The challenge of fighting HIV in South Africa
Dr Dominique Stott, Executive: Medical Standards and Services at PPS.
According to the 2014 Mortality and Causes of Death Report released by Stats SA, HIV is the third biggest killer in South Africa. Despite the great strides that have been made in the fight against HIV/Aids, this disease continues to be one of the country’s biggest challenges.
This is according to Dr Dominique Stott, Executive: Medical Standards and Services at PPS, who says that while there have been a number of remarkable improvements relating to the treatment of HIV, the world is still a long way away from developing a vaccine or cure for the disease.
Dr Stott says that worldwide there are currently various research avenues being explored for a cure for HIV. “As vaccine research is extremely complex, however, the world is still far from a solution for the virus and the challenge to combat the fight against HIV/ Aids will be an ongoing one for several more years.”
She says that apart from the search for a cure to the disease, testing and adherence to treatment protocols continue to remain an ongoing challenge.
Point of care testing for HIV and HIV-related illnesses has become widely available worldwide and is appropriate for use in almost all settings, explains Dr Stott. “The World Health Organisation (WHO) approved kits are accurate, cheap, convenient to use, require minimal training and give rapid results This testing is ideal for rural settings, as there is no need for sophisticated equipment. Those who test positive can immediately be educated about safe sex and put on treatment management programmes.”
She notes that the South African Department of Health (DoH) has made great strides in ensuring accessibility of HIV drugs. “The DoH introduced the one tablet per day antiretroviral therapy (ART) medication in South Africa in April 2013, with about 1.2 million people now on this form of treatment.”
Dr Stott says that this was done after research conducted at the Yale University School of Medicine proved that patients who receive their ART as a single pill per day are more adherent to the therapy. “This leads to lower risk of secondary infection and hospitalisation when compared to receiving multiple pills per day.”
The DoH also implemented a new practice where patients with a CD4 cell count (the CD4 T lymphocyte cell count) below 500 should commence with the ART medication. Stott states that this is a major improvement over the previous lower CD4 cell count of 350, as earlier treatment will improve the long-term outcome for all patients.
Dr Stott says one way that South Africa can win the battle over this deadly disease is through continual education about the virus, regular testing, improved accessibility to treatment and improved detection of the virus.
She says professionals who have employees should encourage HIV awareness at the workplace. “A good way to do this is arrange for anonymous and confidential free HIV testing for all staff, thereby showing leadership.”
“Knowledge is power,” says Dr Stott. “By going for regular testing and knowing their status, HIV positive South Africans have been able to better manage their condition and reduce the mortality rate linked to HIV/Aids related illnesses.”
