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Aids: turning the corner

December 05, 2012

SOUTH Africa has witnessed an “unparalleled” five-year increase in life expectancy since 2005 thanks to the world’s biggest programme of HIV/Aids drug treatment, researchers say.

The trend marks a spectacular reversal from when former president Thabo Mbeki was branded an ‘Aids denialist’ whose dogma was blamed for 330,000 deaths. In a few short years, South Africa has gone from global disgrace to shining example.

Professor Salim Abdool Karim, president of the South African Medical Research Council, said the rise in life expectancy — from 54 years in 2005 to 60 in 2011 — was of the order usually only seen after a major societal shift, such as the abolition of slavery.

In this case, the catalyst was the industrial scale distribution of antiretroviral (ARV) drugs by the public health sector, greatly reducing deaths among people in their 30s.

In 2005, under Mbeki and health minister Manto Tshabalala-Msimang — who promoted a ‘treatment’ of beets and garlic — only 133,000 patients were on ARVs. Now the total stands at 1.9 million, the biggest programme on the planet.

Aids-related deaths decreased from 257,000 in 2005 to 194,000 in 2010, according to the Actuarial Society of South Africa. The rate at which HIV-positive mothers transmitted the virus to their babies decreased from 8.5 per cent in 2008 to 2.7 per cent in 2011.

A national HIV counselling and testing campaign that was launched two years ago has notched 20 million HIV tests in 20 months. South Africa has increased its domestic expenditure on Aids to $1.6 billion, the highest by any low- and middle-income country.

The advances were hailed by the medical journal the Lancet in a paper co-authored by Karim. “The rapid transition from the failed stewardship of ex-president Thabo Mbeki and the disastrous policies of his health minister Mantombazana Tshabalala-Msimang to the leadership shown by the present health minister Aaron Motsoaledi and his team could not have been more striking,” it noted.

The mood is very different from when Karim and colleagues began their research, he said. “Three years ago there were really doom and gloom stories about how bad things were and how we were going in the wrong direction. Now it’s so refreshing to write a positive story.”

South Africa’s first democratically elected president, Nelson Mandela, was slow to address the Aids crisis during the 1990s. But he later took a courageous stand against his own party, visiting a township and donning an ‘HIV positive’ T-shirt ahead of an African National Congress (ANC) conference. In 2005 his public acknowledgment that his son had died from Aids boosted efforts to fight it.

The scourge is far from beaten, however. HIV prevalence has remained static — it is around 30 per cent among pregnant women. Unsafe sex is still widely practised and in 2009 there were on average 935 new HIV infections every day. — The Guardian, London