Hansard: NA: Unrevised hansard

House: National Assembly

Date of Meeting: 01 Dec 2023

Summary

No summary available.

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Minutes

UNREVISED HANSARD 
NATIONAL ASSEMBLY 
FRIDAY, 1 DECEMBER 2023
PROCEEDINGS OF VIRTUAL NATIONAL ASSEMBLY
Watch here: Plenary 

The House met at 10:00

 

The Acting Chairperson Mr Q R Dyantyi took the Chair and requested members to observe a moment of silence for prayer or meditation.

ANNOUNCEMENTS

 

The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): Hon members, before we proceed, I would like to remind you that the virtual plenary is deemed to be in the precinct of Parliament and constitute the meeting of the National Assembly. In addition to the Rules of virtual sitting, the rules of the National Assembly, including the rules of debate apply. Members enjoy the same powers and privileges that apply in a sitting of the National Assembly. Members should equally note that anything said in the virtual platform is deemed to have been said to the House and may be ruled upon.
All members who have locked in shall be considered to be present, are requested to mute their microphones and only unmute when recognised to speak. This is because the mics are very sensitive and will pick up noise which might disturb the attention of other members. When recognised to speak, please unmute your microphone and where connectivity permits, connect your video. Members may make use of icons on the bar at the bottom of their screens which has an option that allows members to put up their hand to raise points of order.

The secretariat will assist in alerting the presiding officer to the members requesting to speak. When using the virtual system, members are edged to retrain or desist from unnecessary points of orders. The First Order and the only item on today’s Order Paper is the debate on World Aids Day; titled Community Response to Overcome the Spread of HIV And the Impact of Aids Interventions. With that said, I now invite and hon Speaker of the National Assembly to lead us in the debate.

 

The SPEAKER
DEBATE ON WORLD AIDS DAY: COMMUNITY RESPONSE TO OVERCOME THE SPREAD OF HIV AND THE IMPACT OF AIDS INTERVENTIONS.

The SPEAKER: Hon Chairperson, hon members of the House ...

 

IsiZulu:

Nk M S KHAWULA: Wamuhle, weSomlomo, ngathi uzalwe namhlanje.

 

English:

The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): Just pause, hon
...

 

IsiZulu:

Nk M S KHAWULA: Ngithi waze wamuhle, Somlomo, ngathi uzalwe namhlanje.

English:
The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): Just pause, hon Speaker. Mam’Khawula, that’s not how we are going to start, and you know what will happen. Please proceed, hon Speaker.

The SPEAKER: Hon Chairperson, hon members of the House, today as we have done since the advent of democracy, our country once again enjoins himself to the global efforts of solidarity
in the fight against HIV and Aids. We also do so within the context of continuing to observe the important period of 16 Days of Activism for No Violence Against Women and Children, which will conclude on the 10 December, the day on which we will also mark International Human Rights Day.

As we mark the 35th World Aids Day, I would like to begin with an emphatic acknowledgement and say that the attention that the world has given to the schedule of HIV and Aids through observation of World Aids Day every year, has done a great deal in turning the tide in the fight against this epidemic.
Through the foresight of the World Health Organisation, this important global campaign has achieved much more than we could have if our focus was only limited to issues of treatment and clinical interventions, although as equally important.
Global awareness campaigns such as the marketing of World Aids Day, have become the most powerful instruments humanity has ever deployed to fight the scourge. It has only been through campaign such as these that we managed to get a real united global response to a common challenge, ensuring that we empower people to make life choices, to avoid growth in infections, the dissemination of proper information, to deter fear mongering and stigmatisation. Most importantly,
solidarity amongst us all so that no one ever feels alone when confronted by the effects of the disease.

The observance of World Aids Day, therefore, also serves as a reminder of what the world can achieve when there’s global solidarity, awareness, and action in addressing any of our common challenges facing the global community today. Hon members, one of the things we need to understand is that we too as Members of Parliament, we are not excluded from being people living with HIV and Aids, whether we share that information or not. And we are not excluded from being accepted within our own families and within the consequences that we represent. So, we should continue to strive in an area of advocacy so that more champions come out to join this campaign of advocacy so that we speak with the mandatory voice, and we can go to our constituencies and never forget that the ravaging sketch of HIV is still alive and well. And we know that HIV and Aids knows no borders and knows no panties as we engage on these matters.

So, the global awareness campaigns such as these ones of today, have become the most powerful instruments humanity has ever deployed to fight the scourge. South Africa has long been at the forefront of the battle against HIV and Aids. As a
country, we have witnessed firsthand, the devastating impact this disease can have on individuals, families and communities. We have however also seen the resilience and determination of our people in fighting back, taking strides to improve awareness, provide treatment and combat the stigmatisation that often accompanies this disease.

Our government’s commitment and leadership in addressing this public health crisis has been evident through various policies and programmes focused on the pandemic. These policies have played a crucial role in the fight against the disease.
Ensuring that the resources are allocated appropriately and that those affected receive the care and support they need.

In recent years, we’ve also witnessed significant successes in our awareness campaigns. Empowering individuals with knowledge and breaking down the barriers of ignorance and fear.
Additionally, our efforts in providing treatment have yielded positive results. Enabling those living with Aids to lead healthier and longer lives. Allowing them to contribute to the growth of our nation. Most importantly, we’ve also seen the increasing success of mother to child treatment interventions, especially before the devastating period of the COVID-19
pandemic, that unfortunately rolled back most of the gains of our public health sector.

We also recognise the significant role played by the SA National Aids Council in our national effort to combat HIV and Aids. Since its establishment in 2000, it has served as a platform for partnership and collaboration amongst various stakeholders including government, civil society, affected communities, experts, and development partners. The council’s primary objective has been to provide leadership co-ordination guidance in implementing our national response to HIV and Aids.

