Mr Speaker, I was privileged to represent the Pan-African Parliament and the Parliament of South Africa when more than 3 000 people came together at the United Nations General Assembly High-Level Meeting on Aids from 8 to 10 July 2011 in New York. The meeting provided an opportunity for countries to take stock of progress and challenges on HIV and Aids and to adopt the declaration entitled "United for Universal Access towards Zero New Infections, Zero Stigma and Zero Aids-Related Deaths", which we are debating here today.
South Africa has made great strides since we all agreed that HIV did indeed cause Aids and the roll-out of antiretrovirals, ARVs, has seen a decline in the infection rate. The recent announcement by the Deputy President of access to ARVs to persons with a CD4 count of 350 is indeed most welcom and perhaps in time we may see a roll-out of ARVs for a CD4 count of 500.
The downside is that our maternal mortality and infant mortality rates are not improving. Current statistics for infant mortality sits at 104 per 1 000 live births and maternal mortality is at 150 per 10 000. The latest news from Statistics SA is that South Africa will in all probability not realise these critical Millennium Development Goals, MDGs, by 2015.
South Africa has largely adopted a traditional market approach in treating HIV and Aids and the target market initially was only pregnant woman. This will not be adequate for the next phase of the Aids response as per the declaration. In order to realise this, we need to have a comprehensive and sustainable approach to the pandemic.
Now I ask: What about other vulnerable groups like drug users, men who have sex with men, sex workers, migrants and prisoners? Reaching zero infections in these so-called unconventional groups will be difficult as they fall outside the social protection net. Resources allocated for prevention services to these groups are either minimal or nonexistent.
South Africa has neither a programme of opiate substitution therapy for drug users who are HIV positive, nor a comprehensive programme of treatment, testing and counselling for sex workers. We could learn serious lessons from both India and Thailand's models instead of the current "ostrich approach" which prevails.
Dr Motsoaledi, South Africa's Minister of Health, reported at the United Nations meeting that HIV in South Africa is now a gender-based disease - meaning that it is spread by men but suffered by women. A speaker from Indonesia went further to say that the 4M group - that is, millions of mobile men with money living in a macho environment - urgently needs to be targeted. These men don't only ignore the calls for actions against HIV, but our education programmes also ignore them.
It was the generally agreed opinion that unless gender-based power relations shift, we will not be able to win the battle. The year 2011 marks 30 years of Aids. In this time more than 25 million lives have been lost and more than 60 million people worldwide have been infected by HIV. Each day more than 7 000 people including 1 000 children, are infected. For every one person on treatment, two new infections occur.
One can see from the depressing statistics that the epidemic continues to outpace the response. In view of these alarming statistics, it is very necessary to shape our country's HIV response if we are to reach the declaration's target of zero new HIV infections, zero discrimination and zero Aids-related deaths.
We can take the first steps towards a world of zero, zero and zero by, firstly, putting people living with HIV at the centre of the response; secondly, protecting the human rights, security and dignity of women and girls; thirdly, by eliminating gender inequality; fourthly, by helping young people get access to life-saving information, such as how to negotiate safe sex and using condoms, by using social networking systems, which they seem more inclined to listen to; and fifthly, by aggressively promoting the merits of treatment 2.0. This is an invaluable United Nations initiative which simplifies HIV treatment to an easy-to-use pill and at- home monitoring, which also serves as a prevention tool.
Finally, we need all partners to come together in global solidarity as never before. With these few steps we can get to zero new infections, zero stigma and zero Aids-related deaths. [Applause.]
Deputy Madam Speaker, the Ministers who are here, and Members of Parliament, using all our five senses - hearing, seeing and the rest - it would seem that everybody is lambasting the ANC. However, I know one thing: It is this ANC that took me out of bondage. I had no dignity. My future was not in my hands. To some I was not a doctor; I was a pseudo- doctor, despite my qualifications. But the ANC brought back my dignity. [Applause.]
We will never not have problems - they will always be there. But we must learn to manage them. We don't pray that we will not falter but that we will learn from our mistakes, because as human beings we will always falter. Our future is in our hands, and I want to be mathematical and say that the future, or tomorrow, is a function of today, times yesterday, minus lack of forgiveness.
We are dealing with a virus that is very clever when compared to other viruses. If you look at it, though, it cannot defeat us for it is unicellular and we are multicellular. It is clever in the sense that it first attacks our protectors, which are our white blood cells and our CD4 cells. It actually resides inside the cell, so if you want to kill it, you have to kill the whole cell before you can get into the virus. That is being clever. It uses the nucleus of the human cell to propagate itself; to multiply and survive. That is why I am calling it a very clever virus, but I don't think we'll be defeated by it. I am convinced that we won't be defeated by it, but we need to fight it together, undivided. I do not think that HIV and Aids is something we can use as a political game, trying to fight each other. United, we will definitely defeat it. If not, we will not be able to reach a zero infection rate.
