Scale up prevention, say experts
A decade ago an HIV diagnosis was considered a death sentence in South Africa.
Today, a national HIV-treatment programme is saving lives, which is a far cry from where we have come.
Then, people were dying like flies and the funeral parlour industry was booming. Today, far fewer people are dying of Aids and those that are HIV positive are living longer and healthier lives. Experts attribute this turnaround to the nationwide availability of antiretroviral drugs.
Professor Carolyn Williamson, head of the medical virology division at the University of Cape Town, said if the government had not taken the fight against HIV seriously and scaled up treatment in the past seven years, hundreds of thousands of people would have died.
“The nationwide availability of antiretroviral treatment (ART) averted millions of unnecessary deaths. Before ART became available to the public, an HIV diagnosis was similar to a death sentence, because doctors would treat opportunistic infections while the virus would continue to spread.”
In the time Williamson was referring to, HIV was indeed spreading like wildfire. And there was no treatment available, particularly for those who relied on the public healthcare sector.
At the time, scientists and activists had lobbied government to make HIV treatment available for the public, but without success. It was only in 2003 that the government approved a plan to make antiretroviral treatment available to the public. The step only materialised after several civic attempts, including lobby efforts of structures such as the Treatment Action Campaign.
Although thousands of people started accessing treatment in the following year (2004), this had little impact at first where it was most needed. Many continued to die as the roll-out kicked off in urban areas and only slowly spread to the smaller towns, eventually reaching the stricken rural structures. At the peak of the HIV epidemic in 2006, UNAids estimated that 350 000 people had died of Aidsrelated illnesses in South Africa.
About a million more were on ART in 2009. This figure doubled in 2012 after the introduction of HIV testing. The latest statistics show that 3.4 million people were accessing ART in the public healthcare sector alone by the end of last year. This makes South Africa’s antiretroviral (ARV) programme the biggest in the world.
With the test-and-treat campaign, which launched in September this year, Williamson said the number of sufferers accessing ARV treatment could increase significantly.
“The advantages of testing and treating people immediately after being diagnosed with HIV is that you control transmission. Once a person is on ART and adheres to treatment, the chances of him or her transmitting the virus to their partner is slim, which is why we need to get everybody who is HIV positive on treatment,” she stressed.
“ARV treatment can drastically reduce Aids-related deaths and new HIV infections.”
But experts believe more still has to be done to prevent new infections. Last year an estimated 330 000 people were infected with HIV in this country, according to UNAids.
This was a massive figure, considering that HIV was a preventable disease, said Dr Edith Masango, an HIV specialist from Johannesburg.
“I think we have become complacent as a nation because of the strides made in the fight against HIV and Aids. People now consider HIV as another chronic disease that can be managed with treatment,” Masango said. While this is a good mind-set, she warned “not to normalise the abnormal”.
Williamson added that South Africans must be careful not to reverse the successes it had gained by being slack.
“Treatment alone will not end HIV. We need to close the tap by preventing new HIV infections as well.
“Prevention is better than a cure,” Williamson said.
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