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State unveils 'ambitious' plan for HIV
Linda Daniels, Independent Online
2007-03-01

The draft National Strategic Plan on HIV and AIDS aims to reduce the rate of HIV infections by 50 percent in the next five years, MPs were told on Tuesday.

The health department's Nomonde Xundu and Director-General Thami Mseleku unveiled the ambitious plan to the National Assembly's health committee on Tuesday.

It aims, among other things, to provide treatment, care and support services to 80 percent of HIV-positive people and their families by 2011.

It also aims to reduce the rate of HIV infection by 50 percent in the next five years.

When asked by MPs if the goals were attainable, Xundu admitted that it was going to be a stretch.

I have to be honest and say it is a very ambitious target... I agree with you it is ambitious, but you don't plan to fail.

Maybe we need to be cautious looking at it it doesn't predict that it will definitely happen, said Xundu.

MPs also grilled Xundu and Mseleku about the possibility of providing treatment to HIV-positive people with CD4 counts above 200.

Currently, only those with CD4 counts of 200 are eligible for treatment.

Low CD4 counts are usually an indication of immune suppression and vulnerability to opportunistic infections.

Xundu said that there are huge numbers of people with CD4 counts of 200 and that increasing that pool with people with CD4 counts above 200 may be setting yourself up for failure.

Mseleku argued that the government's decision to provide treatment to those HIV-positive people with CD4 counts of 200 was not a thumb-suck.

The government had taken that decision based on advice from the World Health Organisation, he said.

It was a very conscious decision not to move in that direction (to provide treatment to HIV-positive people with CD4 counts above 200), both from international advice and our own assessment that we don't think the system is actually ready to manage the numbers and implications, he said.

Meanwhile, hopeful inquiries by MPs about a possible vaccine for HIV being developed were dashed when Xundu said that it doesn't look good.

Xundu said that it wasn't likely to happen in the next five to seven years.

The final draft of the plan is expected next month.

It is being driven by the SA National AIDS Council (Sanac) and is the result of a collaborative effort between the government and the NGO sector.

The plan builds on the previous 2000 to 2005 strategic plan which was hampered by an ineffective national AIDS Council and a lack of leadership on the issue.

Sanac was established in 2000 as a response to the need for a multisectoral focus on the HIV epidemic and to advise government on policy related to HIV and AIDS.

MPs were told that now that Sanac had been successfully restructured, it was up to the challenge of delivering on the plan.

Mseleku also tried to allay MPs' concerns that Sanac would fail, given its past track record.

I agree that Sanac has actually not been functional for the past two years, but the very fact that we are able to (present) the strategic plan shows you that it's a different Sanac.

All the plans that have been outlined are not just the dream of the department, but are actually agreed upon (by all sectors), said Mseleku.

Mseleku said that Sanac represented key leaders from most sectors.

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