I have seen people in this country being discriminated against because they are HIV positive. They are discriminated against by people who do not understand how HIV attacks an individual, how it causes disease and how it moves from one person to another. People who are discriminated against become depressed. They ultimately succumb, and not just to the virus itself, even though they're infected by the virus. They succumb because when you are depressed, your CD4 count actually goes down. I am sure all of us have noticed that when you are stressed and depressed, you quickly develop a flu-like syndrome. This is what happens when you are immunodeficient too. You find that people succumb and die because you add another stress onto the lowered CD4 count.
Some people die because they develop stress, which emerges in other diseases like high blood pressure, diabetes mellitus, etc. Others actually kill themselves because of discrimination. They commit suicide.
I would like to urge that we all learn more about the disease and understand it and know how you get HIV and Aids, so that we do not discriminate against people. We need to work hard here. I know there has been talk that people are not testing for HIV and Aids. People are not testing because they are afraid of the stigma that you get labelled with if you are HIV positive. If we do away with the stigma, we would definitely get to zero deaths.
I commend the ANC, the government and the Department of Health for the decision they took to treat people with a CD4 count of 350 and below with antiretrovirals. Whatever the situation - whether it is men having sex with men or whatever - if you get antiretrovirals, your viral load goes to zero. If your viral load goes to zero, then you are not going to infect the other person. Definitely, this strategy is a very important step. They will not infect others and the prevalence will actually go down. We might get a situation where we will have a zero infection rate after this ARV treatment strategy. Opportunistic infections will not set in and obviously you will not have death after that. What kills people are the opportunistic infections.
Good as it is, this decision and the intentions of government, led by the ANC, will fall flat if we are not going to correct the inequities and asymmetries that we have in South Africa, such as the two health systems. We have health for the moneyed and health for the poor. We have to achieve universal coverage for everybody in South Africa. If we do not do that, we are not going to achieve what we want to achieve.
Let me give an example. You might find a person who is working in one of the better-resourced provinces or the richer provinces, has medical aid and is going to receive treatment because of that. When that person goes home for the holidays in December, there is not going to be a place where he can get proper treatment. Guess what is going to happen. That person is not going to take his treatment because facilities there are not as good as where he comes from. The next thing is that he will develop resistance.
I think South Africa is one of the countries with extreme resistant TB solely because of these inequities and asymmetries. Some people take their treatment when they are in the big towns. Sometimes, when you take treatment, you are told that your medical aid is exhausted. So you have to go to a public institution. When that happens, there can be no doubt that resistance will follow because somebody might actually change the treatment.
A third reason would be that some people might not accept that they are HIV positive and start looking for other doctors who are going to tell them that they are HIV negative, despite the treatment that has already been given. Obviously, that person is going to stop the treatment that he has already gotten.
What I am trying to say here is that we might have viruses that develop resistance. We need to make sure that we work around universal medical coverage so that, whether I live in Johannesburg or Cape Town, it would be easy for anybody to know what treatment I have been getting, and even what my diagnosis is, when I go to the Eastern Cape, for example.
Without the IT connections of a medical system that offers universal coverage, we might as well forget about this succeeding. The NHI that we are talking about is something that should have been done yesterday. It should not be something that we are still talking about. We should have done it. [Interjections.] The reason we are so unhealthy in South Africa is because of the asymmetries and inequities that we have.
There is something I mentioned earlier, when I said the future is about today, times yesterday, minus lack of forgiveness. Even when we work on giving therapy to all, it is only going to be preventive. I am convinced that with the passion that has been shown by the leadership of the ANC, the SA National Aids Council, Sanac, and the Department of Health, we are going to be able to reach zero infections, especially if we work towards universal coverage. Deaths are not going to occur from HIV/Aids, but from something else.
If only we can unite against this unicellular organism and improve our primary health care through universal coverage for everybody. We need to understand the disease, how it occurs and how to prevent it on the primary health care level. In that way we will not continue discriminating against people unnecessarily, sending them into depression. When people become depressed, lowers their immunity, and when that happens they die. The future is in our hands. It depends on us. The bondage that we had is a thing of the past because of the ANC.
Hon Deputy Speaker, hon members, I hope you understand, hon Mike, that the ANC is asking for forgiveness. [Laughter.] The aim of the declaration we are debating today was to recommit the member states of the United Nations to redouble their efforts to achieve universal access to HIV prevention, treatment, care and support as a critical step towards ending the global HIV epidemic by 2015. The other objective is to achieve Millennium Development Goal 6, which is to halt and begin to reverse the spread of HIV. For all these to be achieved, we require a renewed political will and ability for those in government to work together with other stakeholders in order to implement bold and decisive actions.
We must start by first recognising that HIV and Aids constitute a global emergency and consequently pose one of the most formidable challenges to the development, progress and stability of any society. This can only be handled through the development and implementation of a comprehensive response, which takes into consideration that the spread of HIV is often a consequence of poverty. Therefore we cannot wage war against HIV and Aids without waging war against poverty and hunger. The solution should be multipronged.
Food security and job creation can play an important role in the fight against HIV and Aids. This is vital because people die prematurely from Aids because, among others, poor nutrition exacerbates the impact of HIV on the immune system and consequently compromises its ability to respond to opportunistic infections and diseases. That's why HIV treatment, including antiretroviral treatment, needs to be complemented with adequate food and nutrition.
