The Southern African Journal of HIV Medicine has published a CHAI-led study reflecting on the progress South Africa has made towards eliminating HIV. The article draws insights from three major reports published in 2020.[1]
South Africa has one of the highest HIV burdens in the world, with 7.7 million people living with HIV, approximately 13 percent of the total population. While prevalence is high within the general population, it is even higher among men who have sex with men, transgender women, sex workers, and people who inject drugs.
Preventing HIV and getting people on treatment as soon as they are diagnosed starts with good policies. South Africa has long been praised for its exemplary policies. The 2020 Global HIV Policy Report shows that amongst countries in eastern and southern Africa – countries with the largest burden of HIV – South Africa has the highest overall policy-adoption score. The country has made huge strides in improving access to HIV testing over the years, meeting the first of the 90-90-90 targets, with 90 percent of people living with HIV being aware of their status. In addition, it has one of the largest antiretroviral programs in the world, driven by its ‘test and treat’ national policy. It is the first country in sub-Saharan Africa to approve PrEP, an HIV preventative medication, for high-risk populations.
However, the 2020 Global HIV Policy report suggests that South Africa has yet to make progress in three key areas: the use of national laws to procure medicines at more affordable prices, the decriminalization of both sex work, and the possession of drugs.
In addition, COVID-19 has negatively impacted access to testing, treatment, and care for people living with HIV globally, including South Africa. It threatens to undo decades of work to reduce mortality rates from the disease. This article contextualizes the South African HIV response within the global one, and what steps it needs to take to achieve the second and third of the 90-90-90 targets, now and beyond the pandemic.
Citations
- World AIDS Day Report 2020: ‘Prevailing against pandemics by putting people at the centre’, The 2020 Global HIV Policy Report: Policy barriers to HIV progress, and ‘Thembisa 4.3 model.
