Address by Kwazulu-Natal Premier Sihle Zikalala during the commemoration of World Aids Day, Umhlabuyalingana Local Municipality, Manguzi, Shayina Sports Field, 1 December 2020
Our Hosts: Umkhanyakude District Mayor, Cllr. S. Mkhombo and The Mayor of Umhlabuyalingana Local Municipality, Cllr. N Mthethwa;
Our Traditional Leaders and Traditional Leaders;
Leadership of Civil Society in the fight against HIV, TB, and STIs;
The Director-General of KwaZulu-Natal, Dr N Mkhize;
Heads of Departments, DDGs, and Senior of Government Officials;
Our Global and Local Partners in the fight against AIDS;
Community of Manguzi, Mhlabuyalingana, and the entire Umkhanyakude District Municipality;
Members of the Media;
Ladies and Gentlemen;
Each year on 01 December we mark World Aids Day.
We use the day to remember friends, colleagues, and loved ones who have perished from AIDS.
We also use the day to galvanise society behind the vision of zero new HIV infections, zero discrimination and zero-AIDS-related deaths.
In 2020, the international community is commemorating World AIDS Day under the theme: "Global Solidarity, Shared Responsibility."
Inspired by the international theme by UNAIDS, our country through the South African National Aids Council (SANAC), is marking World Aids Day under the theme: "We're in this together, Cheka Impilo."
We also wish to use this occasion to pay tribute to all our nurses and midwives as 2020 has been named the International Year of the Nurse and Midwife. Research says that nurses and midwives constitute for about half of the global health workforce.
We also wish to pay tribute to all our healthcare workers who continue to risk their lives as they are at the coalface of fighting the deadly, infectous Covid-19 pandemic.
Ladies and Gentlemen, you will recall that the Cheka Impilo is national awareness campaign which seeks to encourage all of us to look after our wellbeing and to make responsible and wise health choices.
Once again, we say cheka impilo. We are in this journey together. And we all have a role to play in ending HIV, TB and STIs. Please check your HIV status regularly so that you can stay negative or get care to remain healthy.
We also call on communities to rise against patriarchy and the scourge of Gender-based violence. Do not look away when you see someone suffering from GBV. Act now against GBV because it is one of the drivers of the HIV epidemic.
We also wish to add our voice and agree with the UNAIDS Executive Director, Winnie Byanyima, that given the Covid-19 pandemic storm that has engulfed the world, this year's commemoration is like no other one in our recent history.
The pandemic is certainly threatening the advances that social partners and people living with HIV have made in the fight against AIDS, TB, and sexually transmitted infections. The Covid-19 epidemic has brought much suffering and has increased socio-economic inequalities.
There is indeed all evidence globally that our world has become even more unequal with the epidemics - that there is more gender, racial, and economic inequalities. It is for this reason that we call on the urgent implementation of the National Health Insurance scheme ensure that regardless of income, all South Africans access universal and quality healthcare.
We also join the African Union and many progressive forces in the world that no one must seek to profit from the discovery of the Covid-19 vaccine or vaccines.
This is humanity's opportunity to ensure that the right to health is realised for everyone, not only the wealthy.
Today we are called again to unite not just as a province or a country, but as the entire family of nations across the world to reinvigorate our fight against HIV, TB, and STIs. We call on our communities and other stakeholders to remember that it is our shared responsibility to fight collectively the pandemics of HIV, TB, and the Coronavirus.
This is also the moment for us to seize the day and regain our lost ground in the fight against the TB and AIDS epidemics which was slowed down because of a number of factors including the disruptions that were brought about by the hard lockdown which sought to arrest the Covid-19 outbreaks.
HIV-AIDS remains a global and a provincial emergency
Ladies and Gentlemen, HIV remains a global emergency requiring us to remain focused and steadfast in its prevention and fighting its structural and social drivers.
UNAIDS reports that in 2019 across the globe, about 38 million people were living with HIV. Of these, 25.4 million people were on HIV treatment. And about 12 million people across the globe still require antiretroviral treatment. Thanks to the commitment of government and our social partners, South Africa has the biggest HIV treatment in the world which continues to save lives and improve the life expectancy of our citizens.
About 7.7 million South Africans have HIV, making us to have the biggest epidemic globally. As things stand, KwaZulu-Natal remains the epicentre of the disease in South Africa. In KZN alone, about 2 013 741 people (more than two million) are living with HIV.
As at end of September 2020, total clients remaining on ART treatment was 1 483 354 (nearly one and half million people). And here in Umkhanyakude, about 104 459 people are on treatment.
HIV prevalence among the general population is high at 20.4% and it is even highest at 27% here KwaZulu-Natal.
As we speak, no less than 1.7 million were infected with HIV globally in 2019. This was way off the target of less than 500 000 infections for 2020.
SANAC reveals that the whole world has not met UNAIDS 90-90-90 targets for 2020. The world is currently at 81% of PLHIV knowing their status, 82% on treatment and 88% virally suppressed.
Research shows that South Africa is presently at 93-71-88 for the total population.
Our province of KwaZulu-Natal has received international praise for leading in efforts to reach the 90-90-90 targets. KZN leads the country at 93%.
The provincial breakdown shows that all provinces have achieved the first 90 target, with KwaZulu-Natal performing the uppermost at 93. We applaud, in particular, the districts of Ugu, uMzinyathi, uMkhanyakude and Harry Gwala for successfully meeting their 90-90-90 targets by 2020.
