Republic of South Africa; The Biggest HIV Epidemic


Republic of South Africa; The Biggest HIV Epidemic


Politics: The Economic, legal, cultural and social context 
South Africa was the first country in sub-Saharan Africa to fully approve PrEP, which is now being made available to people at high risk of infection. It is also a country with many of the non-nationals coming different African countries. There is need to institutionalize efforts to combat racial discrimination and ethnic violence.

People: Knowing how many are involved in order to engage
South Africa has the biggest HIV epidemic in the world, with 7.1 million people living with HIV. HIV prevalence is high among the general population at 18.9%.

South Africa has made huge improvements in getting people to test for HIV in recent years and is now almost meeting the first of the 90-90-90 targets, with 86% of people aware of their status.

Prevention: Making prevention a best-practice
The country has the largest ART programme in the world, which has undergone even more expansion in recent years with the implementation of ‘test and treat’ guidelines. 

Planet: The idea of universalizing and synchronizing best practices
An understanding of frameworks promotes internationally acceptable standards of care and reduces on complexities. One such standard in the HIV care world is the use of fixed dose combination of Stavudine (d4T), Lamivudine (3TC) and Nevirapine and Efavirenz-containing combinations that include AZT/3TC or d4T/3TC as a fixed dose tablet (Keith et Al, 2004). International HIV organizations play a key role in advocating for strong targets and indicators by which to measure progress. For example, those focussing on equal access to HIV services for all, call for global indicators to properly include key affected populations. UNAIDS’ Fast Track targets for 2020 include:

90% of people living with HIV know their status; of whom 90% are on treatment; of whom 90% are virally suppressed (90-90-90)

Fewer than 500,000 new HIV infections annually (a 75% reduction since 2010).

Those working in the field of HIV, including policy makers, programmers, governments and community-based organizations operate within the framework of global HIV targets.

Current targets are geared towards ending AIDS as a public health threat by 2030.

South Africa has the biggest and most high profile HIV epidemic in the world, with an estimated 7.1 million people living with HIV in 2016. South Africa accounts for a third of all new HIV infections in southern Africa.

In 2016, there were 270,000 new HIV infections and110,000 South Africans died from AIDS-related illnesses.

South Africa has the largest antiretroviral treatment (ART) programme in the world and these efforts have been largely financed from its own domestic resources. In 2015, the country was investing more than $1.34 billion annually to run its HIV programmes.

The success of this ART programme is evident in the increases in national life expectancy, rising from 61.2 years in 2010 to 67.7 years in 2015. HIV prevalence remains high (18.9%) among the general population, although it varies markedly between regions. For example, HIV prevalence is almost 12.2% in Kwazulu Natal compared with 6.8 and 5.6% in Northern Cape and Western Cape, respectively.

The role of independence, need for labour, contribution by other countries ensuring a post-Apartheid, Apartheid, Black-White Economic inequality, masculinity, femininity, status of children, orphanhood due to wars and HIV, and other historical experiences are intertwined in the self determination of individuals, democratization and notions of sexuality in South Africa. Reading Isak Niehaus (2010), Maurice Dunaiski (2013) and many authors one sees the character and typology of where the barriers to ending HIV in South Africa lie. Labourers or foreign nationals with/without South African stay permits, Women, young girls, men and young boys need the protection of law in case they face any form of violence/violations which may also be a precursor to HIV transmissions, STIs, unplanned pregnancies, maiming and deaths. Secondly, the need for individuals to be empowered in reporting abuses within the existing structures and a guarantee to be heard without shaming. Third, there has to be a system of referral and retention in clinics in case one has acquired HIV or faced physical or mental trauma. Fourth, there has to be a system of safe homes or havens to care for orphans, vulnerable children escaping rituals such as circumcision gone wrong, female genital cutting and gender-related persecution. These same spaces must cater for those living with HIV. The government must invest in structures to support rights of both citizens and non-citizens. In the case of HIV care for orphans the matrikin and older female siblings as benefactors is one good example which must be supported.  For more see: HIV and AIDS in South Africa. 

Middle To Upper Class Decor. Source: Google


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