One of the key strengths of science lies in its multi sectoral approach. It brings together representatives from different sectors, including health, education, labour, justice, social development and others to ensure a comprehensive and integrated response to the epidemic. By fostering collaboration across sectors, SANAC enables us to address - not only the health aspects - but also the social and structural determinants that contribute to the spread of HIV and Aids.
I had an opportunity to attend a meeting of the SANAC Parliamentary Forum where this matter was discussed extensively, amongst others. One of the biggest challenges raised by a young man from Malawi was the challenge of young people, particularly young girls, who continue to be bullied into relationships. Where the infected person will not disclose to the young girls his or her status. And this man was saying that if we do not focus on young people, both boys and girls, to continue to engage because sometimes there’s been a lie. It’s been quiet. We’ve been talking about Covid. We’ve been talking about many cases of cancer. Cancer has become one of the greatest killers in the world right now, and we then tend to put aside this matter of HIV and Aids.

We should continue to our constituency officers to engage young people to come forward, to disclose, to engage with them, to encourage them to test and not make assumptions that because I am young, therefore it means I am not positive. I just thought Chairperson, those are the issues I would like to cover before you stop me. Remember, as well that as we discuss all of these matters, we’re talking about challenges of TB. We are talking about challenges of sexually transmitted infections. Therefore, it is important to even talk about those matters, engage about those matters. Don’t keep it close
to ourselves because we die sooner and earlier when you keep what you believe is a huge secret to yourself and not share with those who are around you.

Now here in South Africa, we have been faced with several challenges. And this includes improvements in policy implementation, the capacity of our public health system and ensuring universal access to care and treatment. We need to continue strengthening our healthcare infrastructure, improving the quality of care and expanding services to reach those who are most vulnerable. We should also strengthen current grassroots partnerships in order to improve community test and treat campaigns.

Chairperson, COVID-19 global pandemic strained our healthcare systems and diverted attention resources away from the fight against HIV and Aids. It is essential that we learn from this experience and build a more resilient and inclusive healthcare system that can effectively address multiple public health challenges, simultaneously. I thank you, Chairperson, and I thank you hon members.

The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): Thank you, hon Speaker. You would have benefited from an extra time given the
early disruption. Thank you. I now recognise the hon Deputy Minister.

The DEPUTY MINISTER OF HEALTH (Dr S M Dhlomo): Chairperson, good morning to yourself and to all the leaders who are logged-in, it’s a privilege for me to be in this debate and follow immediately after my leader, the Speaker. Hon Speaker, Mama [Ms] Maphisa-Nqakula, who has actually eloquently presented to us the challenge that we face in the world.

It’s very encouraging to find great leaders who probably do not have a health background but be able to articulate the challenge that we do face the way we do, because it is not about healthcare workers alone, it’s about civic leaders leading in the same way they we could have thousands of quotations of President Nelson Mandela on this problem that we do face here today.

The World Aids Day, which is a very important day in the battle against the scourge of HIV and AIDS, is what we really are talking about today.

The world gathers today to commemorate this day and I urge all of us to make an effort to really be able to say what are the
concerns around the areas where I live and be able to look into the priorities that each day brings a regarding what we can do to forge forward and not forget those who have since passed on due to the scourge of HIV and AIDS.

We meet today for this year’s commemoration of World Aids Day under the theme “Let communities lead”.

When we launched this team on the 8th of November in Bloemfontein, Free State, we were very clear and we were very clear that our people would have to take the lead about their live. We make it clear then that it is them, our people, who must lead in changing their own lives through good health choices and practises.

It is very important to actually be able to embed this theme on ... another very popular noble ... [Inaudible.] ... that says ‘nothing about us, without us’. Which is an overriding mantra of the people living with HIV and AIDS.

We do so knowing fully well that it is only when the affected people lead the charge on these programmes that there is some legitimate progress that we’ll, therefore, make.
We must also remember when we launched the national strategic plan for 2023-28 on the HIV/AIDS and STIs, we deliberately called it the people’s national strategic plan. Why? Simply because it was developed with the communities and they are part of that. It was also widely consulted with members of the communities.

This theme, therefore, calls upon all of us to appreciate the whole of government and the whole of society’s approach on leaving no one behind.

It is a very critical national strategy planned because it is the last one before the 2030 call by the World Health Organisation, WHO, that calls for a youth HIV-free generation.

Now, it means we must really do much more and better faster this time around.

One is actually particularly honoured to say, despite the disruptions of the COVID-19 that we have just come up, the department has made serious strides and progress regarding the attainment of the United Nations’ 95-95-95 programme.
We all know that the first 95 means that all our people that have tested and they have tested positive must or ... must just know their status. Everybody must know their status, whether the HIV negative or positive.

Now, for those who have tested positive, we are on the second

95 that says that 95 of those citizens who know their status and now are positive must be started on the antiretroviral, ARV, therapy.

And the third 95 is that those who are in treatment must then be virally suppressed. So, they must reach a stage of undetectable because we now have this slogan ‘undetectable equals untransmittable’. You use the first part, you and you. The you equals you is actually taken from that undetectable will make citizens to be not able to transmit the virus to the other partner.

The performance of our department on these targets is currently standing at 95-78-92, meaning that the weaknesses are in the attainment of the second 95. Which means that all the efforts that we do do as a country must be directed towards the areas of our weaknesses.
It is here that we need to work with the communities and allow them to come and lead so that we can trace and find where are the people who have tested positive but have not wanting to start the treatment.

The department and the whole of us in the country have conducted a very deep dive analysis to ensure that the real problem with the attainment of the second 95 is actually embedded within our mobilisation strategies. The major weakness is that many people have disengaged from care, citing various problems such as staff attitude, shortage of commodities and the unfavourable working hours in our facilities.

So, we do not want to shy away from this as a department to say, for those criticisms that are coming our way, we need to improve some of them and some of the issues one is going to raise here would be part of that.

The department also conducted a further analysis to see where is the biggest challenge with regard to the second 95. And in that process we were able to identify 100 facilities which are the highest burdened on the number of people that have disengaged from our care.
Further analysis of these 100 facilities is revealed that 76 out of 100 are in the top four big metros in our country: the City of Cape Town, the City of Johannesburg, the City of eThekwini and the city of Ekurhuleni.

We need to allow the communities to lead in the battle against HIV and AIDS because they know too well the reasons that led the people disengaging from the treatment where they live and work. And we as a department must not be denialist in terms of those issues that they raised through our dialogues and, therefore, work towards improving them.

