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South Africa has one of the highest prevalence rates of HIV/AIDS worldwide, with an estimated number of people infected with the virus that varies from 5.5 million to well over 6 million. UNAIDS believes South Africa to be the country with the second highest total of people living with HIV/AIDS.
According to a 2004 study by the National Department of Health, 29.5% of pregnant women were estimated to be HIV-positive, with the highest prevalence rates in KwaZulu-Natal, Gauteng and Mpumalanga. The same study in 2005 found that females aged 15–24 years have an eight times higher HIV incidence rate than males and account for 87% of the latest HIV infections for this age group.
Women of childbearing age are particularly vulnerable to HIV/AIDS and to the transmission of the virus to their children. Of direct consequence is the devastating effect that AIDS is having on children. UNICEF estimated 240,000 children under 15 infected with HIV in 2005, with many more orphaned or made vulnerable by the disease. An estimated 1,2 million South
African children have been orphaned by AIDS, and this estimate is expected to reach well over 2 million by 2010 if infected parents are unable to access ARV medication.
Added to this are the millions of children who are living with sick parents unable to care for their basic needs, with older children often required to leave school to take on the role of primary caregiver for their siblings.
In November 2003, the National Department of Health published the Operational Plan that commits to providing antiretroviral (ARV) treatment to all South African citizens. This multi-sectoral plan is a significant advance on the HIV/AIDS/STD Strategic Plan for South Africa (2000-2005), which did not include ARV treatment, but the government has been widely criticised for failing to put high-level political support behind the plan’s implementation, and uneven delivery of health services means that many communities are still not receiving effective programmes in prevention, treatment and care.
With more efficient delivery, mother-to-child transmission, which remains as high as 25% in some state hospitals, could be reduced to 2%.
Recognising the urgency, civil society and many companies in the private sector have pioneered major initiatives to respond to the devastating impact of HIV/AIDS. These include political campaigns for access to life-saving antiretroviral treatment by all citizens and interventions to prevent mother-to-child transmission of the virus, and awareness advertising campaigns and national “edutainment” programmes aimed at education and prevention. In addition, thousands of grassroots programmes have been initiated throughout the country, including projects that:
- Focus on education and awareness-raising to help prevent the spread of HIV and empower people to make choices that minimise the risk of being infected with HIV
- Promote voluntary testing and counselling in communities, educational institutions and workplaces
- Help people with HIV/AIDS to obtain anti-retroviral treatment and medical care and to adhere to medical treatment
- Respond to the needs of children who have been orphaned or made vulnerable by AIDS, with an emphasis on responding to their basic needs as well as efforts to keep them in school
- Promote gender equality and reduce the vulnerability of women and girls to HIV infection, involving men and boys in the effort as well
- Provide training and counselling for members of community-based organisations involved in identifying and monitoring vulnerable children and families, mobilising community resources to offer them material and moral support, and assisting them with home-based care
- Advocate for and protect the rights of people living with AIDS and their families, ensuring their access to health and welfare services
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