11.3m Infected and Counting! 28/4/11

Increase of 31 percent from the 8,6 million of a decade earlier.

Windhoek (Southern Times) – Southern Africa now has 11,3 million people living with HIV and AIDS, an increase of 31 percent from the 8,6 million of a decade earlier.

While it is acknowledged that much work has been done over the last ten years to contain the pandemic, governments and experts are in agreement that much work still needs doing.  Domestic resource mobilization for HIV and AIDS intervention programmes remains low with few countries dedicating at least 10 percent of their national budgets despite prevalence rates being above this percentile.

The dependence on foreign funding has also been cited as a problem as it comes with specific intervention conditions that may not tally with individual countries' long-term plans.

For countries like Zimbabwe, foreign funding generally has not been forthcoming for political reasons. Experts also say prevention strategies often fail to address key drivers of national epidemics, including people in stable relationships and adults over 25 years of age.

According to UNAIDS, nine countries in Southern Africa continue to bear a disproportionate share of the global burden. Approximately 5.6 million of PLWHA in Southern Africa reside in South Africa alone and all countries in the region – except Angola – have HIV prevalence rates greater than 10 percent.

In Lesotho, prevalence of more than 15 percent has been noted across all education, income, and migration strata while Swaziland has the world's highest prevalence rate. In 2009, the region accounted for 34 percent of all PLWHA and AIDS-related deaths worldwide. It is not all doom and gloom though.

There has been an encouraging trend towards safer sexual behaviors in the 15 to 24 year age group, according to UNAIDS data from 2000 to 2007. In South Africa, for example, the proportion of 15 to 49-year-olds reporting condom use in their most recent sexual encounter more than doubled from 31.3 percent in 2002 to 64.8 percent in 2008.

Zimbabwe has continued to register a gradual decline in HIV prevalence over the past decade. In 2001, the estimated HIV prevalence in adults aged between 15 to 49 years was 23,7 percent but it dropped to 18,1 percent in 2005.  The national estimates for 2009 revealed a further decline and it now stands at 14,3 percent, a trend that the UN has commended. This has been attributed to behaviour change, delayed sexual debut and increased condom use among other factors. Zimbabwe's Health and Child Welfare Deputy Minister Douglas Mombeshora, in an interview with the Southern Times on Wednesday, said the country had done very well in reduction of the HIV prevalence rate.

'I am happy with the progress Zimbabwe has made but I would want to see more being done and virtually eliminate new HIV infections,' he stressed. According to the 2010 MDG Status Report for Zimbabwe: 'A combination of both prevention efforts and scaling up treatments is likely to have a greater impact that either singular effort.'  The report said by December 2009, only 53 percent of all HIV positive patients were on anti-retroviral treatment.

Zimbabwe has probably the least donor funding for HIV in Africa, with per capita spending of just US$4 compared to more than US$300 in other countries. This has impacted negatively on the government's efforts to put as many people as possible on ART. Of the 11 rounds of funding under the Global Fund to Fight HIV and Aids, TB and Malaria, Zimbabwe has only benefited thrice.

This is despite experts acknowledging that the country's technical capacity and proposals are very good.  South Africa's Health Minister Aaron Motsoaledi also told the Southern Times that the government was working at full throttle to combat the virus but conceded that more needed to done. 'We have a big problem. In South Africa we have put up a lot of programmes. For example we have done away with Voluntary Counseling and Testing and we introduced HIV Counseling and Testing.  'The main difference is that with HCT we go to the people and ask them to volunteer for testing and not wait for them to come on their own to VCT centers.'  The HCT drive seems to be paying dividends.

More than 600 000 people have been tested for HIV in the North West province in the past 12 months, according to provincial health and social development spokesperson Tebogo Lekgethwane. The province is on track to reach its target of testing one-third of its 3.2 million inhabitants before the end of June.

Lekgethwane said 20 410 people had been put on antiretroviral treatment (7 044 men, 11 805 women and 1 523 children under the age of 15).  Some 2 216 pregnant women were also put on ARV treatment together with 542 infants. In 2007, only 28 percent of people in South Africa with advanced HIV or AIDS were on ART. President Jacob Zuma's government has been upping the ante and among its more controversial proposals has been introduction of HIV testing at schools.

Allen Thompson, deputy president of the National Teachers' Union has responded to this saying the health department wanted to have the world's biggest HIV testing scheme at any cost.

Namibia's Health and Social Services Minister Richard Kamwi said they remained worried by the high prevalence rates. 'Namibians are still getting infected by the day therefore my message is prevention, prevention and prevention,' Kamwi said.