Chairperson of the African Union and AIDS Watch Africa Action Committee of Heads of State and Government, Prime Minister Desalegn of Ethiopia

Your Excellencies; 

Colleagues and Heads of States and Governments of Members States of the African Union;

The Chairperson of the AU Commission;

Commissioners;

Ladies and gentlemen; 

 

It is a pleasure and a privilege for me to interact with you on this important topic of HIV and AIDS in Africa.

The scourge of HIV and AIDS counts amongst one of the major challenges that has faced our continent.  At one point the prevalence of HIV and AIDS was more in Sub-Saharan Africa and most affected people reportedly came from South Africa. 

Africa has had to contend with a significant burden of disease due to emerging and re-emerging epidemics, a wide variety of communicable diseases and more recently a looming challenge of non-communicable diseases. 

For all these health challenges, we have worked closely with the international community through the various institutions such as the World Health Organisation, the UN Agencies in the various portfolios, multilateral and bilateral partnerships at the national level and with many civil society organisations across the world.

 

The leadership of the African Union considers AIDS, Tuberculosis, Malaria and other infectious diseases as emergencies requiring bold action, unprecedented levels of financial investments and sustained political leadership.

Over the past two decades, significant progress has been made through a wide variety of mechanisms at the international level such as the UN Declaration on Universal Access, the MDGs, whilst at the Regional level, our efforts have been guided by numerous declarations such as the Abuja Declaration, 2001, the Abuja Call to Action, the Framework on Sexual and Reproductive Health, amongst many others.

Whilst a significant component of resources dedicated to addressing these epidemics and diseases came from the development community, Africa is now in a stronger position to lead, define and drive its own development and more importantly an increasing number of African governments are increasing their domestic allocation to the health sector and in particular to the fight against HIV, AIDS, TB, Malaria and other diseases.

Success in slowing down and eventually eradicating these diseases requires bold leadership, innovation, flexibility, investing in research to generate the evidence required to inform policy, robust planning, precise execution and a good monitoring and evaluation framework.

 

The African Union leadership has applied this formula successfully over the past two decades.

 

Having generated a large number of agreements, declarations and commitments, we have now consolidated these and created an oversight body, AIDS Watch Africa, to monitor the implementation of these important declarations, we have also created various mechanisms to give effect to many of these commitments through plans and strategies.

For example, to ensure that universal access to a comprehensive package of health services is a reality for our people, we have the Pharmaceutical Manufacturing Plan intended to fast-track Africa’s ability to provide affordable medicines for its peoples.

As South Africa, our national efforts to expand access to medicines for HIV, TB and other diseases have yielded great benefits.

Our government led a robust engagement with the pharmaceutical industry which resulted in a 57% reduction in the costs of medicines in South Africa in 2009, and a further reduction of 37% has recently been achieved with the introduction of Fixed Drug Combinations.

 

These efforts have not compromised the quality of the medicines but has significantly contributed to improving access to a large number of people who require health-care.

We will continue to work with our neighbours across the region to ensure that benefits accrue to the whole region.

We also continue to explore new frontiers for collaboration such as the BRICS platform, renewed partnerships with the private sector, foundations and philanthropies based on the principle of mutual accountability and country-led priorities and plans.

 

The efforts and investments are starting to bear fruit as highlighted by some of the most recent reports that have been published by the United Nations Joint AIDS Programme which show that access to antiretroviral drugs has increased from 2, 95 million in 2008, to 3, 9 million in 2009 and to 7 million people in 2013.

This is good news indeed but we must bear in mind that many more people do not have access to life-saving therapy and thus we must strengthen our efforts, advocate for more resources, improve our efficiencies and pursue all avenues to drive down health care costs in our countries and across the region.

Member States of the WHO Africa Region account for 85% of malaria cases, with high rates of mortality in children under five years.

However, over the last decade, improved malaria control has led to a 30% reduction in Malaria cases in 10 African countries.

 

In South Africa we have made some huge strides in the fight against HIV and AIDS since its discovery some 30 years ago.

As a country at the grip of this epidemic, South Africa has indeed been hardest hit by the impact of not only HIV but the TB epidemic as well.

