Chief Directorate: HIV/AIDS and STDs Dr. Nono Simelela Input for Portfolio Committee on Health Hearings 2 – 5 April 2001

Epidemiological Trend in HIV/AIDS, 1990 - 2000

Provincial HIV Prevalence: Antenatal Clinic Attendees, SA, 1998 - 2000 Province Est HIV+ 1998 1999 2000 KwaZulu-Natal 32.5 36.2 Mpumalanga 30.0 27.3 29.7 Gauteng 22.5 23.9 29.4 Free State 22.8 27.9 North West 21.3 23.0 22.9 Eastern Cape 15.9 18.0 20.2 Northern Province 11.5 11.4 13.2 Northern Cape 9.9 10.1 11.2 Western Cape 5.2 7.1 8.7 NATIONAL 22.4 24.5

HIV Prevalence by Province among antenatal clinic attendees in SA, 1999 - 2000

HIV Prevalence Trends by Age among Antenatal Clinic Attendees in SA, 1998 -2000 Age Group Est HIV+ 1998 1999 2000 < 20 21.0 16.5 16.1 20 – 24 26.1 25.6 29.1 25 – 29 26.9 26.4 30.6 30 – 34 19.1 21.7 23.3 35 – 39 13.4 16.2 15.8 40 – 44* 10.5 12.0 10.2 45 – 49* 7.5 13.1 Wide confidence intervals in the age groups of 40 – 49 due to the low numbers of women participating in the study

HIV Prevalence by Age Group among ANC Attendees in SA, 2000

Syphilis Prevalence Trend among Antenatal Clinic Attendees in SA, 1997 - 2000

Personnel and Budget Information Please note that expenditure information is only up to February 2001

Chief Directorate Structure

Report of Major Achievements in 2000/01 Report on achievements from various programmes in the HIV/AIDS unit

Chief Director’s Office HIV/AIDS/STD Strategic Plan for South Africa, 2000 – 2005 - June 2000 Sectoral workshops 9 HIV/AIDS guidelines – October 2000 Integrated Plan for Children and Youth Infected & Affected by HIV/AIDS Collaboration with SANAC Technical Task Teams

Care and Support Database of PWA Support Groups Community-based home care plan developed and approved Training materials developed for HBC and VCT and training conducted Collaborated with Dept of Social Development on Integrated Plan conceptualisation Technical assistance to provinces on business plans for HBC and VCT

Counselling Programme VCT training materials developed 2219 counsellors trained Developed rapid test quality assurance protocols

Youth Programme Lobbying 36 youth formations Improved intradepartmental collaboration Tertiary HIV/AIDS Media Project Participated in SADC Youth Conference in Mozambique

Life Skills Programme Audit of Life Skills Programme in secondary schools, including a national survey Developing support materials (including a parent guide) Collaborate with Dept of Education on Integrated Plan Technical assistance to provinces for business plans on life skills element of Integrated Plan

Partnership Support 5 PWAs employed by government Resource list for PWAs developed Workshop with traditional leaders Road Freight Association AIDS Programme Support to other significant sectors: Women, FBOs, CMA, Trade Unions Training conducted

Research & Surveillance Collaboration on projects: Lesedi, Lechabile, Mothusimpilo Collaborate on syphilis rapid testing Input into female condom project Participate in SANAC Technical Task team Stratified surveillance piloted in Gauteng

TB/HIV Integration Integration of TB/HIV services in 4 districts reviewed (DOH & WHO) Planned expansion of the TB/HIV Districts Committed Belgian Funding for expansion

STI Management STI health promotion materials developed and distributed Flipcharts, pamphlets, posters Guide on Syndromic management developed and distributed

Barrier Methods Distributed approximately 250 million male condoms National Male Condom Policy developed Developed Logistics Management Information System for male and female condoms Female condom introductory strategy developed

Government AIDS Action Plan Mass media advertising Provision of communication resources Public and private sector Media workers projects Living Openly project & exhibition PR campaign using celebrities AIDS helpline – increase in calls E.g. July 2000 = 59 886 calls (1 932 per day)

NGO Funding Funding agreement amended to be in line with PFMA Improved oversight of funded NGOs National Funding Advisory Committee established Funding NGOs to act as mentors to smaller CBOs

Interdepartmental Committee on HIV/AIDS Participated in Impact and Action project Impact of HIV/AIDS on public service October commitment campaign Increased commitment from government departments World AIDS Day celebration at Pretoria Train Station and Church Square

Major Activities for 2001/02 Implementation of the elements of the Integrated Plan Community-based home care Life skills and HIV/AIDS education Voluntary HIV counselling and testing Expansion of research into mother to child HIV transmission Rollout of the Diflucan Partnership Programme

Major Activities for 2001/02 Training of healthcare workers Treatment literacy campaign Establishment of District AIDS Councils

Expenditure reported by provinces (28 Feb 2001) Conditional Grant – 2000/01 Budget Transferred Expenditure reported by provinces (28 Feb 2001) Committed (28 Feb 2001) Integrated Plan for Child Infected & Affected by HIV/AIDS 16 819 829 1 576 861 5 842 448

Reasons for low expenditure Late gazetting of funds (August 2000) Consultative processes to have integrated business plans Lack of human resource capacity at provincial level Long time frames of procurement processes, especially tendering

Conditional Grant 2001/02 Integrated Plan for Children Affected and Infected by HIV/AIDS VCT R22 000 000 HBC R12 100 000 TOTAL R34 100 000

New Developments Inclusion of TB Directorate into the Chief Directorate Donor Coordination Forum on HIV/AIDS United Nations General Assembly Special Session on HIV/AIDS – June 2001 Increased surveillance efforts

Outstanding Policy and Legislation Issues Promulgation of the HIV Testing Policy Shortened, user-friendly version of the HIV/AIDS Strategic Plan for broader distribution Policy on Care, Treatment and Support for HIV infected Persons Guidelines on the use of antiretrovirals in the private sector

Outstanding Policy and Legislation Issues Policy on Care for Children Infected and Affected by HIV/AIDS Policy on Care for the Health Providers Policy on Palliative Care Policy on Care for Victims of Sexual Assault