Therefore, to accelerate performance on the second 95, we are working through the established Nerve Centres in all nine provinces and in the 52 districts through Operation Phuthuma Programme.

These Nerve Centres are the troubleshooting teams which design and implement interventions to ensure that there is good progress.

One is happy to report that this intervention has resulted in us increasing the number of people on treatment by 220 000.
This has effectively pushed us from the statistics that they gave you of 95-78-92 to now 95-76 and 92, to 95-79 and 93.

So, while these are small steps we continue to accelerate and celebrate this progress and, therefore, encouraging those who are really doing it to even do more and much better and faster.

So, we are determined, therefore, to reach these milestones before the end of 2024, that we have set for ourselves.

On Monday, just this week, 27 November 2023, we received a further dose of good news from the Human Science Research Council, HSRC. We shared the results of the sixth South African national HIV prevalence incidence, behaviour and communication survey, which highlighted progress towards ending HIV in South Africa, the country that is called the world’s largest HIV epidemic.

The results are as follows: The report show that the percentage of all people living with HIV and AIDS in South Africa are decreasing from 14% in 2017 to 12% in 2022. This translates to 7,8 million people in South Africa in 2022 as
compared to 7,9 in 2017. Of this 7,8 million people, 5,7 million are on our treatment.

The contributing factors on our lifetime saving efforts are this falling one: Fewer people are getting infected with HIV. More children are born, these days, HIV negative. People are ageing now and they are dying from natural causes.

As indicated above, this report showed that South Africa has made significant progress towards the UN AIDS 95-95-95 targets. And that 90% were aware of their status, very improving; 90% of those that were aware were on treatment and 94% of those on the antiretroviral treatment where virally suppressed.

This is among other things attributable to changes in the treatment guidelines in 2016, which make provisions for treatment to be started ... [Sound glitch.] [Inaudible.] ... requiring that process.

I don’t know whether Chairperson wants to keep my attention.

This report further points out in the direction where a lot of work ... Chairperson, should I Continue?
The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): You have time. please go ahead.

The DEPUTY MINISTER OF HEALTH (Mr S Dhlomo): Okay.

 

However, it is worth noting, my Chairperson, that the report shows that the percentage of young men between age 15 and 24 years who were medically circumcised have gone up by 17% from 2017.

An important achievement, as studies have shown that male circumcision can reduce the risk of heterosexual HIV transmission by up to 60%.

SA National AIDS Council, SANAC, CEO, Dr Thembisile Xulu, also made her comments, actually commending the work that the country is doing towards this, as she was looking to the
five-year national strategic plan, going forward.

 

This survey, Chair, also confirms what we have always suspected to be major areas of weakness. The need to put more men on treatment.
It is for this reason that the department has developed ... same but differentiated approaches to various subpopulations regarding young people over 1,8 ... over 1 800 public health facilities have got what we call youth zones, which offer specialised services packages that are designated for young people.

The department has men’s health strategy and has also participated in this recent Men’s Parliament, which was led by our Deputy President on the 19th of November in Vhembe.

These are some of the subpopulation specific interventions that are implemented, to be specific and direct, with such populations.

The above interventions are part of a differentiated service delivery model on differentiated models of care through these differentiated service delivery, we are able to adapt the service delivery model to suit the needs of the users, rather than using one-size-fits-all.

The department also implements the Pre-Exposure Prophylaxis, PrEP, post PrEP, which are the services delivered to the
people at risk of contracting HIV. We have also approached the treatment guidelines.

We have also improved our treatment guidelines for multi-month dispensing, something that we call Central Chronic Medicines Dispensing and Distribution, CCMDD, where a majority of our citizens who are stabilised on treatment, on HIV treatment, TB, diabetes or any other, we allow them to take medication home for three months and be able to actually continue supplementing and dispensing that medication to them in their homes.

We are, therefore, able to say our clinics are less and less congested because we are able to drive and dispense and take medication to our people. Over 6 million South Africans in our country are on that programme.

As we commemorate this day, we must always remember our people who demised before they could enjoy the use of these interventions. Each time we commemorate we must pay homage to the fallen heroes and heroines so that we do everything in remembrance of their spirit.
One would like to say, the Minister of Health edges all of us, lawmakers and policymakers, to help communicate as far and wide the message that the path to good health equals to our individual and collective efforts.

The path, therefore, now, that we talk to and the slogan, I want to leave the debate, is ‘you is equals to you, untransmittable equals undetectable’.

People with HIV who achieve and maintain undetectable viral loads by taking ARVs daily as directed, cannot sexually transmit the virus to others. Hence the slogan of ‘you equals you’.

A person who is living with HIV, diagnosed at the age of 20 years but taking current age of medication, can live right up to almost near lifespan of 70 years.

We want to say ‘you equals you’ has a positive impact in decreasing mother to child transmission. Something I was listening to my hon Speaker talking about.

It is very important, as this theme says ‘Let communities’,

deliver HIV care people.
I must also indicate this Prevention of Mother to Child Transmission, PMTCT. In 2009, 20% of the babies who were delivered in our families were born HIV positive. We looked around and we checked if there were mothers who were not intervening much early.

It is increasingly very interesting now ... let me be ... [Inaudible.] ... record, give this for record. Less than 2% of murders give birth to HIV positive babies to date, from 20% to less than two. This is an intervention of our government. It is an intervention of this ANC-led government.

And just yesterday, here at where we are, at Mandeni, we launched a programme, Chair, a programme that talks to young people who have come to us to say, but I fell pregnant last year because the attitude of your clinic, I was afraid, there’s an aunt who’s working there, there’s lack of privacy, confidentiality is not guaranteed.

Therefore, we launched a programme where we are going to be dispensing, setting family planning devices in the malls, not dispensing tobacco and some of ... the other people are pushing us to go and dispense that, not this time.
We will actually get ... how you do that? You actually phone a for a particular number that we are developing. Once that number has been phoned, a nurse or a healthcare worker will take you through that as a young person and indicate your choice of family planning based on what there’s been discussions telephonically. And thereafter the young person will be given a code, and that code will allow the young person to go and punch in a machine and dispense.

In that way we are going to improve and increase the number of young people to access these devices and also these medications.

