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

2. Epidemiological Trend in HIV/AIDS, 1990 - 2000

3. 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

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

5. 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

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

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

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

9. Chief Directorate Structure

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

11. Chief Director’s Office
HIV/AIDS/STD Strategic Plan for South Africa, 2000 – 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

12. 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

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

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

15. 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

16. 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

17. 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

18. 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

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

20. 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

21. 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 = calls (1 932 per day)

22. 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

23. 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

24. 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

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

26. 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

27. 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

28. Conditional Grant 2001/02
Integrated Plan for Children Affected and Infected by HIV/AIDS
VCT R
HBC R
TOTAL R

29. 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

30. 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

31. 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