South Africa turns new leaf on Aids

After years of denial, new president promises drug therapy for the vulnerable

South Africa's President, Jacob Zuma, ushered in a "new era of openness" on HIV and Aids yesterday as he declared that drug therapy would be made available to all infected pregnant women and babies in the country.

He used an address marking World Aids Day to make a public break with the denialism that characterised the handling of the pandemic by his predecessor, Thabo Mbeki.

Mr Zuma also said he would take an HIV test himself, which may go some way to salvage his credibility after his notorious testimony that he took a shower to avoid contracting HIV after sleeping with an infected woman.

South Africa has the largest population living with HIV and Aids anywhere in the world. It also has the largest number of people taking anti-retroviral drugs, ARVs, that slow the effects of the disease. However, experts say as many as a million people may be going without treatment.

While President, Mr Mbeki had argued that ARVs were too costly and disputed the internationally accepted science, questioning whether HIV caused Aids. The new policies call for an expansion of HIV testing; for pregnant women to receive ARVs to reduce the number of infected babies being born; for all babies who test positive to receive drug therapy; and earlier treatment for all patients diagnosed with Aids or tuberculosis.

"What does this all mean?" Mr Zuma asked in a live television broadcast. "It means that we will be treating significantly larger numbers of HIV-positive patients. It means that people will live longer and more fulfilling lives."

The announcement follows new guidelines on treatment from the World Health Organisation released on Monday and suggests a new seriousness in dealing with a crisis that has made South Africa one of only four countries in the world to see child mortality rates go backwards in the past decade.

Yesterday, in language that directly echoed the long-time Aids campaigner Zackie Achmat, the ANC leader compared the battle against the disease to the struggle against apartheid.

"At another moment in our history, in another context, the liberation movement observed that the time comes in the life of any nation when there remain only two choices: submit or fight.

"That time has now come in our struggle to overcome Aids. Let us declare now, as we declared then, that we shall not submit."

Questions remain over how the expanded health programme will be paid for, with Health Minister Dr Aaron Motsoaledi admitting to a shortfall of $135m. In the short term it may come from the US, as officials swiftly followed Mr Zuma's speech with an announcement of $120m in new Aids funding over the next two years.

South Africa has some 5.3 million people living with HIV, with over 400,000 more becoming infected last year. A study carried out by researchers from the Harvard School of Public Health estimated as many as 330,000 people died prematurely as a result of Mr Mbeki's stance on HIV and Aids.

The former president appointed the widely ridiculed Manto Tshabalala-Msimang as health minister at the height of the crisis. He then stubbornly stood by her even after she was derided at home and abroad for suggesting garlic and beetroot as treatments for Aids.

In numbers: Living with HIV

5.7m South Africans with HIV

43 per cent Proportion of all deaths in South Africa caused by Aids

1.4m

Number of children in the country orphaned by Aids

280,000 Number of under-14s living with HIV

1st

South Africa's position in table of countries with highest infection rate

413,000 New infections in 2009