In so doing, Chairperson, they will then ... we will decrease in the country teenage pregnancy and the unsafe abortions.

I thank you very much and I can see that the Chairperson is giving me a shout that my time is up.

IsiZulu:

Ngiyabonga kakhulu.

Mrs M O CLARKE: House Chairperson, today we celebrate World Aids Day. It is crucial that we reflect not only on the
progress made, but also on the challenges that persist in the fight against HIV/Aids. As Members of Parliament, it is our responsibility to scrutinise government’s actions, to ensure that good policies are implemented to make a difference and to ensure that the health and well-being of our citizens are prioritised.

South Africa has a long and tumultuous history with HIV/Aids. The scourge of this epidemic has affected millions of lives and around 8,7 million in this country still lives with HIV/Aids and 72 000 children remain infected. Sadly, the stigmatization is still a very real concern for them. Over the years, we have witnessed both commendable efforts and significant shortcomings in the response to this crisis.

South Africa leads the research on HIV/Aids treatment and millions of people today are alive due to the efforts of excellent researchers and caring doctors like professor Abdul Karim and Professor Glenda Gray. Their dedication to researching and treating the stigmatized disease and marginalized group of people shows the calibre of medical professions we are fortunate to have in this country.
In recent years, we have seen somewhat a shift in approach from government with increased awareness and commitment to address the HIV/Aids epidemic. South Africa has made strides in HIV treatment and the availability of antiretroviral, ARVs, drugs has improved, ensuring that those living with HIV can access life-saving medication.

The North Gauteng High Court’s ruling that pharmacists may prescribe and ARVs the programmes like the Pharmacist- Initiated Management of Antiretroviral Therapy, PIMART, are a game-changer to have ensured increased access to ARVs.
However, let us not be blinded by progress alone. South Africa still remains one of the countries with the highest HIV infection rates globally. We acknowledge that some positive steps have been taken, but we must also confront the reality that much work remains to be done. The impact of the covid-19 pandemic has compounded the challenges faced by the healthcare system, further straining resources and diverting attention from long-outstanding health issues, including HIV/Aids.

It is troubling that 23% of HIV-positive people in the country are not receiving treatment, according to the Minister of Health. We must address the persistent issues of stigma and discrimination that hinders progress in HIV prevention and
treatment. Access to health care services, particularly in rural areas, remains a concern and government must do more to ensure that all citizens, regardless of their location or social economic status can access quality health care. We must call for greater transparency in the allocation of resources dedicated to HIV/Aids Programme and a comprehensive review of current policies to identify gaps in efficiencies, ensuring that every rand is utilized effectively to combat this epidemic.

The under expenditure of R62 million during 2022-23 on the national Department of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes is a disgrace, given the persistence of the epidemic and the strikes that still need to be made towards achieving the UNAIDS 95-95-95 Strategy.

So, on this World AIDS Day, let us remember those who have lost their lives. Let us celebrate people like Yvette Raphael, who was diagnosed with HIV in 2000 and is the co-founder and co-director of Advocacy for Prevention of HIV/Aids in South Africa. She is a human rights activist who has spent her life advocating for people living with HIV/Aids, young women, lesbian and gay people and intersex communities. Let us remember Andrew Musani, a social justice and Aids activist who
died on 15 January 2021, at the age of 45. He was an activist who put the voice of marginalised people and communities at the heart of the HIV/Aids response. He was known to many South Africans and internationally for his work. These are just a few to mention. There are many heroes in our country who have been active in the fight against this scourge and have helped so many South Africans. Let us work together towards a future where HIV/Aids is a distant memory and the health and well- being of our people is secured. I thank you, Chairperson.

Dr S S THAMBEKWAYO: Hon Chairperson, on behalf of the Economic Freedom Fighters, I would like to express our deepest condolences to the many South Africans who have died as a result of HIV/Aids over the past year. I would like to pay tribute to those who are living with this virus and who, through their actions, have sought to destigmatize the virus and give strength and hope to the newly infected that they can continue to live their lives and fulfil their dreams by adhering strictly to treatment.

Chairperson, when we made this statement last year, we provided a truncated history of the struggles this country went through against both the spread and the stigma associated with the virus. We argued then, as we do now, that perhaps
more than any other, this country has been left battered by HIV and the syndrome. All of us here have lost parents, siblings, relatives and friends to this deadly disease.
Thousands of young people have been left to fend for themselves as parents have been wiped out by the disease. This has created a generation of parentless young people. The social and economic costs of this are just too immense to even imagine.

We would like to pay tribute to the thousands of activists who put their lives on the line advocating for the access to HIV/Aids treatment. We remember those who at the height of HIV/Aids denialism government’s inaction and pure incompetence stood shoulder to shoulder with those whose lives were destroyed by the virus. It is these activists who gave hope to many activists and families, and it is through the work they did that the government was forced to make treatment available to the people.

Today, antiretroviral treatment is available to all HIV- infected people, prolonging life and enabling HIV-positive people to lead normal lives, regardless of the availability of treatment. In recent years, we have seen a dramatic increase in HIV/Aids-related deaths in this country. This is a direct
result of the collapse of socio-economic conditions in the country. Antiretroviral drugs require people to eat.
Therefore, food security and proper nutrition are important complementary factors in saving the lives of people living with HIV. The failure of the economy to create jobs is fatal in this regard. This is because it deprives people of a fundamental factor in coping with the disease.

The most affected provinces, such as KwaZulu-Natal, KZN, Eastern Cape, Limpopo, for example, also have the highest levels of unemployment. Apart from this, the government has taken their foot off the pedal in terms of HIV-Aids advocacy. And this is making us to lose the momentum against the disease gained in the past. Condom usage is no longer preached about as much, nor is abstinence amongst young people. The growth of socially destructive phenomenon such as [mavuso] which entails older men preying on younger girls, contributes largely to the spiralling out of the new infections.

The fact that there is an increase in infections also means that a large number of people are not taking their treatment or are defaulting. We know that those who regularly take treatment cannot transmit HIV. The fight against HIV/Aids will
not be won until the country tackles social and economic inequalities.

