Speech by the Premier of the Northern Cape, Mrs Hazel Jenkins, on the occasion of World AIDS Day 2011, held in Kathu on 01 December 2011

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Programme Director

Members of the Executive Council

Mayors and Councillors

Community Members of Kathu and surrounding areas

Members of Youth Formations

Distinguished Guests

Ladies and Gentlemen

Today we join millions of people across the globe to mark World AIDS Day.

We are observing World Aids Day every year on the 1st of December as part of the global community to renew our resolve and unite with passion and positive energy to take action and save lives. These efforts are making a real and tangible difference around the world.

It is significant to note that this World Aids Day on 1 December 2011 marks 30 years of existence of HIV/AIDS in the country and it is the 23rd commemorative day.

The StatsSa “Mortality and Causes of Death Report 2008” indicates that Northern Cape was one of 7 provinces with TB as the major cause of death in the country.

While many lives have been lost due to HIV & AIDS and TB during the past 10 years, more than 4 000 (four thousand) lives have been lost between 2004 and 2009 due to TB, while the majority of these have been HIV-related, mainly in the age-group 15 to 44 years.

Ladies and Gentlemen, the management and control of the spread of TB in the province still poses a major challenge. The total number of all TB cases increased from 6127 (2004) to 10 252 (2010). The Siyanda District reported the highest TB incidence rate in 2010 at 469 per 100 000 population. MDR and XDR cases also increased due to improved diagnostics such as the Gene Xpert.

There are currently 314 MDR cases and 41 Extreme Drug Resistant patients reported in 2010 bringing the total number of XDR cases to 71 with the Siyanda District reporting the highest number of MDR and XDR cases. The abovementioned challenges are largely attributed to ineffective community infection control due to poor socio-economic conditions.

However, it is heartening to note that some achievements have been observed despite the increasing number of TB cases. The TB Cure rate improved from 47,7% to 69% from 2004 - 2009. John Taolo Gaetsewe, Frances Baard and Namakwa Districts reported the highest cure rates above 70%. A remarkable improvement has been noted in the smear conversion rate in the past 5 years: 37% in 2004 to 70.8% in 2010. The defaulter rates have also decreased from 14% in 2004 to 5,8% in 2010, although the defaulter rate in the Pixley ka Seme District remains high at 8%.

The success of the TB control programme in the province is attributable to political commitment (increased financial resources) and stakeholder involvement (partnerships with NGOs, business and the mining sectors).

According to the South African Burden of Disease Study of 2000, more than half of deaths in under 5’s were HIV-related, with HIV being the leading cause of death between the ages 15 to 44 years in the province. In the last 3 years alone, about 400 babies have been born with HIV from their infected mothers.

Ladies and Gentlemen, TB and HIV both increase the vulnerability of our population in the province, leading to an increase in the number of social grants.

By the end of 2010, there were 22 406 services rendered to orphans and vulnerable children, while a further 16 101 foster care grants were issued by the Northern Cape Department of Social Development, some of these being related to maternal orphans in the province.

If no meaningful scale-up of the response takes place, it is estimated that the number of orphans due to HIV & AIDS and TB will increase from 11 700 by a further 5 000 children in this province in 10 years if we do nothing more to control and manage HIV and TB. This is according to Actuarial Studies of South Africa (ASSA 2008).

Ladies and Gentlemen, the global theme for the World AIDS Day Campaign is “Getting to Zero” This refers to Zero New HIV Infections, Zero Discrimination and Zero AIDS Related Deaths. The theme seeks to encourage individuals and communities to have a non – discriminatory and non – judgmental approach to HIV prevention, treatment, care and support.

