South Africa's HIV Response: Hope, Tools, and Resolve
Image: Tumi Pakkies/ Independent Newspapers
Earlier this month, more than 3,600 scientists, activists, policymakers, and journalists gathered in Kigali, Rwanda, for the 13th International AIDS Society (IAS) Conference on HIV Science.
It was the first time this major global event took place in an African city outside South Africa, marking a powerful recognition of the continent's critical role in the global HIV response.
The conference came on the heels of deeply concerning news: in January, the US government announced sharp cuts to funding for the President's Emergency Plan for AIDS Relief (PEPFAR), a move that cast a long shadow over the global fight against HIV, particularly in Africa. The numbers are staggering: of the 40.8 million people living with HIV globally, over 26 million (65%) are in Africa. And more than half of all new infections in 2024 occurred on the continent.
A Call to Stay the Course
Despite fears about reduced funding, the mood in Kigali was one of resolve. Delegates affirmed their commitment to ending HIV, recognising the extraordinary progress made in Eastern and Southern Africa. Many echoed a common sentiment: "We cannot stop now. We must fight to the end", emphasising the need for sustained commitment and effort to achieve an AIDS-free future.
That optimism was reinforced by encouraging developments. The pharmaceutical company Gilead announced that Lenacapavir, a new HIV prevention drug administered via two injections a year, has shown high efficacy in clinical trials. If made widely accessible, this could be a game-changer— especially for those who struggle with daily pill regimens.
Further hope came when the US Congress ultimately approved continued PEPFAR funding, although uncertainties remain around the duration and scope of future support.
Video Player is loading.
Play Video
Play
Unmute
Current Time
0:00
/
Duration
-:-
Loaded :
0%
Stream Type LIVE
Seek to live, currently behind live
LIVE
Remaining Time
-
0:00
This is a modal window.
Beginning of dialog window. Escape will cancel and close the window.
Text Color White Black Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Background Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Opaque Semi-Transparent Transparent Window Color Black White Red Green Blue Yellow Magenta Cyan
Transparency Transparent Semi-Transparent Opaque
Font Size 50% 75% 100% 125% 150% 175% 200% 300% 400% Text Edge Style None Raised Depressed Uniform Dropshadow Font Family Proportional Sans-Serif Monospace Sans-Serif Proportional Serif Monospace Serif Casual Script Small Caps
Reset
restore all settings to the default values Done
Close Modal Dialog
End of dialog window.
Advertisement
Next
Stay
Close ✕
Ad loading
What This Means for South Africa
South Africa has the world's largest HIV treatment programme, with over 5.5 million people receiving antiretrovirals (ARVs). Yet we still see more than 100 000 new HIV infections each year. That is unacceptable — and preventable.
To address this, the government launched the '1.1 Million Campaign' in February to close the gap between those who know their HIV status and those who are virally suppressed. But for this initiative to succeed, we need national mobilisation.
Every political leader, community organiser, religious institution, and employer must actively support the campaign. Unfortunately, media coverage has been limited, and public awareness remains low.
Doing More with Less
With reductions in funding from the Global Fund and PEPFAR, and despite increased domestic investment, every rand in our HIV response must count. Managers and community activists in the health and social development sectors must track data rigorously: Who is being tested? Who is on treatment? Who is virally suppressed? Who is using Pre-Exposure Prophylaxis (PrEP) — and who should be, but isn't?
We must also stand firm against stigma. There is no justification for discrimination against people living with HIV or those using preventive treatments like PrEP. They are taking responsible steps to protect themselves and others. They should be commended and supported, not shamed.
The Tools Are in Our Hands
We now have powerful tools to fight HIV. HIV self-test kits are available free at public clinics and affordable at private pharmacies. Oral PrEP— a once-a-day pill to prevent HIV — is also free at government health facilities. And injectable PrEP, which could significantly improve adherence, is expected to be available next year.
Condoms remain a highly effective prevention method. Let's not forget—they also prevent sexually transmitted infections like syphilis and gonorrhoea and help avoid unplanned pregnancies. They are free at all public clinics.
Let's also remember the link between HIV and tuberculosis (TB). People with HIV are more susceptible to TB. If you have symptoms or have been in contact with someone with TB, get tested. Early detection saves lives.
Health Is Everyone's Business
Building a healthier South Africa is not just about medicine—it is about national prosperity. A healthy population is more productive, more resilient, and more able to seize economic opportunity. Each of us has a role to play in protecting our health and the health of our communities.
Let's work together to end HIV. The finish line is in sight—but only if we don't stop now.
Prof Yogan Pillay is the Director for HIV and TB delivery at the Bill & Melinda Gates Foundation. He was previously the Country Director of the Clinton Health Access Initiative in South Africa and senior director for universal health coverage. He has worked in various capacities at the National Department of Health. In 2021, the University of Cape Town awarded him an honorary doctorate, and in the same year, he was appointed extraordinary professor in the Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University.
