Canute-like, SA’s leaders trumpet ARV’s as the HIV infection tide rolls in. - BizNews, 08 December 2016

The South African National Aids Council says the high rate of infections among young women between the ages of 14 and 25 remains a key concern. It says there are at least 2,000 new infections among girls between 15 and 24 per week. That’s 104,000 young women a year!

 

By Sara Gon

South Africa is bereft of political leadership. Nowhere is this more evident than with the response to HIV/Aids. While excitement mounts over unique vaccine trials that are being undertaken here, we learn on commemoration of World Aids Day that over 1,000 new infections per day are occurring in South Africa. That’s 365,000 new infections a year!

The South African National Aids Council says the high rate of infections among young women between the ages of 14 and 25 remains a key concern. It says there are at least 2,000 new infections among girls between 15 and 24 per week. That’s 104,000 young women a year!

“Between age 25 to 40 the number [of new infections] has decreased, but we are still seeing an increased number of young girls between age 15 to 24 [becoming infected]. Although we still see challenges in terms of young people getting infected, the death rate of people living with HIV is stabilising in the country. It’s no longer like it was before,” said Deputy General Secretary of the Treatment Action Campaign, Sibongile Tshabalala (The Daily Vox December 1, 2016).

While the roll out of Anti-Retroviral drugs (ARVs) has increased over time, prevention has to be better than cure, of which there is none. ARVs treat HIV/Aids much like anti-hypertensive medication manages high blood pressure or statins manage high cholesterol. they manage but they don’t cure.

Breaks in treatment can be very harmful, are associated with higher risks of becoming ill, have more side effects or even a higher risk of death. Stopping ARVs causes HIV to multiply and damage the immune system, which  increases the risk of infections (including the crisis of tuberculosis) and cancer. The risk of drug resistance also increases.

And a vaccine is not yet available. Prevention should still be a priority. The early treatment of people with HIV massively reduces their infectiousness.

Sex with an HIV positive person on ARV treatment with an undetectable viral load is probably safer than using condoms because more can go wrong with condoms.

But let’s not be coy about it: a woman can only avoid infection if her sexual partner wears a condom or she can avoid having sex altogether. The power dynamic makes both possibilities unlikely.

There is also very little risk of infection if the man is infected provided he is on ARVs and he has sought treatment early enough.

We’ve had the ARV role out and we have had scores of educational campaigns, which seem to have largely disappeared. The impression is that the success of the ARV role-out meant that education has diminished significantly.

The singular educational process we need is one we haven’t had and will continue not to have, and that is leadership.

Zuma cannot provide this leadership: he is a polygamous traditionalist; he has a colourful and varied sexual history; he is distrusted if not loathed by increasing numbers of the populace; and nothing he would say on the subject would be perceived as having any conviction. His comments about HIV/Aids made during his “rape” trial show ignorance, if not callousness.

As second best there is Cyril Ramaphosa who could really make a mark with a population that is over 50% female. Ramaphosa is also married to a doctor who will have professional insights into the disease. So in many respects he could make the issue his own.

But he doesn’t and he hasn’t. Is this a reflection of the nature of government policy or ANC policy or no policy? For Ramaphosa to utter the cliche about taking individual and collective responsibility is nonsense.

Addressing an event in Daveyton on 1 December 2016 Ramaphosa, the prince of platitudes, uttered words that were eye-wateringly pusillanimous:

“We need to act now. If we don’t act to reduce new HIV infections, the lives of more South Africans will be put at risk.”

“South Africans must take personal and collective responsibility in the fight against HIV/Aids as this is the only way to tackle the scourge of new infections.”

“Working as a team, South Africans have the means to end HIV and Tuberculosis (TB).

“Although the challenges are daunting, we must not be overwhelmed.”

Ramaphosa and other ANC leaders need emphatically, unambiguously and repeatedly to deal with the elephant in the room – the low status with which many men regard women and girls, the relative lack of power women have in relation to men and the violence visited upon women as a result.

Commentators often refer to the stigma of it being a sexually transmitted disease. So nothing hard-hitting is ever said. The collective responsibility of the leadership in this country is to tackle the issue head on and honestly. Questions must be asked as to whom is perpetuating the stigma and they must be called out.

Men must be addressed directly. The tired litany of “we are all responsible” and hope that somehow the message will get through has been shown to be ineffective.

And, no, we are not all responsible. The government is responsible for treatment and prevention processes together with NGOs who assume responsibility when getting involved in this issue.

The bottom line is that the main responsibility lies with men who are HIV/Aids positive to ascertain their status and ensure they don’t transmit it to women. Even if a woman is HIV positive a male partner has control over whether he contracts the infection by deciding whether or not to have sex with her.

So let’s not pretend that we must all take responsibility. It’s time for the government and NGOs to address men directly and often. Sensitivity hasn’t helped; only ARVs have and that’s ducking responsibility.

All the good work that NGOs and the medical fraternity do cannot overcome the need for the country’s leadership to engage men unambiguously. Aids is not a notifiable disease in South Africa. Perhaps because of the intolerable risk to young women it should be.

*Sara Gon is a Policy Fellow at the IRR, a think tank that promotes economic and political liberty 

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