The other area which requires attention in the fight against HIV and Aids is the issue of gender inequality and empowerment of women. It is a well- known fact that women and girls are still the most affected by the epidemic, and they bear a disproportionate share of the care-giving burden. The ability of women and girls to protect themselves from being infected is compromised by physiological factors and gender inequalities. These are generally caused by certain backward cultural attitudes, unequal legal, economic and social status, including sexual and reproductive health. That is why prevention and the empowerment of women must be the cornerstone of our response to HIV and Aids. We have to assess whether our national HIV prevention programmes and expenditure reflect this commitment.
I am saying this because the Centre for the Aids Programme of Research in South Africa, Caprisa, unveiled the Caprisa 2004 Tenofovir gel trial results some time ago. The results showed a 39% reduction in new HIV infections and are a critical first step to getting an effective HIV prevention method for women. The most important thing is that women will be able to use the gel without a man's consent.
The most important step required is getting the Tenofovir gel to the public. The role of government is vital in supporting the necessary confirmatory trials and implementation studies. Sufficient funding is required, and for these trials to proceed, Caprisa needs approximately $100 million. Luckily $58 million has been committed. Since the government owns these patent rights, I don't understand why it cannot produce the required funds. I hope that the SA National Aids Council, Sanac, will take this issue up or provide a comprehensive response to the need.
All of us, as members of this august House, need to be concerned that funding devoted to HIV and Aids response is still not commensurate with the magnitude of the epidemic. It seems that this practice is global and domestic. This has been exacerbated by the global financial and economic crisis. That is why there is a need to ensure that prevention, treatment, care and support programmes are adequately targeted or made accessible across the board.
We must also ensure that the health system gets strengthened, particularly primary health care. This will require the integration of our HIV response into it and the speeding up of training and retention of health care workers. [Applause.]
Hon Deputy Speaker, the recent declaration by the United Nations titled "Uniting for universal access: towards zero new HIV infections" is critical for us in South Africa, especially those of us from KwaZulu-Natal, which is the centre of the Aids pandemic. I think this is long overdue. The prevention revolution should have been implemented a long time ago, with self-empowerment being the key to its success. We believe that the HIV response faces a moment of truth. Currently, the HIV epidemic by far outpaces the response.
We need to unleash this revolution. The UN chief, Ban Ki-moon, also recommended working with countries to make HIV programmes more cost- effective, efficient and sustainable; promoting the health, human rights and dignity of women and girls; and ensuring mutual accountability in the Aids response to translate commitment into action. The IFP is in support of all this, but we want targets that are realisable and urgent health priorities to be met. Too many children are orphaned by HIV and Aids. We are 30 years into the pandemic and need a renewed and energised response.
The report, based on data from 182 countries, highlighted that the global rate of new HIV infections is declining, treatment access is expanding and the world has made significant strides in reducing HIV transmission from mother to child. In some parts of the world, particularly parts of sub- Saharan Africa, Aids remains an overriding emergency.
As we debate this issue, we need to realise that many cannot take treatment simply because of lack of access. We need to be innovative to set realisable and responsible goals. We must remain clear that prevention is the cornerstone of any effective and sustainable response.
There is no reason for children to be born with HIV, because we know how treatment for the prevention of mother-to-child transmission works. However, before the roll-out of nevirapine could become a reality for the women of KwaZulu-Natal, the former premier, Dr L P H Mtshali, had to successfully challenge the government in the Constitutional Court. And we need to continue the investment in research and development to develop new products such as microbicides.
Now, more than ever, we must do all we can to rein in this terrible disease. This will only be possible with committed political will, leadership and access to treatment. [Applause.]
Deputy Speaker, the fact that we are having this debate today on the UN resolution with regard to universal access towards zero new HIV infections, zero cases of discrimination and zero Aids-related deaths clearly highlights how far we have come as a country in the fight against HIV/Aids. Ten years ago, a debate such as this one would not have happened in Parliament.
We have come a long way since the Western Cape first rolled out the availability of life-saving antiretrovirals, ARVs, and set a platform for the rest of the country. The expansion of ARV treatment to people infected with HIV is welcomed by the DA.
If we are to achieve the three zeros we are, however, going to need to do much more. Despite the hard efforts of many in our country, the sexual behaviour of most people has unfortunately not changed. Many men still believe that having unprotected sex is the norm - in fact, their right - and the scourge of the rape of women and children continues at sickening levels, resulting in women and children bearing the brunt of the HIV/Aids pandemic.
If we are to achieve the three zeros, we as a country have to push the platform of our ARV programme to the next frontier by ensuring that all those who are infected have access to ARVs. Many of you will be asking how we can afford universal cover. My answer to you, with regard to the ARVs, is how can we continue not to do so.
