South Africa has comprehensive policies and programmes to address the epidemic. Central to the prevention programmes are communications programmes, including Khomanani, Soul City, and loveLife.

There is a large free condom distribution programme providing approximately 400 million male condoms annually. Free female condom distribution, although expanding, still lags behind. South Africa has a comprehensive plan for the management, treatment, care and support of people living with HIV. This programme had enrolled approximately 370,000 people by September 2007 with ARV treatment in the public sector and an estimated 120,000 people in the private sector. Although still significantly lower than the treatment need it is currently the largest HIV treatment programme in the world.

In 2007 South Africa bolstered its national response by revamping the national AIDS council into a multisectoral body providing high level leadership and coordination. The council consists of eight government ministries and 18 member from civil society and the private sector.

Under the National AIDS Council leadership, South Africa developed a National Strategic Plan for 2007-2011. This sets out the road map for Universal Access to prevention, treatment, care and support. The plan was developed through a consultative and inclusive process, ensuring national consensus on priorities to address the epidemic. The plan has linkages with other national programmes addressing the drivers, manifestation and impact of the epidemic.

Key Achievements

In 1992, the National AIDS Coordinating Committee of South Africa (NACOSA) was launched with a mandate to develop a national strategy on HIV and AIDS. The Government’s Cabinet endorsed this strategy in 1994. A review conducted in 1997, in line with the goals of the NACOSA plan, highlighted the strengths and weaknesses of a health sector which tended to have a disease-specific approach to HIV and AIDS. Some of the recommendations included capacity building for implementing agencies, increasing political commitment, increased involvement of people living with HIV and strengthening integration.

Several policies and guidelines have been developed in order to support the implementation of HIV strategies in South Africa. This work began in 1994 with the finalisation of the Reconstruction and Development Programme document from which most of the other policies flowed. Some examples are: Maternal, Child and Women’s Health; development of the District Health System; Patients’ Rights Charter; the White Paper on Transformation of the Health System in South Africa; workplace policies in all government departments and the Integrated Nutrition Programme.

Other important milestones were: the National Operational Plan for Comprehensive HIV and AIDS Management, Treatment, Care, and Support (The Comprehensive Plan) in November 2003; the National Policy Framework for Orphan and Vulnerable Children (OVC) in 2005 and the National Action Plan for OVCs for the period 2006 – 2008.

In 1999 the National Strategic Plan (NSP 2000-2005) was developed and an assessment was carried out through a consultative process with stakeholders. Its findings and recommendations have been used to inform the NSP 2007-2011. The two primary aims of the NSP 2007 – 2011 are:

• Reduce the rate of new HIV infections by 50% by 2011 and
• Reduce the impact of HIV and AIDS on individuals, families, communities and society by expanding access to appropriate treatment, care and support to 80% of all HIV positive people and their families by 2011

The plan has identified 19 goals that are needed to reach the NSP’s aims and these are structured under four key priority areas (Prevention; Treatment, Care and Support; Research, Monitoring and Surveillance; and Human Rights and Access to Justice).

Key Challenges

There is a unified HIV platform spearheaded by the South African National AIDS Council (SANAC) which sets out national priorities for scaling up treatment, prevention, care and support. This national framework sets out aspirational goals and targets, which need to be translated into operational plans at national, provincial and local level. Future challenges include:

• Develop, implementat and monitor costed sector plans to operationalise the National Strategic Plan
• Strengthen multisectoral efforts to scale up existing and new HIV prevention programmes to reduce further new HIV infections
• Strengthen health and social service capacity across the three spheres of government, civil society and the private sector to prioritize and deliver on programmes and interventions outlined in the national plan
• Strengthen national coordinating authorities, including provincial and local AIDS councils, to discharge their functions
• Support various sectors of SANAC in their effort to scale up programmes prevention, treatment and care services at the community level
• Support and monitor the implementation of the National Strategic Plan, including sector plans, in accordance with the national monitoring and evaluation frameworky

• National Strategic Plan
• South African National AIDS Council (SANAC)
• PMTCT and Paediatric Care and Treatment Fact Sheet