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Date : 20/10/2004
Source: Western Cape Provincial Government
Title: P Uys: Agreement to strengthen HIV and AIDS programme


ADDRESS BY MR PIERRE UYS, WESTERN CAPE MINISTER OF HEALTH, AT CELEBRATION OF AGREEMENT TO STRENGTHEN HIV AND AIDS PROGRAMME, Cape Town, 20 October 2004

Tonight, we celebrate the grant given to the Western Cape Provincial Department of Health by the Global Fund to Fight AIDS, TB and Malaria for the first two-year phase of a five-year programme to strengthen and expand our already comprehensive HIV/AIDS programme, totals US$ 15.5 million (approximately R100 million) . We will also hand over cheques to 28 organisations helping us in this regard.

Since its creation in January 2002, the Global Fund has grown to become the world's largest funder of programmes to fight Aids, TB and Malaria which together kill more than 6 million people each year. The Fund is a public private partnership established under Swiss law, and governed by an international board of 23 members supported by an 80 person secretariat based in Geneva. I was privileged to meet Global Fund Executive Director, Professor Richard Feachem, during a visit to Britain earlier this year. The Manager of the Fund Portfolio in Africa is Mr Duncan Earle.

By the end of 2003 the GF had approved 227 grants totalling US$ 2.1 billion in 124 countries of which 60% was earmarked for Aids programmes. Currently only two percent (2%) of its funds comes from the private sector and the remaining 98% from governments. A key principle of GF's approach to funding is "additionally" - meaning that its resources complement but never replace budgeted funding. In this regard, our Health Department budgeted R90 million for HIV and Aids programmes in the current financial year (this excludes monies budgeted for the care of patients in our hospitals).

The harsh reality is that we have yet to reach a turning point in the spread of HIV in our province The 2003 National and Provincial HIV Antenatal Survey in the Western Cape revealed an HIV prevalence of 13.1% among pregnant women attending public health antenatal clinics. This is up from 12.4% in 2002. While this is not a significant increase, we should be concerned.

District-level surveys showed that the HIV epidemic is spreading and maturing at various rates at local level. Overall the survey indicates sub-epidemics at various stages of development in the districts surveyed with the prevalence ranging from 1-28%. Districts with the highest HIV prevalence were Gugulethu/Nyanga (28.1%), Helderberg (19.1%), Khayelitsha (27.2%), Oostenberg (16.1%), Caledon Hermanus (14.2%) and the Knysna/Plettenberg Bay (15.6%) districts.

Other key findings were:

* In 2001, only 6 (24%) of the 25 health districts reported a prevalence of greater than or equal to 10%, whilst in 2003, 13 (52%) of the 25 districts reported HIV prevalence of greater than or equal to 10%.

* A rapid rate of increase in urban settings, where over 65% of the population reside.

* The HIV prevalence in the under 20 age group (proxy for new infections) has increased consistently over the last eight years.

* The HIV prevalence is highest amongst younger women and continues to increase rapidly amongst 15-24 year old women.

It is clear from the evidence provided by this survey that by far the biggest risk group in our province is the under 20 age group. A finding, that supports what we are doing here tonight: putting more planning and resources into prevention and care programmes targeting the youth and women. It also confirms that we need to continue with intensive preventative strategies such as improving Sexually Transmitted Infections screening and management, particularly at family planning clinics, and promoting Voluntary Counselling and Testing uptake, particularly among the youth.

Currently, close to 5 000 people are receiving ARV treatment at 25 sites throughout our province. By early next year we will have 36 ARV sites accredited and operational in the Western Cape.

Clearly, the fight against HIV/AIDS is far from won. I believe that coalitions - such as the coalition that we represent here tonight, uniting government, the Global Fund, NGO's, public leadership and common purpose - are our best hope.

This grant by the Global Fund - my sources tell me it is the biggest single grant received by any department in the history of the Western Cape - represents an enormous step forward in the fight against HIV and Aids our province. For one thing, it will place us in a position to provide ARV treatment for everybody. It is only the beginning of a program that will see our Province delivering on more treatment, more care and more prevention in the fight against HIV and Aids. Approval by the Global Fund of the second three-year phase of the grant programme is dependent on the achievements of the Department and its programme partners during the first phase of the programme. ~

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