treatment

On 10 December 2012, the Treatment Action Campaign (TAC) turned 14 years old. Since we were born on the steps of St George’s Cathedral in Cape Town on International Human Rights Day in 1998, it seems like the world has changed. This year’s birthday comes at a time where many celebrate signs that we moving in the right direction due to expanded access to antiretroviral drugs (ARVs). This does not mean the war against HIV and AIDS is over, as many of us tend to forget where we come from and that the road ahead needs more focus. We are disturbed that many global leaders - particularly of developed countries - have started to reverse their commitment to see this struggle through and get to Zero new HIV infections, Zero deaths and Zero discrimination.

In the spirit of celebrating our 14 years of activism we note that:

Mother to child HIV transmission in South Africa has been reduced from 30 percent in 2002 to 2.7 percent: this did not fall out of the sky through the mercy of our leaders. It took sweat, struggle, confrontations and court battles to achieve this. The campaign allowed more recognition of sexual reproductive rights of women living with HIV. But despite this, the right to have a healthy child is still taken away through forced sterilisations imposed on HIV positive women. We will continue to defend and advance this right, bearing in mind the life and words of TAC general secretary, Vuyiseka Dubula:


Access to ARVs has expanded from zero people in the public sector up until 2003 to 1.7 million in 2012. This came about as well through sacrifices of many TAC activists who fought tirelessly, went to prison for civil disobedience and died in calling for a National Treatment Plan. Today, South Africa has the largest ARV programme in the world. But this achievement has its own challenges. Today, we are faced with treatment interruptions where many people in the poor provinces, such as the Eastern Cape, are given three days to two weeks of treatment. This highlights the public health sector’s challenges in managing supply chain management amongst its many other challenges.

The cost of ARVs has dropped from R4500 a month in 1998 to less than R200 for 1st line drugs. However, there are still many challenges as the cost of other essential drugs are still persistently too expensive; for example, multidrug resistant TB drugs, cancer medications and 2nd and 3rd line ARV drugs are not affordable to poor people.

There are still many challenges that we all need to address to get to the three zero’s and that include strengthening the health system to respond to the needs of the majority of South Africans. This means the inequalities in health must be eradicated by implementing the Government’s 10-point plan to improve the health outcomes of all South Africans.

For TAC in the next few years our challenge is to ensure that the ARV programme provides an improved quality of HIV and TB care for all people living with HIV. This can be done by pushing for more integration of TB in HIV programmes, integration of HIV in women’s reproductive health and of mental health care in HIV. This includes mobilising others to join forces to ensure equal access to affordable medicines, diagnostics and vaccines. Also, we need to make sure that everyone who is eligible for treatment has access, while retaining those on treatment in care through improving adherence support.

Affordable medicines can only be available where there is no monopoly of the market. TAC says South Africa must amend its patent laws in the interest of public health. We have seen how the ARV tender has managed to negotiate the best prices and that needs to apply to TB medicines, cervical cancer vaccines and cancer treatments.

TAC would like to thank its thousands of members and supporters who continue to dedicate their time, skills and energy to help us achieve all that we have achieved. We also want to remind all of us that the struggle continues.

Support TAC by donating, volunteering or supporting us:

Name of Bank: Nedbank
Account Holder: Treatment Action Campaign
Account Number: 100 972 6269
Branch: Cape Town
Branch code: 100 909

To inquire about volunteering, contact 021 422 1700 or e-mail to manti@tac.org.za.

For more about the Treatment Action Campaign, refer to www.tac.org.za.

From 2011 to 2015, the global community celebrated 1 December, World AIDS Day, under the theme ‘Getting to Zero’, echoing the Joint United Nations Programme on HIV/AIDS (UNAIDS) vision of achieving ‘Zero new HIV infections. Zero discrimination. Zero AIDS-related deaths’. 

Almost four decades after HIV and AIDS first became part of the public consciousness, immense resources have been invested in prevention, treatment and care. Yet, while some countries have made significant strides in reducing prevalence and responding to the health care burden, there is still a long way from ‘Getting to Zero’.

UNAIDS estimates that 22.5 million people living with HIV in sub-Saharan Africa (UNAIDS 2010), representing 68 percent of the global HIV burden, with 5.6 million in South Africa alone. Yet despite high prevalence, there remains widespread stigma and discrimination, which hinder both prevention and care. Social injustices such as gender inequality, violence against women and girls, and homophobia also discourage people from seeking the information and services that will protect them from, and treat, HIV.

