1. Western Cape Wellness Summit 08 November 2011 Infectious Diseases

2. Priority actions to address the burden and to be considered by work groups

3. Certain areas, characterised by a ‘deprivation cluster’ of risk factors, carry a disproportionate burden of HIV and TB disease These areas are associated with ‘social vulnerability’ which creates a high risk environment for HIV transmission Our armamentarium is limited to a few bio-medical interventions We’re not only trying to prevent new HIV and new TB infections We also have a large population of people who are already HIV-infected, and in whom we are trying to prevent premature death Our challenge is getting the interventions into the high-risk communities at scale – a challenge of supply and demand Review 1. Western Cape Burden of Disease report for major infectious diseases, 2007

4. Priority Actions: Group Accept Strategic Objective 4 priorities of: HCT Barrier protection methods, Male Circumcision, ART Services, TB case finding

5. Which led to a discussion of ‘social marketing’ and how to do it differently Need to move away from the individual as the locus of change

6. Priority Actions Combination of mass communication and community mobilization to create a demand and behaviour change. Messages need to targeted Appropriate messages and adequate marketing Change community perceptions e.g. early ART initiation – “ ARVs are no longer the last resort” “HIV disease is a chronic disease not a fatal disease Use positive role models to promote empowerment

7. Priority Actions Target key risk populations; include disability population, prisons, youth (access to schools) Need a strategy to deal with migration Target high burden areas

8. “Highly active HIV prevention inevitably must be combination prevention ” “Nothing more important than a focus on young people ” “investments should focus on promoting normative and social change to reduce multiple and concurrent partnerships, and to greatly increase availability of safe and affordable male circumcision services” “The aggregate effect of radical and sustained behavioural changes in a sufficient number of individuals potentially at risk is needed for successful reductions in HIV transmission” “ Understand but don’t overcomplicate. Broad rapid brushstrokes are sufficient for action” UNAIDS suggested high level strategies…

9. How do we work better together as different sectors

10. Working together True commitment means that sectors and government departments commit actions and resources ( based on NSP and PSP) Use PAC more effectively as well as other structures for reporting on actions at all levels Measure performance In PSP all sectors must identify planned actions – to be costed

11. Working together Invite more members (identified today) to participate in SO 4 Work-Group Invest in research to bring us together e.g. surveillance – joint research, community research in health seeking behaviour, social cohesion and social capital Community strengthening – use right people Use community structures

12. Working together Consensus on a uniform community M & E System High level from political commitment from DOE, Department of Social Services Involve Corporate Sector

13. Suggested amendments to the declaration and why?

14. Priority Actions

15. Thank you