The theme for our country this year is: “South Africa is taking responsibility on a PATH to eliminating the TB and HIV epidemics”. This theme is a follow through of the Presidential pronouncement of 1 December 2009, when President Jacob Zuma announced the 3-pronged theme “I am Responsible, You Are Responsible, South Africa is taking Responsibility”. The emphasis this year is on providing universal access to HIV, STIs and TB prevention, treatment, care and support. This is complementary to the global theme as South Africa will continuously strive to achieve zero HIV infections over the next 20 years.

Programme Director, today ushers in a brand new National Strategic Plan for HIV & AIDS, STI’s and TB and this document is being launched by Deputy President Kgalema Motlanthe in the Eastern Cape Province. The document provides a strategic vision and direction for the country’s response to the three diseases (HIV, STIs and TB) during the period 2012 to 2016.

The Northern Cape will adopt its Provincial Strategic Plan to the national strategies and the 20 years’ vision for South Africa which seeks to eradicate TB and HIV. The plan will be also aligned to the High Level Meeting of Political Declarations in 2011 endorsed by the UN General Assembly for the control and elimination of TB and HIV; United Nations MDG 6 on Combating HIV, AIDS, TB and Malaria; the UNAIDS strategy 2011-2015 “Getting to Zero” and a number of other international agreements.

In line with the national and international resolutions and strategies, in the next five years the Northern Cape will aim to achieve the following results: Sexual transmission of HIV must be reduced by half, including among young people, men who engage in sexual relations with men and transmission in the context of sex work.

Vertical transmission of HIV from mother to child should be eliminated and AIDS-related maternal mortality reduced by half. This is possible in the current environment of HIV Counselling and Testing and ARV services being freely available at all government facilities. Counselling and testing are essential so that people who are infected can know their status, seek care, and using their increased knowledge, change their behaviours to prevent transmission of the virus to others. Those who are tested can also use knowledge of their status to protect themselves.

Universal access to antiretroviral therapy should be ensured for people living with HIV who are eligible for treatment. Special attention should be given to people living with HIV who also have TB. TB deaths among people living with HIV must be reduced by half.

People living with HIV and households affected by HIV will be addressed in all social protection strategies and will have access to essential care and support.

Punitive laws and practices around HIV transmission, sex work, drug use or homosexuality that block effective responses must be reduced by half.

HIV-specific needs of women and girls will have to be addressed in at least half of all national HIV responses. And there must be a Zero tolerance for gender-based violence.

A number of guiding principles will underpin the implementation of the PSP: These are; promoting equity and human rights, in particular as they relate to marginalized groups, the rights of women and girls, and people living with HIV; designing and implementing the response to HIV&AIDS, STIs and TB on the basis of sound evidence of the needs and the most effective strategies; responding to HIV&AIDS, STIs and TB in a comprehensive way, and of closely linking this response to broader health and social development programs.

Ladies and Gentlemen, the next 5 years has to represent a period of improved life expectancy and a better quality of life for all in this country, in particular in the Northern Cape Province.

The Northern Cape Provincial Council on AIDS will develop an Operational/Implementation Plan for HIV and TB which will be modelled on its Provincial Strategic Plan for 2012-2016 (PSP). This Operational Plan will be launched on 24 March 2012 (World TB Day).

While continuing to ensure that programmes, services and support for HIV&AIDS, STIs and TB prevention reach the general population, a greater focus will also be given to sectors of the population at increased risk (truck drivers, sex workers, men who engage in sexual relations with men, migrant, seasonal, mine and farm workers, victims of sexual violence and abusers of alcohol, and the youth).

Therefore, Ladies and Gentlemen, it is critical that departments and organizations dealing with those groups mainstream HIV and TB into respective annual plans and secure funding for their implementation.

Programme Director, interventions for the prevention and control of HIV and TB must have a high impact and be based on their cost effectiveness.