According to REPSSI, along with all of the physical resources, ‘Getting to Zero’ requires new approaches and changes to social environments, especially when it comes to countering stigma and discrimination.

“There is a need to scale up work with communities and families to transform attitudes. This starts with helping them deal with the emotional and social challenges they are facing,” says Noreen Huni, executive director of REPSSI. “Supporting people living with HIV, reducing stigma and discrimination, and caring for affected families is key to achieving Getting to Zero.”

REPSSI works in 13 East and Southern African countries to lessen the devastating effects of HIV and AIDS, conflict and poverty on children by providing social and emotional support to children, their families, and care givers. Working alongside community-based organisations, development practitioners, and teachers, the NGO (non-governmental organisation) helps develop skills necessary to provide care, love, and protection.

Given the prevalence of the pandemic in the region, it is almost impossible for governments and health facilities to shoulder the burden of care alone. Community and family care are vital, yet can be hindered, because of fear and discrimination.

Winfrida Mwashala is the executive director of the St Lucia Hospice and Orphanage in Arusha, Tanzania. Mwashala participated in a ground breaking certificate course in Community-Based Work with Children and Youth, developed by the Regional Psychosocial Support Initiative (REPSSI) and the United Nations Children's Fund (UNICEF). According to Mwashala, applying what she learned to reach out to the community to counter stigma has enabled St Lucia to reach far more children than they could do alone. Previously, St Lucia was a residential care home for children abandoned due to stigma.

“The home could only take up to 30 children at once. Now, we have reached more than 9 000 children at community level,” says Mwashala with a smile. By addressing stigma and supporting families, this new approach has helped reduce discrimination, and children are now being cared for within their own communities.

Living with HIV, Chipo Mwanza* is supported through Roma/Ng’ombe Home Based Care, in Zambia. She started a Tracing Book after training from REPSSI and CATIE, through which she could make notes about her health.

“All the dates are included, appointment days, when you are going for a CD4 count, etc., all are written down,” she explains. “This makes the work of the medical staff lighter, gives a doctor an opportunity to know your history without wasting time.

Along with helping to facilitate medical care, the Tracing Book also helps people living with HIV take responsibility for their health, and see that they have the ability to live positively.

“The tracing book also helped my daughter to accept her status and live a happy and healthy life,” she adds. “It helped to change our mindset from just thinking of being sick to having new thoughts of moving on in life and your future. I thought I would die in 2006. But am still going strong and even encouraging other friends.”

The ‘Getting to Zero’ framework clearly recognises the importance of caring communities, citing, “Where HIV related stigma, discrimination, inequality and violence persist, the global response will forever fall short of the transformations required to reach our shared vision.”

These echoes the words of United Nations secretary-general, Ban Ki Moon: "stigma remains the single most important barrier to public action.”

UNAIDS has set out a number of key steps to advance global progress in achieving targets for universal access to HIV prevention, treatment, care and support and to halt and reverse the spread of HIV. Among these are halving sexual transmission of HIV, ensuring universal access to antiretroviral therapy, and addressing people living with HIV and households affected by HIV in all national social protection strategies, to provide for access to essential care and support.

This strategy is a roadmap marking milestones on the path to achieving UNAIDS’ vision of ‘Getting to Zero’. On the one hand this means putting law policies and programmes in place to create legal environments that protect people from infection and support access to justice. On the other, it means a fundamental shift in attitudes, replacing fear and stigma with love and care.

World AIDS Day is an opportunity to re-affirm our commitment to fight against HIV/AIDS, remember those who have died, and celebrate accomplishments, such as increased access to treatment and prevention services. It’s an opportunity to reflect on how far to go and what more needs to be done – and to ask ourselves, what am I doing to Get to Zero?

* Not her real name.

- Kopano Sibeko is a journalist at Community Media for Development Productions. 

According to an authoritative United Nations report, the death toll is falling but there is still no hope for an end to the worldwide pandemic.

The report states that risky sexual behaviour is continuing around the globe and even increasing in some countries, threatening to derail efforts to stop transmission of the HIV virus and bring the AIDS epidemic to an end.

It further states that although drug treatment for people with HIV is saving millions of lives and deaths are falling, the prospects for stopping the spread of infection are not promising.

To read the article titled, “Attempts to avert HIV are off target,” click here.