It is not to be won if we do not resolve the stubborn problem of crimes. Not less than 40 000 women are raped in this country every single year. There is no ... [Inaudible.] ... saying that some of these women without early treatment would also get infected with the virus. We must deal with the crime and resolve our economic problems. We must continue preaching about the importance of consistent condom use, the need to be faithful to one sexual partner, and the importance of testing so that people know their status.

As we head into the holidays, we encourage all young people in this country to take care of themselves and refrain from social behaviour that could endanger their lives. May the souls of those who have passed on find eternal peace. May those living with HIV find hope and strength. And may we all do our part to rid our society of this deadly disease. I thank you, Chair.

Ms Z MAJOZI: Chairperson, it is Majozi. I am standing in for hon Hlengwa. Can I keep my video off? I have load shedding. I tried opening it up and I can see that I am losing connection.
As we all know, South Africa remains the epicentre of the HIV and Aids pandemic. However, recent data has shown that our country is making significant strides in curbing the spread. The six South African National HIV Prevalence, Incidence and Behaviour Survey has indicated about 7,8 million people were living with HIV in South Africa in 2022, compared to
7,9 million in 2017.

However, stigma continues to force many people living with HIV to feel shame about their status. It can make someone more likely to face discrimination, less likely to adhere to their medication, and can significantly worsen mental health.
Therefore, education on HIV and Aids remains a key factor in fighting against the attached stigma. I am not only referring to formalised forms of education, such as teaching children in schools through subjects such as Life Orientation, but also going out into communities and educating those who might not have access to this crucial information.

In our country, we are fortunate to have many amazing civil society organisations, doing their part to fight against the spread of HIV and Aids and the subsequent stigma. And it is these very organisations that the government needs to
capacitate, especially considering the R1 billion reduction in HIV and Aids funding made to the national budget.

HIV and Aids is a treatable disease, much like any other chronic condition. However, this is only possible if people know their status. Therefore, we call upon the government to increase the distribution of self-testing HIV and Aids kits, especially to communities situated in rural areas, where it is often difficult to reach essential health services or where clinics are consistently understaffed. Through community-based civil society organisation, we can empower communities to not only break the stigma of HIV and Aids, but also to provide them with the much-needed resources to know their status and get the help and medication they need.

Therefore, there needs to be a greater intent on the part of the government and all political parties to work closely with these organisations, as we have come to learn over the years that hard medical battles are best fought and won as a collective. Thank you.

Mrs H DENNER: Hon Chair, ending Aids is an opportunity for a uniquely powerful legacy for today’s leaders. They have the chance to be remembered by future generations as those who
ensured policies, programmes and investments that put a stop to the world’s deadliest pandemic. They can save millions of lives and protect our health. They can show what leadership can do. However, none of this will come automatically.

During the year 2022, Aides claimed a life every minute. Millions of people worldwide still miss out on treatment, including 43% of children living with HIV, this, according to Winnie Byanyima, Executive Director of the United Nations programme on HIV and Aids, or UNAids. In South Africa, nearly
8 million people are living with HIV. Though it’s notable that the rate of infection has declined somewhat over the years, there are still very worrisome red flags.

During 2022, there were 164 000 new HIV infections in the country, compared to three times more than that in 1999 at
538 000. Very worrying, though, is the rate of infection and evidence of HIV and Aids among women aged 25 to 49, at 31%. The UNAids set the 95-95-95 target for countries in the global fight against the largest, most deadly pandemic in modern history. South Africa’s score on these targets is 94,5; 77,4 and 91,5. This means that by 2022, according to the available data, 94,5% of people living with HIV have been diagnosed. Of
those, 77,4 is receiving treatment, and of those 91,5% have viral suppression.

Sadly, this somewhat good news ends there, because as of 2022, South Africa is third on the list of highest incidence rates of HIV infections worldwide, with 3,15 newly infected persons per 1 000 inhabitants of the country. The most alarming HIV infection rates are among KwaZulu-Natal youth aged 15 to 24, with approximately 1 300 youths in KwaZulu-Natal contracting the virus every week, as was confirmed during the 11th South African Aids conference that took place in Durban earlier this year.

So, sadly, it seems that we are actually not winning the fight, because for every step we take forward, we are forced to take two steps back. We are forced by one of the poorest healthcare systems in the world. We are forced by poor economic circumstances and one of the highest unemployment rates in the world. We are forced by a pandemic of poverty that leads to other social ills like alcohol and drug abuse, prostitution and crime. And We are forced by one of the poorest education systems in the world that leads to youth unemployment and all the social ills that I have just mentioned.
All these factors create the perfect environment for a pandemic like Aids to spread like wildfire and the ANC government is sadly directly to blame for this. You have broken the economy, the education system, the healthcare system, and have plunged our society into poverty and desperation. You are undoing all the good work that has been done towards ending this pandemic.

The FF Plus recently published and submitted to the Human Rights Commission, a comprehensive report on the horrors of state hospitals, under the ANC government. These horrors constitute crimes against humanity, and we will not stop until the ANC is removed from government, when they can no longer enable the spread of pandemics and kill South Africans, through their fraud, corruption, incompetence and self-serving tendencies.

We would like to thank and commend all those individuals who actually contribute to the fight against HIV and Aids, despite seemingly unsurmountable circumstances. The success in this fight is theirs, not the ANC government’s. I thank you.

Ms M E SUKERS: Hon Chair, around the globe today, the world commemorates World Aids Day, a disease that changed our world
and the way we speak about sex and sexuality. Rather than hiding away from it, it forced openness about the most intimate parts of our lives. The fight against HIV Aids is a battle that introduced holistic approaches to fighting disease and particularly in our country, the grassroots campaigns contributed greatly to change mindsets and fight the stigma of a disease that used to be seen as a death sentence.

The interventions advances and breakthroughs in treatment are because of those committed and excellent clinicians, scientists, caregivers, who made it their mission to battle this disease and improve outcomes for those affected. It cannot be stressed enough that more needs to be done by this government, and each and every one of us here in this House, to better our country’s circumstances and to position it to win the battle against HIV and Aids.

This government fails on many accounts, when it comes to servicing our communities in poor and rural areas across all nine provinces. Those living with HIV and Aids in these communities face challenges that makes every day an uphill battle. Restricted access to medical attention and shortages of medication, lack of basic services, such as clean drinking water and ablution facilities are just some of the things that
add to the mountain that we must climb in order to foster a realistic community response to overcome the spread of HIV and to implement sustainable interventions.