The development and implementation of this plan is to be based on human rights and gender sensitive considerations. The stigma associated with HIV remains extremely high and fear of discrimination causes some people, including more-at-risk population groups, to avoid learning about their HIV status, disclosing their status, or seeking medical care. Therefore, to successfully address HIV, we need more and better community-level approaches that integrate HIV prevention and care with more comprehensive responses to social service needs. The human rights sector, including the Human Rights Commission and the Department of Justice, must mobilize their efforts in tackling and addressing the issues related to human rights violations of people living with HIV and TB including vulnerable groups.

The National Campaign of 16 days of Activism for No Violence against Women & Children started on 25 November 2011. Every year, thousands of women and children become victims of sexual violence in the Northern Cape. Gender based violence is a human rights and social protection issue that must be addressed by the province. It is also one of the main contributing factors to the spread of the HIV epidemic. In addition, the gender-based violence is being fuelled by high levels of alcohol abuse. (Northern Cape has the second highest rate after the Western Cape). The Departments of Justice and Social Development must strategize jointly on addressing these cross-cutting issues with the support of communities and civil society organizations.

As a result of our ongoing investments in research and years of clinical experience, people living with HIV can enjoy long and healthy lives. To make this a reality for everyone, it is important to get people with HIV into care early after infection to protect their health and reduce their potential of transmitting the virus to others. For this reason, the National HCT Campaign has now been institutionalized and every person visiting a health facility must be offered free HIV Counselling and Testing in order to diagnose HIV infection early for prompt assessment for treatment, if necessary.

I wish to remind you that government has now made ARV available to all HIV positive people with a CD4 count of less than 350 in order to improve life expectancy and survival.

It is important that all people living with HIV are well supported in a regular system of care which emphasizes a positive attitude and healthy lifestyle. This can be achieved through collaborative efforts of Department of Health, DBE, DSD, NGOs, CBOs, FBOs and community mobilization.

It is also important to stress that initiatives must be based on engagement and consultations with all stakeholders, while ensuring greater involvement of people living with HIV and AIDS and TB. The participation of affected people must be central in the formulation of initiatives.

The role of partnerships and a multi-sectoral approach in the realization of the Provincial Strategic Plan 2012-2016 cannot be over-emphasized because, it is through combining the resources, skills and experiences of all sectors of society that the PSP goals and objectives can be achieved. The multi-sectoral approach is based on commitment from all provincial stakeholders and the political leadership and support at all levels in order to execute a well-structured and effective response.

To this end, and in line with the latest resolutions and National Strategic Plan 2012-2016, my Office will put in place a system for effective coordination of the truly multi-sectoral response to HIV and TB in the province for the next 5 years. The monitoring and evaluation of our contribution to this response will be critical in order to ensure that the key result areas of the Plan 2012 -2016 are achieved. For this reason, Ladies and Gentlemen, I expect that all Departments, sectors and other role players will understand that South Africa is in a crucial but exciting period in the history of HIV/AIDS and TB. We have learnt important and valuable lessons from our interventions of the past 20 years. The time has come to turn the dual epidemic around, and that time is now.

In conclusion, I wish to remind you that the Northern Cape Province has the smallest population in South Africa, but the largest territory; therefore, this makes it more challenging to reach the entire population with programmes and services. On the other hand the Northern Cape has just over 1million inhabitants and if we do not control the epidemic now, in a number of years it might be too late.

Therefore, I call on the concerted intervention of all the political and senior leadership of this province, civil society, business, and all role-players right up to an individual level, to ensure that an enabling structural environment is created for our NC PSP development, implementation and mobilization.

I wish to acknowledge the role of our partners for their contribution in the past year, in particular the role of UNAIDS, PEPFAR/USAID/CDC, all NGO’s, CBO’s and the private sector. The Northern Cape Province looks forward to your continued support as we enter a new era of intensification of our response to eliminate HIV and TB by 2022.

At all times, preventing HIV from spreading is a vital way of helping South Africans at high risk to arrest the threats of AIDS.

So please support those with HIV, talk about the virus with your children, your partner, friends and colleagues.

I Thank you.

Ke aleboga

Baie Dankie