A recent study conducted by the HIV Prevention Trials Network has revealed that by initiating treatment of HIV-positive people, it reduces the risk of transmission to their partners by 96%. We have roughly 1 700 new infections per day in South Africa, which relates to about 620 000 infections per annum. We are simply not breaking the stranglehold that the pandemic has on our country. If we take the findings of the research and extrapolate it to the annual number of new infections, we would be able to reduce this number by a staggering 595 000 new infections per year. The study known as HTPN 052 was designed to evaluate whether or not immediate versus delayed use of ARVs by HIV-infected individuals would reduce the transmission of HIV to the HIV-uninfected partner and benefit the HIV-infected individual. Findings from the study were reviewed by the independent Data of Safety Monitoring Board. The board concluded that the initiation of ARVs to HIV-infected individuals substantially protects their HIV-uninfected sexual partners, with a 96% reduction in risk. The study is the first randomised clinical trial to show that treating an HIV-infected individual with ARVs can reduce the risk of sexually transmitted HIV. The study began in 2005 and was conducted in 13 sites across Africa, Asia and the Americas. HIV-infected persons were required to have a CD4 count of between 350 and 550 and therefore did not require HIV treatment for their own health.
In addition, a year ago South African medical scientists received worldwide acclaim for their successful field trials of the vaginal gel that can protect women against HIV infection. This gel, developed by the Centre for Aids Programmes of Research in South Africa, Caprisa, was used in the field trial of among 890 uninfected women in KwaZulu-Natal. The trial found that a cut in the rate of HIV of between 39% and 54% was recorded.
The gel was viewed internationally as a breakthrough because for the first time it gave women an unobtrusive way to take control of their own sexual health, instead of relying on their male partners. But after the standing ovations and publications in prestigious science journals, the expansion of the research project has halted, thanks to the bureaucratic inertia of the Medicines Control Council.
Seventeen month ago, in March 2010, Caprisa applied for a new clinical trial. The Medicines Control Council, MCC, has still not responded. It is unacceptable that the MCC should hold up the progress of the significant breakthrough in HIV infection and the DA appeals to the Minister of Health, who is not here today, and to his colleagues in Cabinet to put pressure on the MCC to approve this trial and the subsequent licensing of the gel with appropriate speed.
These exciting breakthroughs need to be taken seriously. We need to lead the way and take the initiative so that we do not miss these golden opportunities. We need to determine the cost of the initial outlay of providing universal ARVs and what the future savings would be as a result of drastically reduced infections and health costs. We failed 10 years ago to take decisive action against HIV. We dare not fail again.
I call the next speaker, the hon Motsepe. This is her maiden speech.
Hon Deputy Speaker, hon Members of Parliament, gender inequality and violations of women's rights put women and girls at risk, leaving them with less control over their bodies and lives than men. Women and girls often have less information about HIV and Aids, as well as fewer resources to take preventive measures. They face barriers in the negotiation of safer sex, which is reflected in economic dependency and unequal power relations. Sexual violence, a widespread and brutal violation of women's rights, intensifies the risk of transmission.
While it is assumed that marriage provides protection from HIV and Aids, evidence suggests that it can be a major HIV factor, especially for young women and girls. The imbalance reflects not only the heightened physiological liability of girls and young women, but also the high prevalence of intergenerational partnerships.
The lack of woman-initiated prevention methods and broader social inequality impedes the ability of young women to reduce their sexual risk. More than 30 million people are living with HIV. Globally, women account for half of all infections.
Women increasingly make up the majority of HIV/Aids-infected persons in sub- Saharan Africa, where the epidemic has reached its highest levels. In parts of Africa and the Caribbean, young women aged 15 to 25 are up to six times more likely to be HIV positive than men of the same age.
Despite the epidemic's vast toll on women and girls, fewer than half of countries provide a specific budget for HIV-related programmes for women and girls. Millennium Development Goal 6 calls for the reversal of the spread of HIV by 2015. To that end, more resources are needed, and strategies and programmes must be targeted to women in particular.
In a United Nations, General Assembly's special session in 2001, more than 180 countries agreed that gender equality and women's empowerment are fundamental in reducing girls' and women's vulnerability to HIV and Aids. This can be achieved only with a collective sense of shared responsibility and accountability. Middle-income countries accounted for 52% of HIV and Aids expenditure. However, low-income countries remained almost wholly dependent on external support.
Women are bringing a gender-equality and human-rights perspective to all spheres, spearheading strategies that make clear links to underlying factors such as violence against women, the feminisation of poverty and women's limited voice in decision-making.
According to the 2008 World Health Organisation and United Nation's Aids global estimates, women comprise 50% of people living with HIV and Aids. In sub-Saharan Africa, women constitute 60% of people living with HIV and Aids. In other regions, men having sex with men, injecting drug users, sex workers and their clients are among those most at risk.
Many countries, including some with severe and growing epidemics, have not given the response that the pandemic deserves. Middle-income countries, in particular, should cover their own HIV and Aids costs, with the possible exception of a few hyper-endemic countries that will need continued assistance.
Low-income countries will remain largely dependent on international HIV and Aids assistance in the coming years, highlighting the need for the more effective use of resources, streamlining donor reporting requirements, alignment with national strategies and institutions and more predictable funding. Low-income countries have an important role to play in funding and taking ownership of their response. Long-term financing for the response highlights the urgent need for sustained support for the Global Fund.
