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Background
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President Bush’s Emergency Plan for AIDS Relief (PEPFAR) enables USAID and other U.S. government agencies to treat the crisis urgently. South Africa is home to one-quarter of the people living with HIV and AIDS in 15 countries assisted by PEPFAR. About 75% of South Africans infected are in the early stages of the disease, showing few symptoms, if any. HIV-related illnesses and deaths will increase dramatically in the next five years unless prevention and treatment programs are fully implemented. PEPFAR aims at results in prevention, treatment, care and support, particularly assisting orphans and other vulnerable children. USAID works with partners in South Africa’s government, local businesses, communities, faith-based groups and other nongovernmental agencies to reach the country with AIDS assistance. USAID specifically assists partner organizations to build management and technical abilities to reduce the impact of HIV/AIDS. USAID provides care for more than 200,000 people. |
South Africa has made remarkable progress since democracy replaced apartheid 13 years ago. New opportunities are reaching millions of South Africans with health, education, business and improved services (including water, housing and electricity). However, serious problems still remain: unemployment is about 30%; poverty affects nearly half the population; and the country has one of the most unequal income distributions in the world. Economic growth has not been sufficient to address these issues.
Public health staff work hard to consolidate a once splintered health system into a single approach that serves all patients fairly.
The AIDS epidemic severely strains the limited resources of the health system and threatens the well-being of families, particularly children. More than 5.5 million South Africans have the AIDS virus. The number of people of reproductive age with HIV prevalence has risen to 30% from less than 3% a decade ago.
The Challenge:
South Africa has more HIV-infected adults and children than any other country in the world. About 1,700 South Africans become infected with HIV every day. AIDS is the leading cause of death among adults. Up to 60% of hospital beds are occupied by patients with HIV-associated illnesses. UNAIDS estimates more than 2 million South African children have been orphaned by AIDS (lost at least one parent). AIDS also hits South Africa’s education sector, public service and economy hard, and can impoverish surviving family members.
Prevention:
USAID’s prevention efforts encourage youth to practice safe behavior using the ABC model—“Abstinence, Be faithful for younger youth, and provide information on correct and consistent use of Condoms for older youth or those at risk,” in that order. Another priority is to provide the drug Nevirapine to pregnant women who are HIV positive to prevent passing the virus to their unborn babies. USAID is expanding these services to sites that will train health practitioners in prevention of mother to child transmission techniques in highly affected provinces. USAID also works with local groups to expand successful community-based HIV/AIDS prevention and education activities. Support is given to several adolescent-friendly programs focusing on abstinence and male involvement.
USAID supports non-governmental and faith-based groups on the community frontlines to provide information on correct and consistent use of condoms, testing, counseling and other services that help South Africans make healthy informed choices.
Treatment:
USAID assists people to get treatment for HIV in many ways. Managing the disease includes treating related infections such as tuberculosis, that attack a weakened immune system. USAID helps to track how patients react to drug treatments so adjustments can be made for the most effective medical assistance possible. USAID assists the South African Government and businesses to establish workplace policies, provide treatment and help employees affected by AIDS to continue to work productively.
In 2004, USAID brokered a partnership that works with public facilities and non governmental organization treatment sites to augment staff and train health care providers in administering antiretrovirals (ARVs) and full treatment services to more than 30,000 HIV positive patients in 15 different locations. More patients will be assisted at more sites during 2006.
Community care and support:
USAID funds several projects that support adults, youth, orphans, abandoned and other vulnerable children dealing with AIDS. These programs range from homes for children with HIV who have nowhere else to go, to households where children are responsible for the family. People with AIDS in South Africa have had limited choices for treatment and care. USAID supports efforts to expand availability of treatment and care in public and private sectors. USAID helps train community members and supports hospices and other community projects working with people living with HIV and AIDS at or near their homes. Many people in programs that USAID assists say that they would have no hope if not for the compassionate support of a local neighborhood care-giver. USAID will improve this type of vital assistance during the year, equipping caregivers to teach patients how to manage their pain, get treatment and obtain other services available for people in their circumstances.
Primary health care:
USAID supports South African Government efforts to improve access to health services at all levels. Focus is currently on districts and municipalities where medical staff and residents need the most help. Progress has been made in improving District Health staff abilities to deliver quality care. Training has been conducted in management, budgeting, monitoring, evaluation and documentation. The explosion of the AIDS epidemic places further pressure on the health system. USAID is working with the S.A. government to include HIV/AIDS prevention, counseling and care in primary health efforts, especially for mothers and children. USAID helps strengthen community networks, such as hospital and clinic committees, to teach people better ways of managing their health. Child survival support further gives young people the chance for a healthy life with proper nutrition, immunization and education.
Improve tuberculosis diagnosis and treatment:
Tuberculosis (TB) is a public health emergency and the leading cause of death in communities with high levels of HIV. The Medical Research Council of South Africa reports that South Africa faces one of the world’s most devastating TB epidemics with approximately 302,461 cases and 29 632 deaths expected this year. HIV-infected people are highly susceptible to TB infection, fueling the transmission and deaths caused by the lung disease. USAID assists highly affected communities in five provinces to increase the number of people getting tested for TB and completing their treatments. Clinic staff, doctors and community volunteers are trained on early detection and treatment of TB, promoting greater awareness that TB is curable.
Other Programs:
Every USAID program addresses HIV/AIDS. USAID funds several research studies to find out how HIV/AIDS affects South Africa’s people and economy. This information is important to decision-makers who allocate resources to respond to AIDS in South Africa.
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