Statement from the NICD/NHLS for World AIDS Day 2017

The National Institute for Communicable Diseases (NICD), which falls under  the National Health Laboratory Service (NHLS), commemorated World Aids Day on Wednesday 29 November at the PRF Auditorium, Sandringham, Johannesburg. This was in the form of a panel discussion themed “My Health, My Right.” Prof Adrian Puren issued a statement summarizing the situation in South Africa as follows.
There are worldwide efforts to eradicate HIV/AIDS by 2030. This is an ambitious goal. South Africa, in its response to these efforts, has adopted the UNAIDS 90-90-90 targets to be reached by 2020.  Thus, 90% of all HIV positive person must know their status; 90% who know their status must be on antiretroviral therapy and 90% of those on treatment must be virally suppressed.  South Africa has the largest number of HIV infected persons with estimates of 7.1 million (2016 estimate).
The South African government has made significant investments to reduce the burden of HIV infections and disease.  These investments focus on key treatment and prevention programmes. Close to 10,000,000 tests are performed annually and it is estimated that 86% of HIV positive persons know their status. South Africa has the largest antiretroviral programme with an estimated 4.2 million on treatment (65% of the infected population) and 85% of those on therapy are virally suppressed. New infections have declined from 500,000 in 2005 to 270,000 in 2016 and mortality has declined from 270,000 AIDS-related deaths to 110,000. There are significant numbers of HIV infected persons who start care late with low CD4 cell counts (20%) or who drop out of care and return with low CD4 cell counts. It is essential that the programme treatment programme include TB and Cryptoccal meningitis screening. Finding TB cases and placing them on treatment is a high priority as is STI screening and testing given the high burden of STI disease. Efforts continue to ensure that testing remains a routine and that the hard-to- reach populations such as men, men who have sex with men, sex workers, person who use drugs, have access to testing and treatment and care.  In order to achieve these objectives
 HIV self-screening will be introduced at targeted populations to provide access to HIV self-screening devices. Access to pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are additional tools to prevent infections in vulnerable populations and the results of the PrEP pilot studies will further inform policy and implementation. The incidence of HIV remains unacceptably high in young girls and young women and the Department of Health’s flagship programme, She Conquers aims to support young girls and women by addressing social and structural determinants of health. South Africa has made great progress to manage and control the epidemic as reflected in the increased life expectancy and reductions in morbidity and mortality and the successes in the prevention of mother to child transmission of HIV (PMTCT). Several challenges remain and in particular the high incidence in young girls and young women and key populations. To address these problems will require additional interventions beyond the current approaches.  The South Africa HIV epidemic is complex and made up of several epidemics that requires unique approaches. The interventions need to continue to emphasize a person-centred and rights-based approach.
Issued by: National Institute of Communicable Diseases (NICD)