Over the last two decades, we have developed several strategies and interventions to reduce the number of new HIV infections, expand access to treatment for people living with HIV, especially pregnant women and are continuing to address the impact of these epidemics through a robust social security programme including other initiatives such as food security.

 

Having recognized that the rate of new HIV infections continued to outpace our investments and efforts, we embarked on a series of large scale studies in a number of critical aspects of the response.

These studies titled; The Know your epidemic, Know your response and national and provincial AIDS Spending Assessments were undertaken in 2010.

The studies have helped us craft an improved, evidence-led and robust National Strategic Plan for HIV, TB and STIs 2012-2016.

Over the last three years, a number of highly impactful policies have been implemented to address the dual epidemics including their social determinants.

 

Some of the policies we have introduced include:

 

·         The introduction of provider- initiated HIV Counseling and Testing culminating in the roll-out of the worlds’ largest HIV counseling and testing campaign.

·         Expanding access to antiretroviral treatment to pregnant women, persons co-infected with HIV and TB and the general population.

·         Providing prophylaxis to HIV positive persons to prevent TB infection. 

          

We have strengthened our health system through the introduction of new diagnostic technology for TB, the Gene-Expert machines, investing in our laboratory systems, training a wide range of health care providers and introducing legislation in numerous portfolios to support our efforts.

Most notably, we have increased our resource allocation to the health sector and the social cluster across all three spheres of government to enable us to achieve our vision of a long and healthy life for all South Africans.

 

These investments have moved us closer to our goals and to date some of the outcomes we have recorded include the following:

 

•          Over 20 million people have tested since April 2010;  

•          Over 10 million people have been screened for TB;

•          On average 500 000 new patients are initiated on  Anti Retroviral Treatment;

•          2 million patients are now on treatment to make our program the largest in the world;

•          Over 75% of eligible patients are on treatment at CD 4 count at 350 or less;  

•          We have reduced HIV and AIDS related death by 50% to less than 270 thousand patients;  

•          We have also improved life expectancy from birth to over 60 from around 54 years in 2007;

•          The transmission of HIV from mother to-child has decreased significantly over the last 3 years from a high of 8% in 2010 to 2, 7% nationally with some districts reporting even lower rates of transmission.

 

These achievements have however, not made us complacent and we continue to review our programmes, introducing new and innovative approaches in line with international guidelines and protocols.

 

For the first time this month, we have introduced a Fixed Drug Combination (FDC), which means people living with HIV will now receive one pill a day instead of four tablets or more in some cases to maintain their health.

One pill a day will improve adherence to treatment, lower costs and indeed reduce the burden on our health system.

On-going collaboration with other countries in the Region will provide more opportunities to share lessons, document best practice, and maximize efficiencies through harmonization of protocols and policies across national borders and expanding partnerships in common areas of research and development.

 

The World Health Organization reported that about 4% of South Africa’s population is at high risk of Malaria, 6% at low risk while the rest of the South African population reside in Malaria risk free areas.

In South Africa we have three Malaria endemic areas in the provinces of Kwa Zulu-Natal, Mpumalanga and Limpopo provinces.

South Africa is according to the WHO only one of five countries that has dedicated domestic expenditure to control Malaria.

 

The estimated expenditure for Malaria control exceeds $5 dollar per capita.

Our country is one of eight African countries that have achieved a reduction of more than 75% in Malaria new case or patients admitted with Malaria disease or symptoms.  

The majority of the Malaria cases have been reported in Limpopo, Mpumalanga, Gauteng and Kwa Zulu-Natal.

A review of data from 2001 to 2009 in one of the affected province, Mpumalanga has shown that death from Malaria was reduced by 70%.  

 

Mobility across the borders poses a challenge in Malaria control.  Strategy to collaborate with our neighbours is likely to yield better outcomes.

Some of the strategies include sharing of surveillance data as well as interventions focussing on rural communities.

I believe we have gone a long way towards ensuring that our people do not regard HIV and AIDS as a death sentence, we are at a point where many now understand that HIV and AIDS is a manageable disease.

 

You can live with this disease healthily for many years as long as you can protect yourself from re-infection. 

Our efforts are indeed starting to pay off in our struggles against HIV and AIDS.

 

I thank you.