Foster Mohale is the National Department of Health Spokesperson
Hashtags

Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles

TimesLIVE
6 hours ago
- TimesLIVE
Findings give hope for monthly HIV prevention pill
There are several antiretroviral formulations proven to prevent HIV infection: a daily pill, two different jabs that offer protection for two and six months respectively, and a vaginal ring for women that has to be replaced monthly. In a few years, a long-acting pill may join the ranks, if it works. The pill, for now called MK-8527, has the potential to prevent HIV infection for up to a month in its current formulation. It is a nucleoside reverse transcriptase translocation inhibitor (NRTTI), which means it disrupts a specific step in the cycle by which the virus makes copies of itself. The pill is now moving onto pivotal phase-three trials, after promising results from a smaller phase-two study presented at the International Aids Society (IAS) conference held in Kigali, Rwanda. The phase-two study, conducted in trial sites in South Africa, the US and Israel showed that MK-8527 was well tolerated and had a safety profile similar to a placebo. It also showed the levels of the antiretroviral were at the required levels in the bodies of study participants, though the study was not designed to determine whether it is effective. Whether MK-8527 actually prevents HIV infection will now be tested in two large phase-three studies across multiple countries, including South Africa. In these studies, the efficacy of the monthly pill will be compared with a daily HIV prevention pill that is already widely available in South Africa's public sector. The daily pill contains the antiretroviral drugs tenofovir disaproxil fumarate and emtricitabine. Latest findings The phase-two study looked at three different doses of the monthly pill — 3mg, 6mg and 12mg — as well as a placebo. The 350 participants, about one third of which were from South Africa, were given one pill (either an active pill or placebo) every month for six months. They were monitored for at least two months afterwards. None of the participants acquired HIV during the study. The researchers enrolled adults who were at a low risk of being exposed to HIV and excluded pregnant and breastfeeding women, and people who had previously used MK-8527 or a similar antiretroviral drug called Islatravir, said Dr Kenneth Mayer, a professor of medicine at Harvard Medical School, who presented the findings in Kigali earlier this month. The levels of the antiretroviral in the blood of all the participants were measured on day one and two, on the last day of taking the pill, and again at the first follow-up visit after stopping the pill. Based on these results, Mayer said there doesn't appear to be a build-up of drugs in the body that might prove toxic over time. This supports evaluating the use of a monthly pill over a longer period (than the six months in the study), he said, 'without concern that increasing drug levels will cause toxicity after a longer period of monthly administration'.


The Citizen
21 hours ago
- The Citizen
Health minister calls for bold action as TB vaccine nears reality
Minister of Health Dr Aaron Motsoaledi has stressed the urgent need for innovative solutions to combat tuberculosis (TB), a disease that has historically affected not only South Africa but countries around the world. 'We are here because we believe that TB – a disease that has shaped the history and health of our country and indeed, the whole world – can be ended. Not through words alone, but through action, partnership, and innovation,' he said on Thursday. The minister was delivering the keynote address at the country's TB Vaccine Preparedness Workshop in Johannesburg. The workshop aims to advance policy and decision-making for the introduction of TB vaccines. Protecting the most vulnerable Addressing policymakers, scientists and community leaders, Motsoaledi said the upcoming phase will introduce preventative TB vaccination measures, which will also support the fight against HIV and Aids. For over a century, South Africa has relied on the Bacille Calmette-Guérin vaccine to protect children from TB, but the minister pointed out that there has been no tool to protect adolescents and adults. 'These are the very groups most at risk of getting sick and transmitting TB,' he said. With several new TB vaccine candidates in the late stages of clinical trials, the most promising options are expected to be available in the next few years. The workshop positioned South Africa as one of the first countries ready to deliver a new generation of TB vaccines to the most vulnerable populations, including adolescents and adults. Ending 'slavery' of disease The minister expressed confidence that upcoming trials would yield positive results, potentially leading to a new vaccine for older age groups. TB remains a leading cause of death from infectious disease and a major contributor to poor health both locally and globally. 'Imagine the day when we announce the availability of the vaccine for tuberculosis,' he said, likening it to 'the day of true freedom from slavery' for those affected. Motsoaledi described the disease as a form of 'devastating slavery' that fuels poverty and premature death. 'South Africa is not waiting for the world to act. We are preparing – intentionally, early and inclusively.' Commitment to readiness The minister used the country's first national gathering on TB vaccine readiness to reaffirm South Africa's leadership in the global fight against TB and HIV. 'When South Africa wins against TB and HIV and Aids the world will win the war,' he said. He noted that throughout his tenure, he has sought to elevate TB on the global health agenda, recalling his 2018 address at the United Nations calling for world leaders to act. 'While global attention has often turned to emerging health threats, South Africa has remained focused on the enduring challenge of TB,' he said. He also acknowledged the devastating impact of TB on communities already battling HIV. Systems, trust and investment 'Today's discussions remind us that vaccine introduction is not just about science – it is about health systems. It is about trust. It is about readiness.' Motsoaledi emphasised the importance of preparing the health sector for the rollout, saying the agenda highlighted key areas such as evidence generation, delivery systems, and supply chain readiness. 'Investment in human life means everything,' he said, calling for strong financial backing and stakeholder support. He urged participants to build community trust and advocate for broad acceptance of the new vaccine. 'We must walk the path with our people,' he said. – Breaking news at your fingertips… Follow Caxton Network News on Facebook and join our WhatsApp channel. Nuus wat saakmaak. Volg Caxton Netwerk-nuus op Facebook en sluit aan by ons WhatsApp-kanaal. Read original story on