It is our view that some of the educational content that is found in our schools are not suitable for the consumption of very young children and it is the ACDP’s opinion that this fuels the spread of HIV and Aids, rather than works towards curbing it.

We have to do better as a nation and encourage our children, especially the youth, to abstain from sexual activity and to focus on their schooling and studies. It is the ACDP’s plea today that this government cares more for its people, does more for its people and implement policies that are practical, and not self-serving that will drive South Africa to enable all its communities to respond in unison to overcome HIV and Aids. I thank you.

Ms T Z MAKATA: House Chair, hon members, human immunodeficiency virus, HIV, acquired immunodeficiency syndrome, Aids, remains one of the major public health issues which threatens the lives of our people and the development of our society.
According to the World Health Organization, globally,
39 million people were living with HIV in 2022. It was also noted that African regions are more severely affected by the HIV with about 3,2% of adults living with HIV and accounting for more than 2/3 of the people living with the HIV in the world.

However, although HIV and discriminatory affects anyone, regardless of socioeconomic status, research has found that women and girls are disproportionately affected. Globally, in 2022, they were 20 million women and girls living with HIV over the age of 15. Which is higher compared to the
17,4 million men living with HIV.

 

In South Africa, 4,800,000 women were living with HIV, compared to the 2,600,000 men aged 15 and older living with HIV. This disproportionality is informed by numerous factors, such as gender-based violence, poverty, harmful gender norms and sexual abuse, which heighten the susceptibility of women and girls.

These vulnerabilities are not only dangerous to the well-being of women and the girls, but immensely hinder the purpose of
our collective interventions to prevent and manage HIV worldwide.

In combating HIV, acquired immunodeficiency syndrome, United Nations, UN, also noted the gap stated by the limited attention focused on by boy child. This is because their attitudes and behaviours of men play a pivotal role in the transfer bearing, on the high infection rate and vulnerability of women and girls.

Some of the notable reasons for this are the following:

 

Men are less likely than women to use health services. Men are less likely to take an HIV test, for example, in 2016, estimated 45% of men tested for HIV, compared to the 59% of women. And this means they are less likely to know whether they are HIV positive. As a result, fewer South African men living with HIV, start and remain on HIV treatment. And men are more likely to die of AIDS related causes.

Younger women in South Africa bear a disproportionally high burden of high infections, largely as a result of sexual relations with older men. As young women mature, HIV infection
spreads to their male peers, when these men have sex with younger women, the cyclic is repeated.

Therefore, because of the interconnection of the cycle of HIV with the behaviour patterns and actions of men, we must devise strategies and strengthen global efforts to educate and support men to unlearn negative practices and courage informed the life cycle, lifestyle, and sexual decision, as well as improved access to health and social service.

Young people are also a vulnerable group, which is very susceptible to infections due to multitude of reasons; ranging from alcohol abuse, transactional sex, and drug abuse. Study shows that of the 410,000 young people aged 10 to 24 years, who contracted HIV for the first time in 2020, 150 000 were teenagers between the ages of 10 to 19.

Furthermore, it is noted that about 25% of adolescent females, and 79% of adolescent boys between the age of 15 to 19 in eastern and southern Africa are the most affected by HIV.

The ANC-led government has noted the need to have tailored interventions which resonate with young people for interventions to be more impactful. This is why our government
decided to establish the adolescent and youth friendly services.

Through the 1845 established youth zones in public healthcare facilities, our government can address challenges which deter young people from seeking help and increase the uptake of health services, which has tremendous impact towards South Africa, achieving the unit 95-95-95 target, which aspires to have 95% of the people are living with HIV, knowing their HIV status, 95% of the people who know that they are living with the HIV being on a lifesaving antiretroviral treatment, and 95% of the people who are on treatment being virally suppressed by the year 2030.

Furthermore, through the youth zones, our government can reach young people to do the following; to increase awareness about HIV and encourage testing and adherence to treatment, provide comprehensive healthcare, include primary health care and mental health services, provide sexual education as well as sexual abuse and gender based-violence support, promote access to health and other services.

Hon members, our efforts are against HIV, should also be directed to other vulnerable groups in our society, such as
sex workers. Sex workers are especially at high risk of conducting HIV, due to sexual nature their work, stigma, discrimination, limited access to safe sex education, sexual abuse and constrained access to comprehensive health care services when they need them.

The lack of community support and the harsh treatments they receive at public health facilities are also noted to be reasons why sex workers are detected from accessing healthcare. This then hinders the prospects of testing and treatment for HIV and increases the odds of HIV transmission and sexually transmitted diseases.

Therefore, it is essential that HIV interventions are inclusive and adequately address the unique challenges faced by sex workers. We have to strengthen efforts to reduce barriers to access for all vulnerable groups and create a safe and supportive environment for all without fear of judgement or ... [Inaudible.] ... repercussions, if we are to make a headway in the fight against HIV.

Despite these challenges, our government has made progress in the fight against HIV, noting that of the eight million people living with HIV, about 5,7 million of them are on treatment.
And of those on treatment and tested for viral load suppression, about 92% were virally suppressed as of November 2022.

Furthermore, the National Strategic Plan for HIV, tuberculosis, TB, and sexually transmitted disease, STI, in 2023-2028, noted that the new HIV infections have been declining and continues to do so.

Hon members, although there is a progress, HIV has been persistently undermining our collective global efforts. We must not be deterred but rather affirm the fact that our aspirations, of a HIV free society, are attainable. The onus is on each and every one of us to play a role in creating an informed and tolerant society, to support and reinforce efforts to eliminate HIV/Aids.

Furthermore, we cannot win the war against HIV without simultaneously addressing the socioeconomic challenges which lay a breeding ground for HIV to continue plaguing our communities; such as inequality, poverty, gender-based violence and the lack of comprehensive sex education.
By addressing these social determinants, we will be able to reduce the vulnerability of our people and eliminate HIV and Aids. I thank you very much, House Chair.

