HIV AIDS
Dynamics of the South African epidemic The South African epidemic is exacerbated by: · social and family disruption as a consequence of apartheid and migrant labour · high mobility and a good transport infrastructure, allowing spread of the virus · high poverty and low education levels, resulting in more risk taking behaviour and commercial sex work · a burdened and transforming health system · an overwhelmed and inadequate welfare system · high levels of sexually transmitted diseases (STDs) · the low status of women in society and relationships, making it difficult for them to protect themselves in sexual relationships · shifting social norms which permit high numbers of sexual partners · a resistance to change high risk behaviours, often centred around notions of culture resistance to condom usage · a lack of clear and non-judgmental information and services for young people and denial about teenage sexual activity · significant denial of homosexuality in the black community and a history of poor government interventions for the gay community Summary South Africa has a complex interrelationship of multiple epidemics, a heterogeneous society in transition and a government struggling to meet the needs of a united South Africa emerging from years of social engineering projections Anthony Kinghorn and Malcolm Steinberg of HIV Management Services report that: that projections indicate that within 3 years almost 250,000 South Africans will die of AIDS each year This figure will rise to more that 500,000 by 2008 Average life expectancy is expected to fall from about 60 years to around 40 years between 1998 and 2008 Impact · HIV/AIDS will pose significant economic costs to business over time but the macro-economic impact is likely to be limited to a Gross Domestic Product (GDP) growth rate reduction of about 1% per annum · HIV/AIDS care will become a substantial part of health care spending · Tuberculosis (TB) services and cure rates could deteriorate seriously · Women will become more burdened by bearing the brunt of infections and care of the infected · The HIV epidemic will produce large numbers of AIDS orphans (by 2005 there will be nearly a million children under the age of 15 who will have lost their mothers to AIDS) · Education will be affected through staff becoming infected and through increasing needs of affected and infected children · Welfare will face the challenge of dealing with those debilitated by AIDS, the numbers of AIDS orphans and the increase in elderly whose adult children die prematurely · The majority of South Africans will be affected by this epidemic as it impacts on family members, friends and colleagues · Social and political instability may increase Response Response from the state An AIDS Advisory Group was appointed in 1985 but a specific AIDS Programme infrastructure was only established in 1991, consisting mainly of a network of AIDS Training, Information and Counselling Centres In 1992 the National AIDS Co-ordinating Committee of South Africa (NACOSA) was established, consisting of concerned individuals, non-governmental organisations (NGOs), AIDS service organisations (ASOs), local, provincial and national government, the African National Congress (ANC) Health Secretariat, as well as representatives of business, unions and churches.