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As people around the world mark World AIDS Day, December 1, the government of South Africa is to announce an ambitious five-year plan to combat the disease, which is estimated to infect 11 percent of the population. The plan contains new strategies for the government, which has been widely criticized for its response to the disease. Correspondent Scott Bobb reports from Johannesburg.
AIDS activists in South Africa are expressing cautious optimism about a new five-year plan, aimed at combating the deadly virus.
The director of the HIV/AIDS program in the national health department, Dr. Nomonde Xundu says the new plan aims to address what she calls some deep limitations of the previous program.
"There are two main goals going forward, which is: reduction of the rate of new infection; also reducing the impact of AIDS on individuals, families, communities and society," noted Xundu.
She says the plan proposes to cut the rate of new HIV infections in half, within five years, a target which she admits is ambitious. The plan also aims to provide support to 80 percent of those already infected with HIV.
Such support includes hospice care and treatment with anti-retroviral drugs. It also includes programs to combat infectious diseases associated with HIV, such as tuberculosis, and to boost psychological support and community awareness. The previous plan was severely criticized because it did not set targets and did not have an evaluation system.
The head of the Southern African HIV Clinicians Society, Dr. Francois Venter says key senior leaders in the South African government downplayed the gravity of the AIDS epidemic. They blamed it on other diseases and, at times, undermined government programs by sending conflicting messages on how to deal with AIDS.
"Having that sort of leadership has meant we have gone nowhere for the last couple of years, other than [having] a government that has almost been forced into providing an anti-retroviral program that has been limited in terms of its scope," said Venter.
He says anti-retroviral drugs, which can prolong the life of an AIDS victim almost indefinitely, reached only 20 percent of those who needed them. As a result, more than one million South Africans died of AIDS, during the past five years.
The government was also severely criticized for ignoring AIDS groups in its policy making. But Dr. Xundu of the health department says this has changed and AIDS groups are now included in the government's National AIDS Council.
"There is a debate with civil society and experts as to how we make the decisions on the details of the targets themselves; but we agree on the high level, broad targets," she said.
Venter says the government has taken into account some major concerns of HIV/AIDS civic groups and, as a result, they now support the plan.
"The framework that will be released in December will be agreed to," said Venter. "The initial draft that was presented to us wasn't nearly ambitious enough, in terms of number of people being treated and a whole range of other indicators that they were proposing."
However, he says some major concerns remain, such as testing for HIV and tuberculosis and reducing mother-to-child transmission of HIV.
Because of such issues, the government is to announce a framework and set of principles to fight HIV/AIDS. It will announce a more detailed plan next year.
The director of the AIDS Law Project, Mark Haywood, says he sees a new commitment, at the highest level of government.
"The South African government has clearly recognized that its approach to AIDS is not sustainable and is causing it embarrassment, but perhaps most importantly of all is leading to many avoidable HIV infections and many avoidable deaths," said Haywood.
Dr. Xundu says the new plan does not represent a change of direction by the government, but rather a better understanding of the complexities of HIV/AIDS.
"It's [the plan is] enhancing and strengthening what is in place already; but also use the additional evidence and information to strengthen the strategies and programs going forward," added Xundu.
She says the government now recognizes that a program to combat HIV/AIDS must also include easing poverty, fostering development and raising the status of women.
It must also include community programs, so people understand better the challenge of the epidemic and where they can obtain the resources to fight it.
And, she says more efforts must be made to change risky behavior, which has not declined despite the fact that most people now know it can kill them.
Venter, of the AIDS Clinicians group, says prevention programs have not succeeded and three million new infections are expected in the next five years.
"Whatever we are doing at the moment is not working and that needs to be acknowledged and acted upon," continued Venter. "And, we need some brave leadership and brave thinking, in terms of what we can do to try and stop new infections."
He says the country needs a nationwide crisis plan as well as new approaches, such as involving lay counselors and community workers to ease the burden on overworked hospitals and clinics.