Lack of education and economic security affects millions of women and girls, whose literacy levels are generally lower than that of men and boys. Educating girls makes them more equipped to make safer sexual decisions.
Working together, taking extraordinary and unified steps towards building a world free of HIV and Aids, and the correct use of medicine turn HIV and Aids from a death sentence into a chronic illness and reduces mother-to- child transmission. [Applause.]
Deputy Speaker, the ACDP welcomes this opportunity presented by the UN to take stock of progress and assess the barriers that prevent us from overcoming the Aids epidemic. At first sight, the declaration by the UNAIDS meeting to unite for zero new Aids infections, discrimination and deaths sounds like a wish list, but it is one that we desperately need to become a reality.
In 1851, tuberculosis, or "consumption", was totally out of control in Europe and America, with one in four people dying from the disease. The best practice then was a healthy diet and fresh air in all weather. One hundred years later, in 1953, BCG vaccines used on 50 000 children showed an 80% reduction in infection. All-out war was then declared on TB, with magnificent results. Then, for 30 years in the West, TB was a rare disease - until Aids. We have been at war against HIV for many years, but, in the words of Madiba in 2004, "We can't fight Aids unless we do much more to fight TB."
About 70% of HIV-infected people have TB, and South Africa is said to have the highest TB burden on the planet. The SA National Aids Council, Sanac, CEO, Dr Nono Simelela, says South Africa should consider itself to be having a TB-HIV epidemic, instead of just Aids. She believes Aids is being managed, but we can expect higher levels of co-infection with TB.
HIV and TB now both fall under the oversight of Sanac, the body co- ordinating policy and practice in dealing with the dual epidemic. The current policy is that the HIV-infected people without TB are given six months of prophylactic treatment to prevent them from getting TB. But Simelela is concerned that the distribution and uptake has been very slow.
The ACDP believes that the UN declaration of zero new Aids infections, discrimination and deaths is in danger of falling short - considering the enormity of co-infection levels - if insufficient focus is placed on TB and the follow-up of patients on treatment.
Somlomo namalungu ahloniphekile, masincome loyo owenza isiphakamiso sokuthi sixoxe ngalesi simo samagungqu amathathu. Sincome futhi ukuthi lesi sihloko esikhuluma ngaso sifike ngenyanga yabantu besifazane, ngoba yibona abashaywa kakhulu yisifo sengculazi, yibona abagulayo, yibona izinzala, futhi kube yibo abanakekela abagulayo. Ngakho- ke bathwele kanzima.
Ngiphendule umfowethu, u-Comrade Waters, okhuluma ngokuthi i-Medical Countrol Council, i-MCC, ayivumi ukubhalisa iTenofovir. Mhlawumbe njengeKomidi Likazwelonke leZempilo, asixoxe nawe mhlonishwa Walters ukuthi siyimeme i-MCC ukuze sibhekane nalesi simo.
Engizokhuluma ngakho namhlanje yinqubekela phambili eseyenzekile ngesimo sokubhekana nengculazi kanye nesandulela ngculazi. Ingculazi ayihambi yodwa, ihamba nomngane wayo oyi-TB. Njengamanje-nje siyancoma kakhulu ukuthi uMnyango Wezempilo sonke lesi sikhathi kade ukhipha ijuphe lama- femidom. I-femidom ikhondomu yabesifazane. UBukhipha nje isigidi ngonyaka we zezimali, kodwa manje usitshele ukuthi kulo nyaka wezezimali uzokhipha izigidi eziyisithupha. Siyakuncoma lokho ngoba izinga selithe ukukhula. [Ihlombe.]
Kubalulekile ukuthi abantu uma ngabe bewasebenzisa bawasebenzise kahle, ngendlela abafundiswe ngayo. Abesilisa siyabakhuthaza ukuthi abangathi phela uswidi umnandi uma ukhishwe ikhasi. Abawufake ikhasi [Ihlombe.] ukuze bakwazi ukuvikela lesi simo sengculazi.
Bese ngiphinda futhi ukuthi siyancoma ukuthi uMnyango Wezempilo usuqalile ukuthi uhambe wenza ukusoka. Usoke abantu besilisa, ikakhulukazi labo abasebancane. Okwesibili, sincome abaholi bendabuko abakhuthaza lokhu, ngoba nokho izinga labantu abahambe baya kosoka selikhulile. Makuthi uma besoka bangakhohlwa ukuthi bangadli uswidi uvuliwe, mabawuvale. [Ihlombe.]
Ngisho ukuthi ngamanye amazwi, basebenzise ijazi lomkhwenyana. Bangayi ocansini bengafakanga ijazi. I-Lancet Laboratories yenze uphenyo, sase sithola imiphumela yalolu phenyo ukuthi isimo sesandulela ngculazi kanye nengculazi simbi ezweni. Isimanga ukuthi iMpumalanga Kapa yona ayihambisani namawele ayo, iKwaZulu-Natali neLimpopo ngokuphakama kwesimo sengculazi. Kubo siphansi.
