Address by Deputy President David Mabuza on the occasion of South Africa's 2020 World AIDS Day commemoration event, Soweto, Gauteng

Co-Programme Directors: Acting MEC for Health, Mr Jacob Mamabolo and SANAC Women’s Sector Representative, Ms Silungile Mntambo, 
Minister of Health, Dr Zweli Mkhize, 
Deputy Minister, Dr Joe Phaahla,
Premier of Gauteng, Mr David Makhura, 
Executive Mayor of Johannesburg, Cllr Geoff Makhubo, 
CEO of the SANAC Trust, Dr Thembisile Xulu, 
Deputy Chair of SANAC, Ms Steve Letsike, 
USA Ambassador in South Africa, Amb Lana Marks, 
UN Resident Co-ordinator in South Africa, Ms Nardos Bekele-Thomas, 
Representatives from Business, Labour, and Broader Civil Society,  

Ladies and Gentlemen,

We meet here today, at Itireleng Community Health Centre, in Dobsonville, Soweto, to commemorate World AIDS Day under the theme: “We’re in this Together, Cheka Impilo”. 

Also, we meet here to celebrate the important work that nurses, midwives and community health workers provide to our people and communities. The World Health Assembly designated 2020 as the International Year of the Nurse and Midwife to highlight their indispensable work to give lifesaving care, advice, medicine and treatment.   

The agility of the nurses has been very instrumental in our country in addressing public health epidemics, most notably the rapid roll-out of antiretroviral treatment through Nurse Initiated Management of Antiretroviral Treatment, Nurse Initiated Management of Drug resistant TB, and of late the management of COVID 19. 

Sadly some of these dedicated cadres contracted these diseases in the line of duty, and some succumbed to these deadly diseases, most notably COVID 19. Their selfless diligence will always be appreciated by our people and we bow our heads in their honour, may their souls rest in eternal peace.

Our national theme for this commemoration is linked to the global theme, which is “Global Solidarity, Shared Responsibility”. This is a clarion call to every South African to make responsible health choices since the social wellbeing of a community depends on the actions of every individual within the community. 

Each one of us needs to play their role in reducing new HIV and TB infections, in stopping gender-based violence and femicide, and in protecting the most vulnerable in our society, including adolescent girls and young women. 

Our “Cheka Impilo” National Wellness Campaign is integrated into the theme as a challenge to every South African to always “Cheka Impilo” and know your status.

It is a campaign that aims to initiate people on HIV treatment, find the missing TB cases and screen people for non-communicable diseases. Cheka Impilo or testing is emphasised because if a person does not know their health status, it is difficult to treat them for a disease or virus like HIV, TB, non-communicable diseases as well as Covid-19.   

Since we launched this society-wide campaign in 2018, we have made some good progress, although much more work still needs to be done to ensure that indeed, access to healthcare is a human right for all people and not only for the few. 

In the period from April 2019 to March 2020, we were able to test more than 18 million people for HIV, thus exceeding the annual target of 14 million that we had set for ourselves.  Our treatment programme has also reduced the number of deaths due to AIDS by 60 percent.   

Fellow South Africans, 

We have chosen to commemorate this World AIDS Day here at Itireleng Clinic because of the sterling work they do to support adolescent girl, young men and women.  This clinic offers youth friendly services, and they also work in partnership with the ward-based outreach teams in the community, as well as non-governmental organisations.

This relationship that Itireleng Clinic has with the community, is a practical reminder to all of us, that we can only win the fight against HIV and TB if we work together in solidarity to save lives and livelihoods, protect the vulnerable and marginalised.  

Earlier today, we had the opportunity to listen and take part in a session where adolescent girls and young women shared with us their experiences and insights as people living with HIV. This dialogue was more than just a talking session, as these young people also offered solutions to the challenges that they are confronted with.