SANAC reports that in order to achieve 90-90-90 targets, our country must increase the number of adult men on ART by 570,096, adult women by 480,401 and children by 58,963. It also says that we need to focus on initiation onto ART and ensuring that people do not default on their treatment.
We know that HIV thrives in conditions of poverty and that it becomes a huge burden to women in conditions of gender inequality, gender-based violence, and patriarchy. It is for this reason that our provincial strategy on HIV prevention is also anchored on the pillar of addressing women empowerment to better fight the social drivers of HIV, TB, and STIs.
Young girls and young women aged between the ages of 15 and 24 remain mostly vulnerable to HIV infections. We urge all the young girls of KwaZulu-Natal to prioritise their education and skills acquisition to prevent situations that compel them to be in abusive relationships with men.
Equally, we wish to send a strong warning to older men to behave responsibly and stop taking advantage of the economic circumstances of young girls and women. We urge parents to also play their part to bring up the boy child in a manner that boy children will grow up respecting women and their bodies.
We repeat that prevention is better than cure. Those who are already engaging in sexual activity, please use a condom all the time. A condom does not only prevent STIs, but also unplanned pregnancies.
Research drawn from the district profile of Umkhanyakude reveals that this is a poverty stricken rural municipality with high unemployment figures. There is high occurrence of malnutrition in children younger than 5 years. Many people here live below the poverty line.
The District is said to be amongst the 10 districts in the country with the highest Multi poverty index (MPI).
Social vulnerability in the province is said to be very high due to the following driving forces:
(a) It has the highest malaria prevalence in the country;
(b) Twenty to thirty percent (20-30%) of adults are HIV positive.
(c) The HIV prevalence rate is at 41.1%, higher than both the provincial and national average.
The latest figures from the provincial department of health shows that Umkhanyakude has done exceptionally well to reach its 90-90-90 targets. In September 2019, Umkhanyakude was at 93%-89%-93%. And in September 2020, it is at 94%-93%-90%.
We applaud these results and also insist that this is certainly not the time for complacency. We must maintain this momentum and keep on promoting the prevention of new infections.
Both Umkhanyakude and Ugu need to do more to improve Mother to Child Transmission of HIV. The current provincial PCR positivity rate is 0.81 percent and our target for 2021 is 0.5%. We are concerned that here in Umkhanyakude the figure is 1.5% and in Ugu it is 1.4%.
With the easing of the lockdown restrictions, we also hope to expand medical male circumcision (MMC). Between April and October 2020, we performed 8070 MMC and our adjusted target for 2021 is 50 840. We applaud His Majesty, iSilo, for his great support of MMC in KwaZulu-Natal which has proven to reduce HIV infections.
Ladies and Gentlemen, we also urge people to test for TB if they have signs of it. This can include unending coughs that lasts for more than three weeks. Remember - no person is supposed to die from TB. It is curable. If you are infected, please adhere to your treatment and complete your course.
We are happy that unlike in the past, to have HIV does not mean a death sentence. We continue to see people on treatment living healthy and productive lives and contributing to the wellbeing and success of our province.
We continue to call on our people to get tested and to take treatment if they have the virus.
Let us fight stigma and discrimination of those who live with HIV and those who have TB. We all know that stigma discourages people from testing or them from asking for support. It is a silent killer and it is against our human rights ethos as a nation.
KZN strategy to increase testing and treatment
Compatriots, KwaZulu-Natal is implementing a countdown toward reaching 90-90-90 targets campaign running until December 2020. The campaign is focussed on tracking and tracing all clients that have defaulted treatment.
We urge all communities to work with our trusted and hardworking Community Health Workers who each have been assigned a target to find and return back to care a minimum of four defaulters.
Our provincial Department of Health, MEC Nomagugu Zulu is leading our province in implementing targeted HIV index testing in order to improve HIV positivity yield and initiate all clients testing HIV positive within seven days. In addition, we are advancing community testing as an integral part of COVID-19 screening and testing. We are also using the pre-ART list to trace positive patients who were not initiated on ART.
For 2020.2021, we set ourselves to test 3 290 136. So far, we have only reached 60.8%, having tested 1 999 090. Restrictions on travelling because of Covid-19 certainly had an impact on our testing ability.
Ladies and Gentlemen, it is truly in our hands to have an HIV-free generation by 2030. Let us all test, and take our treatment as advised by healthcare workers. Please remember that treatment adherence is also important in surviving a severe Covid-19 infection.
Let us also unite to prevent the second wave of Covid-19.
Please, observe COVID-19 safety measures which include avoiding the shaking of hands and touching eyes. If you are in public, including visiting clinics, hospitals, and malls, always wear your mask, sanitise, and observe social distancing.
We urge our youth to stay away from social ills like substance abuse and alcohol. These increase a person's chance of engaging in irresponsible and risky behaviour like having intercourse without protection. It also causes others to forget their treatment, and it is an established fact that substance abuse contributes to the weakening of one's immune system.
Let us unite against GBV and hate crimes directed at the LGBTQI community.
Discriminating against gays and lesbians often discourage testing and people getting treatment. It is simply against our best Constitutional values and we must end it.
We are in this together!
Once again, we say halala for the hard work that Umkhanyakude has shown in reaching the 90-90-90 targets.