Abahamba phambili, iKwaZulu-Natali, iMpumalanga, i-Freyistata, bayeza-ke nabanye. Inkinga ukuthi yenziwa yini iMpumalanga Kapa ukuthi ibe nezinga elincane. Malungu ahloniphekile, lo mbuzo nginishiyela wona ukuze nani nizame ukuthola ukuthi lokhu kubangwa yini. Umphakathi njengamanje ubambe iqhaza.
Uke wakhuluma omunye uzakwethu nge-Caprisa, kulenyanga endlule iKomidi leZempilo kanye neKomidi leSayensi kanye noBuchwepheshe avakashele endaweni yasemakhaya Emafakatini, e-New Hanover, KwaZulu-Natali okuyiyona ndawo eyisizinda lapho i-Caprisa yenza khona lolu cwaningo lwe-Tenofovir noma i- gel.
Bonke abantu bakuleyo ndawo babambisene, amakhosi, abezenkolo kanye nomphakathi wonkana ubambisene kulesi simo ngoba amavolontiya aphume khona. Ukwenziwa kwalolu cwaningo lusizile ngoba kuphume amavolontiya kanye nomphakathi batshala ivangeli lokuthi akusetshenzelwe ukuthi isimo sengculazi sibe ngcono. Uyazama nokuthi wenze izinga lemfundo libengcono ngoba liphansi kakhulu.
Esakuthola ukuthi abantu babenomndlandla futhi bezimisele. Bayakwazi nokuthi uma kusetshenziswa i-Tenofovir isetshenziswa kanjani. Siyakuncoma lokhu, nokho noma kwenzeka ezindaweni ezisemakhaya kodwa abantu bakhombisile ukuthi kuneqhaza abanokulibamba. Siyamncoma no-Caprisa ngomsebenzi awenzayo njengoba sebeshilo abakhuluma ngaphambi kwami ukuthi lolu cwaningo lwanconywa ezweni lonke.
Bese ngiyalapha kumama nabantwana, ngikhuluma njalo ngenqubekela phambili esiyenzile. Ayikho into eyenza ukuthi umntwana aphile kangcono ngaphandle kokuthi ancele ibele likamama. Kuyakhuthazwa-ke ukuthi umama ancelise umntwana. Kunemibono ehlukene, bathi kuze kuphele iminyaka emibili kodwa okusemqoka ukuthi kumele ziphele izinyanga eziyisithupha ingane incela ibele.
Kulabo abavele benengculazi, ingane kumele incele ibele lodwa, ingaphuziswa ngisho amanzi. Kusho ukuthi ayiphuzi lutho. Asimuphi ngisho amanzi, uncela ibele likamama. Ngakho-ke kubalulekile ukuthi uma siphuma lapha siyobaluleka ukuthi abanengculazi kumele bancelise izingane ibele lodwa.
Njengamanje uNgqongqoshe kulezi nsukwana ezindlule uthe ubisi lwabantwana lwebhodlela luzokhwisha yiziphathimandla zezempilo, abantu ngeke basakwazi ukuyoluthenga nanoma yikuphi. Sifuna ukuthi omama kube yibona abazoncelisa abantwana. Kusho ukuthi akekho umuntu ozoteta bese eba yintombi angancelisi. [Ihlombe.] Phela izintombi azincelisi.
Sikhathazekile njengoba kuthiwa sonke asize sizohlola, sizazi ukuthi simi kuphi. uNgqongqoshe, ngoNhlangulana ngaloyo nyaka wayethe, ufisa kubekhona abantu abayizigidi eziyi-15 abahlole isimo sabo, kodwa kube manje abantu abavelile ukuzohlola bayizigidi eziyi-13.
Sikhathazekile ngoba ngokwezibalo zabezempilo, abantu besilisa abezi ukuzohlola. Sicela bonke abantu besilisa abalapha ukuba bahambe bayokhuthaza abantu ezindaweni zabo ukuthi bahambe bayohlola. [Ihlombe.] Iyona ndlela ezosisiza ukuthi sibone ukuthi sikhona yini isidingo sokuthi sizame ukuvimba.
Bese ngiza kulama-ARV esikhuluma ngawo nsuku zonke. Sonke siyawazi umyalelo owathi umuntu one-CD4 Count ikakhulukazi okhulelwe uzonikezwa ama-ARV ngo- 350 CD4 Count. Kulabo abaphethe ezekubelethisa nokukhulelwa sithi umama okhulelwe kusuka emavikini ayi-11 kuya kwi-14 kumele aqale ukuya emtholampilo ukuze ahlolwe. Uma ngabe udinga ama-ARV kumele awathole ngaleso sikhathi. Siyanikhuthaza ukuthi uma niwathathe uma nifika emakhaya.