In the true spirit of being in this fight together, they committed to work with us in dealing with issues that concern them. These include:

• Ensuring that they are treated with respect and dignity when they present themselves at health and other facilities for services;
• Developing more strategies that will focus on targeted services for adolescents living with HIV;
• Improving on social security support for adolescents living with HIV, and
• Putting strategies in place to address stigma and discrimination which they suffer as adolescents living with HIV.

 
We have listened to your input and are committed to supporting you. As partners in the response to HIV and TB, we must respond to the health needs of adolescent girls and young women. In the same vein, we must intensify the “She Conquers” campaign for adolescent girls and young women. With this campaign, we seek to:

• Decrease new HIV infections in girls and young women,
• Decrease teenage pregnancies,
• Keep girls in school,
• Decrease gender-based violence, and
• And increase economic opportunities for young people, especially adolescent girls and young women.

We are encouraged by the fact that HIV infections in adolescent girls and young women have declined in the last decade.  But we also know that much more work still needs to be done to protect and empower this vulnerable group.

Programme Director, 

As South Africa, we support the theme of global solidarity and shared responsibility. The global impact of the Covid-19 pandemic on our work to ensure that we end AIDS by 2030, has been significant. 

No government in the world, can on its own without the active support of global and all other social partners including civil society, defeat the colliding pandemics of HIV, TB and Covid-19. We much are better and much stronger when we stand united, and in sharing our responsibility towards building an HIV free society.  

Global solidarity demands that we double and increase our efforts, capacities and resources to support and encourage the 38 million people currently living with HIV globally. Shared responsibility requires all of us to support and encourage the more than twelve 12 million who are awaiting life-saving HIV treatment.

Global solidarity and shared responsibility, is about working together to achieve what the World Health Organisation’s Director-General, Dr Tedros argued for, that, “Universal health coverage means ALL people have access to ALL the services they need, for ALL diseases and conditions”.  

This is important since HIV and Covid-19 become exacerbated by inequality in lack of access to health infrastructure and social safety nets. For us as government, guaranteeing human rights and public health are mutually inclusive. 

We are required to put people at the centre, especially the people most at risk of infection and the marginalised, namely, young women and girls, adolescents, sex workers, people who inject drugs, transgender people and gay and other men who have sex with men. 

As a country, we have made great strides in meeting the first target of ensuring that people know their HIV status. At present, 92 percent of people living with HIV know their status. Of course, there are provinces that are doing better than others, but in general, South Africans are testing and this behaviour needs to be encouraged and maintained. 

We have ensured that 73 percent of people diagnosed with HIV, receive sustained anti-retroviral treatment. Therefore, the country has a treatment gap of 17 percent. We are encouraged that our country’s performance to reach a 90 percent viral suppression level, stands at 88  percent. 

As we record these successes, we need to remain focused and initiate more people on treatment, as well as make sure that they stay on treatment and are virally suppressed. It is important that HIV-infected people start treatment and stay on treatment in order to limit transmission and the rate of new infections. 

Together we can do this. Together as a country we can reach the remaining two 90-90 targets, and ensure that HIV and TB are turned from perceived death sentences into a manageable and treatable diseases. We are encouraged by the recently released Thembisa, which is a leading mathematical model of HIV in South Africa. According to this model, most provinces are making progress in the attainment of the 90-90-90 targets, with KwaZulu-Natal leading in this fight. Together, we need to build on this progress and accelerate our efforts.

Most importantly, as government we remain committed to address concurrently HIV, TB and Covid-19. Our programmes and resources are dedicated to respond in equal fashion to these multiple health conditions, along with non-communicable diseases, without sacrificing one for the other. By taking this approach, we will be able to rationalise the scarce resources and improve efficiencies, without one problem undermining the other.

Ladies and Gentlemen, 

We remain committed to reach the National Strategic Plan target of reducing the number of new HIV infection to less than 100 thousand by 2022. 
 
However, our task at hand is facing some tangible hurdles due to unfortunate behaviour patterns where the use preventative and protection measures against HIV infection are underutilised. It is further concerning that men, generally, do not come forward to test. It is concerning that gender-based violence and femicide is a rising epidemic in South Africa. 

