South Africa
unveils plan to cut HIV infections, boost AIDS treatment

The South African government proposed a five-year plan Wednesday to halve the number of new HIV infections in their country, saying it had failed to persuade young people to change their sexual habits.

In a report, the government also said the country needed to better address the stigma associated with the disease, which discourages many people from being tested, and vowed to expand its treatment and care program to cover 80% of people with AIDS. The report's frankness--and the warmth with which it was received by AIDS activists--marked a turnaround after years of international condemnation for policies that many said went against medical advice and activists' efforts. The health minister in particular has been criticized for questioning antiretroviral treatments and promoting nutritional remedies, such as garlic and lemons, to fight the disease.

''This plan marks a turning point in the struggle to stop the HIV/AIDS epidemic,'' said Zwelinzima Vavi, the general-secretary of the Congress of South African Trade Unions. ''We hail the new spirit, which signals the end to acrimonious debate and the standoff between government and important sectors of our people.''

Poor coordination and lack of clear targets and monitoring has helped AIDS to become a major cause of premature death in South Africa, with mortality rates increasing by about 79% from 1997 to 2004, with a higher increase among women, the 120-page report said.

About 5.54 million people were estimated to be living with HIV in South Africa in 2005, with 19% of the adult population affected. Women in the 25-29 age group were the most affected, with prevalence rates of up to 40%. ''There are still too many people living with HIV, too many still getting infected,'' the report said. ''The impact on individuals and households is enormous.'' Children were also vulnerable, with high rates of mother-to-child transmission.

A separate report from the Human Sciences Research Council said there were an estimated 571,000 new HIV infections in 2005--roughly 1,500 per day. The report, which appeared in the South African Medical Journal, said that more than one third of the new infections were in the 15-24 age group and that women accounted for the overwhelming majority.

A two-day conference, beginning Wednesday, brought political and business leaders together with AIDS activists to discuss ways to implement the government's five-year plan. ''The National Strategic Plan includes ambitious targets to reverse the course of HIV and AIDS over the next five years,'' the acting health minister, Jeff Radebe, said. ''These bold targets reflect our commitment to combat HIV and AIDS.''

The government appointed Radebe last month, after Health Minister Manto Tshabalala-Msimang left her duties due to illness. Since taking the post, Radebe has sought to mend fences with doctors and AIDS activists, including the main Treatment Action Campaign group, after years of Tshabalala-Msimang advising South Africans that natural remedies were better for fighting AIDS than antiretrovirals.

Deputy President Phumzile Mlambo-Ngcuka, appointed last year to help revamp the country's AIDS strategy, said the government had set aside 14 billion rands ($1.89 billion) for the plan, and she called on businesses to match its contribution. She called for targets to be set and met to ensure the plan had the required impact, saying ''our actions must be measurable.''

The proposed plan--meant to be finalized by the South African National AIDS Council later this month--set a target for reducing the number of new HIV infections by 50% by 2011. To reach the target, it called for more effort in empowering women, who often are targeted in sexual abuse, and to encourage people to be tested for the virus.

More also must be done to promote behavior changes in young people, the report said. Mlambo-Ngcuka urged youths to delay their first sexual experiences and to be at the forefront of the fight against the disease. ''We would like to make sure our young people believe there can be and there will be an Africa free of AIDS,'' she said.

The Treatment Action Campaign, in the past highly critical of government efforts, welcomed the proposed five-year plan as one of the ''best responses'' to the epidemic. ''We can already recognize significant departures from the previous plan (for 2000-05), which didn't have targets or recognize the drivers of the epidemic,'' said Sipho Mthathi, the campaign's general secretary, according to the South African Press Association.

The report said the government should aim to provide ''appropriate packages of treatment, care, and support to 80% of HIV-positive people and their families by 2011.'' Currently, nearly 250,000 people are receiving antiretroviral therapy--about 20% of the estimated number of people living with HIV.

The report also said a tuberculosis epidemic in South Africa was closely linked to AIDS, and voiced concern about the emergence of a nearly untreatable TB strain that preys on those with a suppressed immune system. More coordination in managing the two diseases was needed, it said. (AP)