Kusuka evikini le-11 kuya kwele-14 kumele baqale baye emitholampilo wabazithwele ukuze bakwazi ukuhlolwa nokuqala ukwamukela ama-ARV, kuze kufike isikhathi sokuteta bese ingane ithola i-nevirapine. Uma umuntu esetetile kuphoqelekile ukuthi aye emtholampilo wabantu abatetile, ngoba sifuna izingane ezingazi kuba nengculazi.
Siyancoma ukuthi eNingizimu Afrika intengo yemishanguzo yengculazi yehlile, ngemuva kokukhulumisana nabayidayisayo. Ingculazi esikhathini esiningi ihamba newele layo, elibizwa nge-TB. Esikhathini esiningi abantu baya emitholampilo ngoba becabanga ukuthi bane-TB. I-TB iyahlolwa ngemuva kwalokho bahlola nengculazi ngaphandle kokubuza isiguli. Sinenhlanhla-ke ngoba ngokukhuphuka kwezinga lwempucuko sekukhona nama-GenXpert machine. Umuntu uyakhwehlela isikhwehlela, ngalo lolo suku athole imiphumela. Imishanguzo iqalwa ngaso leso sikhathi ukuthi umuntu makalashelwe ingculazi kanye ne-TB.
UMnyango Wezempilo usuwenze ukuthi abantu bathole imithi yabo eduze emitholampilo, kuqalwe izinhlelo lapho onesi balolongwe ukuthi uma umuntu efika efuna usizo akwazi ukuthola imishanguzo yengculazi. Sithi ... (Translation of isiZulu paragraphs follows.)
[Ms B T NGCOBO: Speaker and hon members, we must commend the person who recommended that we should debate this situation of the three zeros. We should also appreciate that the topic we are debating came about during women's month, because they are the ones who are more affected by the Aids pandemic - they get sick, they bear children, and they are the ones who take care of others. They are burdened.
Let me answer my brother, Comrade Waters, who says that the Medical Control Council, MCC, does not want to register Tenofovir. Perhaps as the Portfolio Committee on Health, we should talk to you about you inviting the MCC so that we can address this situation.
What I am going to talk about today is the progress made with regard to dealing with HIV and Aids. Aids does not develop alone; it works with its partner TB. Right now we commend the Department of Health for issuing femidoms. A femidom is a female condom. The department used to issue one million during a financial year, but now the department has told us that it will issue six million in this financial year. We appreciate that because the level has increased. [Applause.]
It is important that people use them correctly according to the way they have been taught. We encourage men not to say that a sweet is tasty when it is unwrapped. They should wrap it ... [Applause.] ... so that they can prevent the spread of Aids.
I reiterate that we commend the fact that the Department of Health has started with the circumcision of males, especially those who are still young. Secondly, we commend the traditional leaders who encourage this practice, because the number of people that have gone for circumcision has increased. When they circumcise, they should remember that they must not remove the wrapper when they eat a sweet; they must wrap it. [Applause.]
In other words, they must not have unprotected sex. Lancet Laboratories conducted research and the results indicate that the HIV and Aids situation in our country is very bad. The surprising thing is that the Eastern Cape is not on the same level as its twin provinces, namely KwaZulu-Natal and Limpopo. Their infection rate is low.
Those in the forefront are KwaZulu-Natal, Mpumalanga, and Free State - the other provinces follow. The problem is, what makes the Eastern Cape have low levels? Hon members, I leave this question to you so that you can figure out what causes this. The community is now participating.
One of the hon members spoke about Caprisa; in the past month, the Portfolio Committee on Health and the Portfolio Committee on Science and Technology visited the rural areas of Mafakatini, New Hanover, KwaZulu- Natal, which is the site where Caprisa is doing its study on Tenofovir or gel.
Everybody in that area - chiefs, religious people and the community - are working hand in hand to deal with this situation. The volunteers are also from that area. Doing this research has helped because the community and the volunteers agree that the Aids situation should be improved. It is also trying to improve the low level of education.
We found out that people are geared up and determined, and they know how to use Tenofovir. We commend this, even though this is happening in the rural areas, people have shown that they are playing a role. We also commend Caprisa for the work that they do, like those who spoke before me have said that this study was commended throughout the country.
When I refer to women and children, I always talk about the progress that we have made. There is nothing which makes a child live a better life except for him/her to be breastfed by the mother. Breastfeeding is encouraged. There are different views on this subject - some say that a child should be breastfed for a full two years. However, it is important that the child be breastfed for six months.
For those who are HIV positive, the baby must only be breastfed and must not even drink water. This means that the child must not drink anything else. We should not even give him or her water but only breastfeed him or her. It is therefore important that when we leave here, we must go and advise them that those who are HIV positive must only breastfeed.
Over the past few days the Minister said that the formula will be distributed by health officials, hence people will no longer be able to buy it anywhere else. We want mothers to breastfeed their children. This means no one will give birth and thereafter behave like ladies who do not have infants and not breastfeed their children. [Applause.] Ladies who do not have infants do not breastfeed.
We are worried because it is said that all of us should come and be tested, so that we can know our status. The Minister in June that year said that she had a target of 15 million people coming for testing, but till now only 13 million people have been tested.
