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.