The Citizen
a day ago
- The Citizen
World Brain Day: More than 40% of dementia cases can be prevented
World Brain Day: More than 40% of dementia cases can be prevented The World Health Organization estimates that 57 million people globally live with dementia, with this number expected to reach 153 million by 2050. A total of 60% of people with dementia live in low- and middle-income countries, but this will rise to 71% by 2050. Welma Geldenhuys, senior social worker of the Association for Dementia and Alzheimer's of South Africa in Pretoria, said that for the association, World Brain Day is about creating awareness for communities and families of how to let people with dementia live lives of dignity and quality. 'At the association, this is something we truly advocate for,' said Geldenhuys. Overall, around 45% of cases of dementia are potentially preventable by addressing 14 modifiable risk factors at different stages during the life course. These include things such as not completing secondary education, social isolation, and depression, as well as several medical conditions such as hypertension, obesity and diabetes. 'We need to get the word out that it is important to get a professional diagnosis of the illness by an expert medical professional because the right treatment and medication can be administered,' explained Geldenhuys. Diet might also be an important aspect to look at in addition to these 14 factors, and has a key role in reducing the risk of chronic diseases that affect dementia risk. Speaking ahead of World Brain Day, Dr Patty Francis, president of the Neurological Association of South Africa, said dementia is no longer an inevitable consequence of old age, but 'the result of decades-long exposure to modifiable risk factors'. Dr Francis said the brain is highly sensitive to long-term physical, emotional, and environmental stressors. 'The rise in dementia in our region is deeply concerning, considering that we carry high burdens of HIV, hypertension, diabetes and stroke, all of which are linked to increased dementia risk,' she said. 'The most powerful message we can share this World Brain Day is that dementia is not just about ageing, it's about lifelong brain health. What we do in our 30s, 40s and 50s has a direct impact on our risk later in life.' Although addressing risk factors at an early stage of life is desirable, there is also a benefit from tackling risk throughout life; it is never too early or too late to reduce dementia risk. 'Dementia does not happen overnight. It often starts with decades of unmanaged risk factors such as high blood pressure, physical inactivity, obesity, smoking, poor sleep, alcohol abuse, and hearing loss, all of which silently damage brain tissue. When addressing these, research shows dementia could be prevented or delayed in up to four in 10 cases.' 'Every stage of life offers an opportunity to protect your brain,' said Dr Francis. 'From maternal nutrition to childhood immunisation, and from midlife stress management, to staying socially connected in older age. Preventions start early and are lifelong.' While dementia presents differently in each person, common warning signs include: – Memory loss that disrupts daily life – Difficulty performing familiar tasks – Language problems such as difficulty in speaking or writing – Confusion with time and place – Trouble understanding visual images – Misplacing things and losing the ability to retrace one's steps – Decreased or poor judgement – Personality or mood changes – Withdrawal from work or social activities – Problems with reasoning or problem-solving. Other red flags include trouble with planning and organising, poor co-ordination and control of movements, and confusion and disorientation. 'It's important not to dismiss symptoms as just getting older,' Dr Francis said. 'Even in younger adults, persistent cognitive changes should be assessed by a neurologist or specialist physician.' Some forms of dementia are amenable to therapy, such as HIV-related dementia or deficiency in vitamin B12. While there is currently no cure for Alzheimer's disease, early diagnosis and treatment can significantly slow progression and improve quality of life, with options, including: – Medication to manage cognitive symptoms and behaviour – Cognitive rehabilitation – Occupational therapy – Management of underlying conditions like hypertension or diabetes. Dr Francis said new drug developments, such as anti-amyloid therapies, are promising but remain costly and limited in availability in most low- and middle-income countries. 'In South Africa, our most urgent need is access to early screening and specialist care, particularly in under-resourced communities. 'We also need to destigmatise dementia, so families feel supported, rather than isolated,' she added. 'This World Brain Day, we are calling on all South Africans to prioritise brain health from the earliest stages of life. 'Healthy brains build healthy communities and the power to prevent dementia starts with awareness, education and action.' If you suspect someone you know is showing signs of dementia, you can get support and guidance from your local GP or community clinics for referral to specialists, or Alzheimer's South Africa. A workshop on dementia will be held on August 20 at the Sungardens Hospice in Lynnwood, Pretoria, by Alzheimer's South Africa from 09:00 to 13:00. More information is available from Welma Geldenhuys, who can be called on 082 821 4862, or visit the ADASA website on Do you have more information about the story? Please send us an email to [email protected] or phone us on 083 625 4114. For free breaking and community news, visit Rekord's websites: Rekord East For more news and interesting articles, like Rekord on Facebook, follow us on Twitter or Instagram or TikTok.