Together, we must fight the scourge of violence against women and children. Partnerships with our communities, and accountable leadership among all our social partners, are vital to recommit to building social cohesion and moral regeneration in the family, at schools, and in places of work.  

Our history as a nation, is steeped in unity of purpose. Every battle towards building a non-racial, non-sexist and democratic South Africa, has been possible because of our conscious decision as a people to stand together and craft a different path for our nation. The same approach of partnerships and of united action, is what is required to combat the spread of HIV and TB in our communities. 

We need the same unity of purpose in ending gender-based violence and femicide. If we embrace collective and shared responsibility, we can ensure that no new infections are registered in our families, communities and workplaces. For us to be victorious against HIV, we need to be victorious against the social and economic injustices that undermine our efforts. 
 
We commemorate this World AIDS day in the middle of 16 Days of Activism against the Abuse of Women and Children. It is critical for us to decisively address gender-based violence and femicide, inequality as well as insecurity. We must also ensure that all marginalised groups especially young women have equal access to education, health and employment. If we fail to do this, all our efforts to address HIV will be futile.

Partnerships and leadership are needed to address patriarchy and toxic masculinity that fuel gender-based violence and sexually transmitted infections. Rebuilding social cohesion is critical not only in HIV prevention but in the elimination of violence against women, children and key populations. 

Programme Director,  

The setbacks we encountered towards fully reaching the 90-90-90 can be corrected. We can be back on track to end HIV/AIDS by 2030 by doing the basics right, which include dispensing multi-month HIV medicine in primary healthcare facilities. We must ensure that front-line workers, like nurses and midwives, are protected and given the requisite safety equipment to be effective in their work. 

One critical success factor of the HIV response, is the importance of support and buy-in from communities to ensure that there is seamless coordination of the HIV and TB response at all levels. Key amongst these stakeholders and partners, are the AIDS Councils at the provincial, district and local levels. 

Community support and community centres like Itireleng, remain the backbone of our fight against HIV and TB. Since the launch of the current National Strategic Plan, we have been working with the provinces and the districts to build the capacity of the AIDS Councils to effectively lead the coordination and implementation of this Strategic Plan. 

We are encouraged that all nine Provincial Councils on AIDS are up and running. We applaud all the Premiers who have committed to providing leadership of the AIDS Councils and are leading from the front. We urge the Premiers and District Mayors to ensure that their Provincial and District Councils on AIDS are functional. 

We will not succeed in our response without the full commitment and participation of leaders at all levels. We are in this together, so let us all pull together to intensify our response to these epidemics.

Ladies and Gentlemen, 

Building on the great successes of the consensus that has accompanied and strengthened our response over a period of more than a decade, the SANAC Government and Civil Society Sectors have agreed to strengthen their partnership on service delivery and implementation of priority campaigns. Strong partnerships among the sectors of SANAC, remain a cornerstone for our effective response to the challenges of HIV and TB.  

In this regard, the last SANAC Extended Plenary, approved the partnership strategy between Government and Civil Society Sectors. This partnership is actually the binding thread that elevates SANAC as one of the best practice models globally; wherein government and social partners work congruently together towards a common goal of saving lives.

Today, we officially launch this partnership that will see Government Departments and Civil Society sectors working together towards the achievement of the goals of our National Strategic Plan.

Allow me to congratulate the management of this clinic and the SANAC sector of People Living with HIV, for deciding to form a partnership to bring back on to treatment those people who have been lost in the programme. This is an important step in ensuring that the sector of People Living with HIV supports the work of the clinic, and together they find sustainable solutions to challenges faced by people living with HIV.

In conclusion, in this collective journey, we thank our local and international partners for walking with us. We urge our partners, including the UNAIDS, the Global Fund, PEPFAR and others, to continue to support our national response as they have been doing over the years. This is a partnership that we will always cherish which symbolises in action and deeds, genuine global responsibility and partnerships that make a tangible difference. 

We wish you all a successful World AIDS Day.

I thank you.