Mr B N HERRON: House Chair, access to immunodeficiency virus, HIV, treatment in South Africa reveals a complex landscape, shaped by affordability concerns, ethical dilemmas, legal challenges and servicing economic factors.

Continued efforts from government, civil society and the international community are essential to addressing these challenges and ultimately eradicating HIV/ acquired immunodeficiency syndrome, Aids, in South Africa.

Civil society engagement and community involvement are of paramount, empowering advocacy groups and nongovernmental organizations, NGOs, can amplify the voices of those affected. And sharing their perspective shapes both programs and policies.

It is only by actively endorsing and listening to those who are combating this disease that we may have any chance of eliminating HIV/Aids. One of the key roles in community engagement on HIV/Aids is destroying the stigmas that surround
it. Societal values and social stigma attached to the virus makes it harder for those affected to seek treatments as well as to stop the spread.

This change can only occur through education and a concerted public awareness campaign, with adequate funding. While the recent negative infection news is positive, only actions to education can eliminate this ... [Inaudible.] ... at its source.

Stigma solutions are numerous, but they are also solvable. One of the easiest and most reliable ways to solve this problem is investing in a functional telecommunication service or hotline that allows anonymity. With modern era, access to the internet or telecommunication, these channels could become a primary means of communication.

The ability for our citizens to receive advice, trust, and anonymity, all while avoiding the hurdles of transport or their perceived public embarrassment, would make digital services crucial in the battle within our communities.

Legal and policy changes are evident or required as well. The first example can be seen in the enforcement of South Africa’s
comprehensive sexuality education policy. This policy is not implemented or policed and due to this, many school-governing bodies, principals, and religious leaders refused to act on it.

Secondly, the national strategic plan on gender-based violence and femicide will never be fully implemented or truly successful unless sex work is fully decriminalized by adopting the long overdue Criminal Law Amendment Bill of 2022.

In summary, a multifaceted approach encompassing legal reforms, increasing funding, community engagement, healthcare professional training, and technological innovation informed by evidence from collaborative research efforts, is crucial for ensuring ethical and legal access to HIV treatment in South Africa. Thank you, House Chairperson.

Mrs M B HICKLIN: House Chair, every year on the 1st of December, people across the world come together to pay homage to the multitude of people who have succumbed to the greatest preventable health epidemic the world has ever known - Aids. We honour lives lost and celebrate the medical advances that enable us to continue living with this manageable chronic illness due to the dedication and commitment of millions of
people on whose shoulders we stand in gratitude. It’s a lot like politics. We stand here to honour fallen heroes, people who have shaped our lives by their courageous actions, many of which happened years, if not decades, before some of the people in this House were born. People like the current President and CEO of the SA Medical Research Council, Professor Glenda Gray, the late Doctor Ruben Sher, former director of the SA National Aids Training and Outreach Programme, the late Dr Dennis Sifris, Dr Steven Miller, Dr Clive Evian, Dr James McIntyre, Dr Ashraf Grimrod and Dr Dave Johnson, to mention just a few. All of these incredible human beings treated HIV and Aids patients when no one else would; and when there was no other real treatment option available.

I stand here today as a proud South African pioneer who wrote the very first Aids awareness brochures in this country in 1984. I am proud of my activism and of my commitment as a member of the then Progressive Party - the precursor to the DA. We fought for the right of people suffering from the gay- related immune deficiency syndrome, the gay plague, as Aids was referred to as we helped to educate people on how to protect themselves against catching a preventable but life- threatening disease. You see, House Chair, even in 1984, every life mattered to the DA because we care. Unlike the ANC, who
pays lip service to caring, we cared about enabling all people to access appropriate health care even when it was almost impossible under the National Party government. The same National Party that didn’t join the DA after the 1994 elections but were absorbed into the ANC.

Back in the 1980s and 1990s, education was key, as was the provision and access to azidothymidine, AZT - the only antiretroviral, ARV, drug on the market that tried to treat the disease. In 1995, the ANC’s s Quarraisha Abdool Karim was tasked with putting into action a national aids convection plan, but she didn’t get the support she required. It was just a tick box exercise. A decade later, the almost mind-numbing statistics revealed the depths of the failure.

By 2003, an estimated 40 million men, women and children were infected with HIV worldwide. In 2004, 4,9 million people acquired HIV in one year alone. United Nations, UN, Aids reported that South Africa had the highest number of people living with HIV in the world. Human immunodeficiency virus prevalence in pregnant women rose from 4% in 1992 to 39% in 2002. KwaZulu-Natal was the worst affected province. In 2004, over 300 000 South Africans died from Aids. The death rate for women rose from 28% in 1998 to 48% in 2004. All of this took
place under an uncaring, selfish, unsympathetic ANC government.

Between 1990 and 2008, Thabo Mbeki was the ANC President and Aids denialism reached its peak. He criticised the scientific consensus that Aids was caused by HIV. He proceeded to deny patients access to ARVs, and withdrew support from clinics that had started using AZT to prevent mother-to-child transmission. Azidothymidine, AZT, was extremely expensive and now this option to access life-saving medication was removed by the ANC government in state-owned hospitals and clinics.

In addition, the use of nevirapine, known to reduce HIV transmission to babies during labour was restricted to only two pilot sites, despite the drugs being donated. The drugs were simply not made available - access denied by the ANC. International pressure forced an implementation programme for the prevention of mother-to-child, PMTCT, during labour and by 2005 nevirapine had reduced PMTCT significantly in South Africa.

House Chair, 35 000 HIV-infected babies’ lives would have been different if the ANC had only cared enough. Instead of providing support to appropriate intervention and ARVs, Mbeki
appointed “Dr Beetroot” as his Minister of Health. Manto Tshabalala-Msimang earned her nickname when she promoted garlic, beetroot, potato and lemon juice as herbal treatments to treat Aids, saying ARVs were harmful and poisonous. This appointment has the blood of thousands of Aids victims as its legacy.

For eight years, the ANC endorsed the Mbeki’s government’s decision to label science as unscientific, dangerous and ineffective. In 2003, Thabo Mbeki claimed he had never met anyone with HIV and Aids. And only last year, in his capacity as Chancellor of Unisa, continued his Aids denialism. How insulting! How demeaning, and how degrading to the 7,5 million people currently living with HIV and the 5,5 million people taking life-saving ARVs in South Africa every day.