We are worried because according to medical statistics, males do not go for testing. We ask all the men who are here to go and encourage people in their constituencies to get tested. [Applause.] This is the only way which will help in order for us to see if there is a need for prevention.
Now I want to talk about ARVs, which is what we talk about everyday. We all know the message that a pregnant person will be given ARVs, especially those whose CD4 Count is 350. We say to those who are in charge of antenatal clinics, that a woman who is 11 to 14 weeks pregnant must start going to the clinic for testing. If she needs ARVs she must get them at that time. We encourage them to take them when they arrive home.
Women who are 11 to 14 weeks pregnant must start going to the antenatal clinics so that they can be tested and also to start receiving ARVs until they give birth; thereafter the child gets Nevirapine. When a person has given birth she should go to a postnatal clinic, because we do not want children to become HIV positive.
We commend the fact that in South Africa the price of Aids medication dropped, after the discussion with the retailers. Most of the time Aids works with its twin brother called TB. In most cases people go to clinics because they think they have TB. TB is checked after an HIV test is conducted, without asking for the patient's permission. We are lucky because of the advancements with regard to the level of development, we now have GeneXpert machines. A person coughs up sputum and on that same day he or she gets the results. Medication is given at that time so that a person can be treated for HIV and TB.
The Department of Health has made sure that people get their medication at their local clinics; they started programmes whereby nurses are trained so that when people come for help, they are able to get HIV medication. We are saying that ...]
... these are the initiation programmes, where the nursing staff can provide this treatment.
Lokhu kwenza ukuthi abantu bangayi ezindaweni ezikude, beze ezindaweni abahlala kuzo bathole izeluleko, banikezwe imithi yabo. Sizokhumbula ukuthi abanye bethu babengakazalwa, kwakukhona isifo sochoko saphela, kwabakhona i- influenza bathi yango-1918 cishe sonke njengoba silapha eNdlini sasingakazalwa, nayo yaphela.
Kwakukhona i-TB bafika omame bamaFulentshi bathola umjovo we-TB, iyaphela i- TB. Kwafika umdlavuza, uma umuntu enomdlavuza kwakuthiwa nali ithikithi lakho lokufa, lokuya esihogweni noma ezulwini. Isifo somdlavuza naso sesiyazameka.
Ngineqiniso ukuthi lapha e-Afrika siyogcina esiyitholile indlela yokwenza ukuthi ingculazi ingabhebhetheki. Uma ngabe singakwazi ukuyilapha kodwa siyoyithola indlela yokuthi ingabhebhetheki. Ngiyancoma-ke ukuthi le nkulumo yanamhlanje yenze ukuthi sibambisane sonke, sisebenzisane sonke, saba munye.
Siyethemba ukuthi noma singeke sikwazi ukufinyelela kumaqanda amathathu oMgomo wesithupha wenThuthuko yeMileniyamu ngo-2015, kodwa ngelinye ilanga siyobe sesiwatholile, mhlawumbe eminyakeni yethu yokuphila noma yesizukulwane esizayo. Ngiyabonga. [Ihlombe.] (Translation of isiZulu paragraphs follows.)
[This ensures that people do not have to go very far, as they can go to the local clinics and receive counselling and medication. Some of us will remember that - and others were not yet born - there was a disease called leprosy, and now it is no more. There was an influenza outbreak around 1918; almost all of us in this House were not yet born, and it is also no more.
There was TB, then the French woman came along and found a TB injection, and TB is slowly coming to an end. Then there was cancer; when a person was diagnosed with cancer it was said that they received their death ticket to either go to hell or to heaven. Now cancer can be managed.
I am sure that here in Africa we will end up finding a way of stopping the spread of Aids. If we are unable to cure it we will find a way to stop it from spreading. I thank the fact that today's debate has enabled us to co- operate, to work together and to be one.
We hope that even though we will not be able to achieve the three zeros of the sixth objective of the Millennium Development Goals in 2015, one day we will; perhaps in our lifetime or in that of the next generation. Thank you. [Applause.]]
Deputy Speaker, there is no doubt in any of our minds that HIV is one of the greatest challenges of our time. Several times today we have heard it echoed that dedicated leadership is vital to reaching universal access goals towards HIV prevention, treatment, care and support.
We are mindful that traditional donors are cutting back funding for HIV and Aids and, therefore, innovative approaches like the pharmaceutical manufacturing plan for Africa and drug-harmonisation regulations need to be explored.
The declaration is quite ambitious, but it urges vigorous action to end mother-to-child transmission of HIV, to reduce by half the number of deaths from tuberculosis among people living with HIV, and to boost campaigns to prevent HIV transmission among the most vulnerable.
Colleagues, thank you for the collegial and constructive manner in which the declaration was debated. It is indeed a major milestone, as my colleagues said earlier, that all of us are in agreement on the challenge of HIV and Aids and are speaking in one voice.
In conclusion, I would like to quote the United Nations General Assembly President, Joseph Deiss of Switzerland, who said, "This declaration is strong, the targets are time bound and set a clear and workable road map, not only for the next five years, but beyond." I thank you. [Applause.]
Debate concluded.