IMPLEMENTATION PLAN TO SCALE UP HIV/AIDS PREVENTION AND TREATMENT 1

National Strategic Plan on HIV and AIDS, Goals To reduce the rate of HIV infection by 50% by % of people that need treatment to be provided with antiretroviral treatment 2

The Turning Point (World AIDS Day – 01 December 2009) Major Announcements made by the President: New treatment regiments -Pregnant women to start treatment at CD-4 count of 350 or less -All TB/HIV co-infected people to start treatment at CD-4 count 350 or less TOP SECRET3

The Turning Point continued A new package of preventative measures -All pregnant women not on treatment to start PMTCT at 14 weeks -All HIV positive infants (1 year or less) to start treatment on diagnosis, regardless of their CD- 4 count ( born HIV positive annually in SA TOP SECRET4

Implementation of World AIDS Day Announcements Prevention strategy for HIV/AIDS Information, education, mass mobilisation STI detection and management Know your status – HIV testing and counselling Widespread provision of condoms (male and female) Medical male circumcision Prevention of mother to child HIV transmission (PMTCT) Safe blood transfusion Post-exposure prophylaxis Life skills education 5

6 I AM RESPONSIBLE... I must take responsibility for my own health and HIV status i.e. if I am HIV negative, to stay negative, if I am HIV positive, to seek support and services to ensure I am healthy and don’t spread the virus to others, be they partners or children Campaign Theme – Continuation from World AIDS Day

7 WE ARE RESPONSIBLE We must take collective responsibility for enabling those in our sphere of influence to make healthy choices (be they our children, our sexual partners, our employees etc.) Campaign Theme – Continuation from World AIDS Day

8 SOUTH AFRICA IS TAKING RESPONSIBILITY Government and social partners are taking collective responsibility to ensure that quality services are available when people present to test and to treat Campaign Theme – Continuation from World AIDS Day

HCT Targets – Initial launch districts- conducted on 30 April TOTAL POPULATION TARGETED POPULATION TARGETED PRETEST COUNS TARGETED TESTS ECOR Tambo1,828,5571,009,611544,177494,709 FSFezile Dabi794,184519,765280,154254,685 GPEkurhuleni2,622,2981,805,692973,268884,789 KZNuMgungundlovu1,001,811657,349229,354322,101 LPCapricorn1,206,089696,763375,555341,414 MPGert Sibande920,205568,001306,152278,320 NW Dr. Kenneth Kaunda708,193466,495251,441228,583 WCCape Town3,242,0092,167,5161,168,2911,062,083 NC JT Gaetswe (Kgalagadi)197,627116,97063,04757,315 Total12,520,9738,008,1624,191,4393,923,999 9

HCT Targets- Provinces TOTAL POPULATION TARGETED POPULATION TARGETED PRETEST COUNS TARGETED TESTS ECAll districts 6,884,4824,117,741 2,219,4622,017,693 FSAll districts 2,972,9831,926,174 1,059,396963,087 GPAll districts 9,859,5436,834,865 3,683,9923,349,084 KZNAll districts 10,077,6206,243,334 3,365,1573,059,234 LPAll districts 5,357,9493,144,090 1,694,6641,540,604 MPAll districts 3,646,1232,236,374 1,205,4051,095,823 NWAll districts 3,229,0782,038,488 1,098,745998,859 WCAll districts 4,945,7323,280,801 1,768,3511,607,592 NCAll districts1,108,599689,675371,735337,941 National48,082,10930,511,54216,466,90714,969,917 10

Full range of services provided by HCT sites HIV counselling and testing (HIV) Blood pressure (Hypertension) Blood sugar (Diabetes mellitus) HB (Anaemia) TB screening (symptomatic screening, 5 questions) – Full clinical TB screening is yes to any of the 5 questions (sputum, culture, x-rays) 11

Testing CURRENTNEXT 12 MONTHS 15m HIV tests over next 12 months 3.8m HIV tests between April and June m HIV tests over the last 12 months

CURRENTNEXT 12 MONTHS 6m Female condoms distributed 1.5b Male condoms for campaign + 1b for 2010 FIFA World Cup 450m Male condoms distributed and 1m female condoms Condoms

Medical Male Circumcision CURRENT NEXT 12 MONTHS All Provinces by 2011 Add 2 Provinces (NC & MP) by 1 st December KZN immediately 2.5m by 2015 Small Pilot projects

INH Prophylaxis for TB Prevention CURRENTNEXT 12 MONTHS 8,000 patients provided INH prophylaxis Increase to 45,000 HIV+ patients accessing INH

ART for Pregnant Women CURRENT NEXT 12 MONTHS Maintain 85,000 Additional 56,000 will qualify for treatment through the new policy 85,000 Pregnant women receiving ART

TB-HIV Co-infected Patients CURRENTNEXT 12 MONTHS Maintain Additional 66,000 patients will access ART through new Policy CD4 <200 already on ART

Infants accessing ART CURRENT NEXT 12 MONTHS Maintain children on ART 20,000 Infants initiated on ART through new policy Additional 7,000 children above 1 year will be added onto ART 35,000 children accessing ART

Total ART Patients CURRENT NEXT 12 MONTHS Maintain existing patients, and additional 450,000 patients with CD4 < 200 to be initiated Additional 56,000 HIV+ Pregnant women Additional 66,000 TB co-infected patients added onto ART 20,000 Infants Initiated 923,000 patients initiated on ART

ART Provision CURRENTNEXT 12 MONTHS Additional 460 ART sites (full package) TB Testing and Treatment Centres providing ART Antenatal Care facilities providing ART 490 ART Centres 4,300 PHC Facilities providing Full package ART by March 2011

Human Resources CURRENTNEXT 12 MONTHS 1,500 Nurses trained to initiate ART by 1 st APRIL 4,800 Nurses trained and initiating ART by March 2011 Less than 250 nurses initiating treatment through pilot programme

Summary Estimates by end of June 2011: Total tested: 15 million Total testing positive: 1.65 million 22

Strategies and Interventions Progress Output: Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis Implementing Health care provider- initiated Counselling and Testing (HCT )Campaign Patients Counseled: 6,021,330 Tested in Public sector: 5,105,873 Tested in Private sector: 369,432 Total number Tested : 5,474,505 Acceptance rate: 85% Tested positive : 936,168 Positivity Rate : 18% Target reached to date: 68,6% 23

HIV Data Jan 2011 ProvincePre-testTestedPositive Negative Positivity8 months targetTarget Achieved EC 847,410678,23785, ,986 13% % FS 382,086313,35765, ,348 21% % GP 953, , ,814 24% % KZN 1,532,8211,150,388245, ,438 21% % LP 819,485691,80388, ,737 13% % MP 383,739349,65995, ,601 27% % NC 100,27696,61810,961 85,657 11% % NW 530,637414,08672, ,807 17% % WC 471,238457,28745, ,517 10% % SA 6,021,3305,105,073936,168 4,168,905 18%7,983,95764% 24

Strategies and Interventions Progress Output: Combating HIV and AIDS and decreasing the burden of disease from Tuberculosis Rapidly scaling up access to Antiretroviral Therapy (ART) for people living with HIV&AIDS, especially identified vulnerable groups; Over 1,2 million patient are on ART and we plan to increase access to 1,5 million patients by end of this financial year. Expanded the service providing ART from 490 to about 1,500 new facilities which are providing ART Increased the number of nurse providing ART from 290 to more than 2000 trained nurses that are equipped to initiate ART and manage HIV patients at the PHC facilities 25

THANK YOU 26