But 2024 is just around the corner and the ANC will see just how your arrogance, selfishness and lack of caring will cost you. [Time expired.]

Ms A S HLONGO: Thank you very much, hon Chairperson, I think hon Hicklin must love the ANC that even on an important day like this, on a debate of World Aids Day, her debate focused mostly on the African National Congress. Hon Chairperson, in
response to the HIV/Aids epidemic, our government has developed several strategies to curb the virus, such as the National Strategic Plan for HIV, TB and STI. Our country is also part of numerous global and continental commitment made to end HIV and Aids. These partnerships are essential for us because South Africa has one of the highest HIV infection rates in the world. Therefore, it is imperative to establish partnerships to exchange experiences, resources, and strategies in order to develop more effective interventions for HIV and Aids prevention, treatment and care. As the ANC- led government, we appreciate that the HIV and Aids epidemic is a global health challenge which can only be overcome through jointly, co-ordinated responses, which include research, standardised treatment protocols and sharing best practices.

As the African continent, we bear many lessons from the COVID-
19 pandemic and note the significance of unity and strengthening the African voice and global platforms in advocating for fair access to medical medicines and gaining the support for the international community. It is only through our unity that we will be able to manage the epidemic more effectively in the continent and establish more resilient healthcare systems that can withstand future public health
challenges and help us attain Agenda 2063. Through these local and global collaboration, South Africa is equipped with the necessary skills, knowledge and resources which have proven to have a positive impact on reducing the prevalence of HIV and Aids in our communities.

Hon House Chairperson, the battle against HIV and Aids is a collective effort that necessitates co-ordinated action from all sectors of society, locally and abroad. However, at the centre of all our government interventions have been partnerships with stakeholders and collaboration with communities. Communities play a pivotal role in combating the spread of HIV, serving as the bedrock of prevention efforts, treatment, and inherence and social support for those affected by the virus. In our community, social institutions such as families and educational institutions have an important role to play in the fight against HIV, with each having a unique contribution to offer to support and reinforce efforts to prevent and manage HIV. For an example, the family is one of the primary units of socialisation which informs one’s values, beliefs, and attitudes. Therefore, families play an important role in providing a supporting environment for people living with HIV through encouraging treatment, inherence, as well as assisting dispelling myths and stigma associated with HIV
through open and honest dialogue. Thus, fosters a space of acceptance and understanding.

The family also has a role to play in promoting sex practices, encouraging responsible lifestyles, and promoting HIV testing. In turn, this will assist early diagnosis and treatment. Hon House Chairperson, our education institutions, which include basic schooling and institutions of higher learning, are also primary units of socialisation. They are also responsible for grooming the minds of our learners and students to positively inform their attitudes and behaviours. Our education institutions must assist us in raising HIV awareness by disseminating accurate information through comprehensive sexuality education around the issues of safe sex practices and contraceptives, which are meant to empower young minds with the knowledge they need to navigate life making wise and informed decisions about their lives and health.

Furthermore, these institutions are responsible for ensuring that their curriculum assists in challenging the misconception and negative beliefs about HIV and Aids, which goes a long way in reinforcing efforts to reduce the stigma and discrimination against people living with HIV. Hon House Chairperson, community leaders such as chiefs and pastors have an important
role to play given their high positions in our communities. This is because these figures are deeply respected and trusted by our community members, and thus can play a transformative role in dispelling myths and misconducts about HIV transmission, prevention and treatment. This can have a domino effect on breaking down barriers of silence and fear.
Furthermore, their influence can assist in spreading accurate information about the virus, its mode of transmission and the effectiveness of modern treatment option.

Hon House Chairperson, as the ANC, we are encouraged and applaud our government for the strides taken towards collaborating with community leaders and other key figures who’d influence the health decisions of our people, such as traditional healers. Such collaborations efforts are crucial because figures such as traditional healers have trusted positions within our communities, making them effective communicators and educators.

They also have a deep understanding of local cultures and practices which can be valuable in promoting HIV prevention and treatment. In this regard, we call for strengthened collaboration between traditional healers and medical practitioners, which can create a more comprehensive and
culturally sensitive approach to HIV prevention, treatment, and care, for an example traditional leader or traditional healers can play a key role in courage and community members to get tested for HIV and link them to medical care, if they test positive. Furthermore, through such collaborations lies the potential for the development of new HIV prevention strategies as traditional healers have a wealth of knowledge about medical plants and traditional practices that may have anti-HIV properties. By working together with medical practitioners, traditional healers can help to scientifically evaluate these traditional remedies and develop new HIV strategic preventions that are both effective and culturally accepted.

Hon House Chairperson, there is a clear message coming out from today’s and previous engagements on HIV and it’s that it is possible to achieve an HIV free society and that it requires collective efforts. As Africans, we must always remember our roots, by embracing the spirit of Ubuntu, which has a profound impact on combating the spread of HIV. Ubuntu reminds us that we do not exist in isolation, but rather belong to communities where our well-being is intertwined with those whom we share space with. It reminds us that...
IsiZulu:
...Umuntu, umuntu ngabantu.

 

English:

Meaning that I am because we are. Leveraging the spirit of Ubuntu, fosters collective responsibility and emphasising the significance of community involvement in HIV prevention and management. It underscores the importance of social support and collective care for those affected by HIV.

Hon House Chair, as we close this debate, let us take a moment and appreciate and applaud the many South Africans who have stood up and decided to champion HIV, by taking care of the sick, fostering children who have lost parents to the virus, as well as making strides to create a more just and tolerant society for people living with HIV.

IsiZulu:

Siyabonga.

English:
We call upon all communities to join hands and stand united in the fight against the epidemic. All interventions hon House Chair against HIV and Aids require robust community
involvement to support government strategies. We will only defeat this virus through shared leadership, shared responsibility, and shared accountabilities. Thank you very much.

The ACTING HOUSE CHAIRPERSON (Mr Q R Dyantyi): Thank you, hon Hlongo. That concludes the debate and the business of the day. The House is adjourned. Thank you.

Debate concluded.

The House adjourned at 11:18.

 

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