu-Natal (15.8%) at the upper end of the scale.

Marking a welcome change from South Africa's history of HIV the South African Government launched a major HIV counselling and testing campaign (HCT) in 2010.

By raising awareness of HIV the campaign aims to reduce the HIV incidence rate by 50 percent by June 2011.


1982 – The first HIV infections were diagnosed in South Africa in two white, homosexual flight attendants who had travelled to the United States. This lead to the belief that HIV was largely a white, homosexual disease in SA, as was the case in the US and Europe. As a result, the homophobic apartheid government, which was in power at the time, disregarded the health risk and ignored the issue.

1987 – The first black South African was diagnosed with AIDS-related illness.

1990, Chris Hani, chief of the ANC guerilla force (known as ‘Spear of the Nation‘) said, ‘Those of us in exile are in the unfortunate situation of being in the areas where the prevalence is high. We cannot afford to allow the AIDS epidemic to ruin the realization of our dreams. Existing statistics indicate that we are still at the beginning of the AIDS epidemic in our country. Unattended, however, this will result in untold damage and suffering by the end of the century.' Chris Hani was tragically assassinated shortly before democracy was achieved.

1991 – Heterosexual HIV infection rates equalled homosexual ones. (Heterosexual infections has since become the main mode of transmission of the virus in SA)

Coinciding with the turbulent political period, HIV and AIDS started to gain national public interest though it is not difficult to understand why all energy was focused on deciding South Africa’s political fate seeing the need to address a complex and tough negotiation process needed to end apartheid.

1992 – ( a decade after the 1st reported case), a group of political parties, trade unions, academics, business organisations and civil society groups formed the National AIDS Coordinating Committee of South Africa (NACOSA).

1994 – South Africa’s first democratic elections, and the ANC Government adopted a National AIDS Plan – but the scheme hardly translated into action.

Scandals: - made situation worse!

Sarafina II – A musical screenplay which was supposed to raise awareness of HIV and AIDS was judged widely to be beside the point and confusing. The government funded play used large amounts of unapproved European Union money.

Virodene - South African Government caused worldwide embarrassment when it committed millions to medical trails of an antiviral drug Virodene. Virodene was found to contain a toxic industrial solvent.

1998 – Aids Activists and researches called for the scientifically approved drug AZT to be administered to prevent transmission of HIV from mother to child. ANC turned down this call arguing it would rather focus on education and prevention campaigns then treatment.

HIV-positive AIDS activist Zackie Achmat formed the TAC in December 1998.

1999 – Newly elected president Thabo Mbeki appointed Manto Tshabalala-Msimang as health minister, heralded an even stronger stance against antiretroviral drugs. Mbeki’s questioning if HIV causes AIDS adding to the conflict between organisations like the TAC.

2001 – Death of presidential spokesperson Parks Mankahlana, Official ANC statement reported that his death was due to heart failure after a long illness. When the SA media speculated that his illness was AIDS related, it sparked heated national debate on the ethics of HIV reporting, including objectivity, privacy.

Court Cases

2002 – The TAC and Children’s Rights Centre filed a court motion and later a constitutional claim against the health minister and provincial MEC’s to compel them to make Nevirapine available to women giving birth in state hospitals. The court ruled in favour of the TAC in 2001 and again in July 2002.

2003 – TAC focuses shift to pushing government to roil out ARV treatment through the public Health system. When health minister refused to sign a draft national treatment plan, the TAC launched a civil disobedience campaign. More than 10,000 people protest in front of parliament during Mbeki’s State of the Nation address.

19 November 2003, Cabinet finally announces the health department would make available ARVs to all who need them.

2004 – 2005 Rollout of ARVs slow with treatment guidelines only being issues in September 2004 and supplies of ARVs only being selected in March 2005.

2006 - Tshabalala-Msimang insists that a healthy diet and nutritional supplements, including garlic, beetroot and the African potato, could offer an alternative to ARV treatment. Stephen Lewis, publicly slated Tshabalala Msimang’s statements at the 2006 International AIDS Conference in Toronto Canada. At the same conference, AIDS law Project leader Mark Haywood demanded that the health minister be fired.

Tshabalala-Msimang was hospitalised in late 2006 and her deputy Nozizwe Mandlala-Routledge with Deputy President Phumzilie Mlambo-Ngcuka made major steps to bring back the reputation of the South African National AIDS Council (SANAC), attempting to repair the damaged relationship with civil society organisations, particularly the TAC.

2007 – Government launched its progressive HIV and AIDS and STI Strategic Plan for SA 2007 – 2011, indicating a shift in its health policy. Its main objective being to provide ARV treatment to 80% of people who need it and to half new HIV infections by 2011.

Later that year Mbeki sacked Madlala-Routledge, allegedly because she was too critical of her predecessor and himself. Tshabalala-Msimang was reinstated resulting in the newly built bridges between the department of health and civil society groups quickly crumbling yet again.

2008 – Tshabalala-Msimang finally lost her post to Barbara Hogan in September 2008. Hogan’s term was short lived despite her popularity and commitment to cooperate with civil society.

2009 – Newly elected president Jacob Zuma appointed a previously little-known politician Aaron Motsoaledi to the position of health minister. Aaron Motsoaledi has so far made a number of positive statements, showing intention to tackle the epidemic and improve health services provision.

2010 - For the first time in the history of the South African epidemic, a real properly resourced HIV testing campaign was launched. Minister of Health Dr. Aaaron Motsoaledi is leading the largest every HIV testing drive on the continent with a target to test 15 million people by June 2011


Kirsten Palitza, Natalie Ridegard, Helen Struters and Anton Harber “What is Left Unsaid” Published by Fanele an imprint of Jacana Media (PTY) Ltd on behalf of the Anova Health Instutute, in 2010

Fidel Hadebe, Vukani Mnyandu; Department of Health, 22 Feb 2011

Center for Law and Social Justice, Minister Aaron Motsoaledi delivers — 15 million people to be tested. Get tested. Prevent HIV. Get treated. Always use a condom!

Professor S Karim, University of Natal, King George V Avenue, Durban 4041, South Africa, International Epidemiological Association 2002

Sher R. Acquired immune deficiency syndrome (AIDS) in the RSA. S Afr Med J 1986

1 comment:

  1. Hi Alan, ek hou regtig baie van jou blog en vind dit insig gewend. Well done!

    Johan Obbes


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