Responding to HIV and AIDS at all levels
Title: Multi-sector HIV prevention programme (MHIVP)
Commissioned by: German Federal Ministry for Economic Cooperation and Development (BMZ)
Country: South Africa
Lead executing agency: National Department of Health (NDoH)
Overall term: 2011 to 2021
South Africa is the country with the most widespread HIV epidemic in the world. In all, some 6.4 million people are living with HIV (2012). Each year about 470,000 people are newly infected with the virus, and 200,000 people die of AIDS-related diseases. 70 per cent of the roughly 500,000 people falling sick with tuberculosis each year are also HIV-positive. This situation is being exacerbated by the development of tuberculosis strains resistant to treatment.
The main reasons for the HIV epidemic are frequent changes of sexual partner and a low use of condoms, as well as low rates of male circumcision. Sexual violence, alcohol and drug abuse increase the risk of transmission. Social inequalities, especially gender-based disparities, coupled with stigma and discrimination are additional factors in the spread of the disease.
The social causes and consequences of the epidemic are among the biggest obstacles to social and economic development in South Africa. The South African Government has established AIDS councils at national, provincial and local levels. These are intended to kick-start and sustain the urgently needed exchange of information between all state, civil society and private-sector actors involved in the response to HIV and AIDS. The councils will also help coordinate intervention measures more effectively.
There is still a need, however, for a coherent implementation plan for the national AIDS strategy, one that is properly coordinated and answers the existing needs. At the same time, education measures have yet to achieve the desired behavioural changes, and they have not been systematically tied to medical and social services.
In the provinces of Eastern Cape and Mpumalanga, young people and employees have altered their behaviour and expose themselves to fewer risks.
The programme strengthens the competence and effectiveness of governmental and non-governmental partner organisations engaged in prevention measures. It also directly supports programmes of youth outreach and health promotion in the workplace. Through its cooperation with KfW development bank, especially in the youth sector, it is reinforcing innovative communication approaches to encourage risk-mitigating behavioural change.
The programme is assisting the South African National AIDS Council (SANAC) and the provincial and district AIDS councils in establishing results-based management and an effective coordination structure. It is expanding the availability of effective prevention measures and youth-friendly health services for young people. In this respect it works, for example, with loveLife, South Africa’s leading non-governmental organisation for HIV prevention and youth development. The programme supports the NGO with its results-based monitoring and evaluation, and with quality management for its youth health activities.
The Eastern Cape Department of Health receives support in making its health services more youth-friendly. To this end, the programme has commissioned Health Focus (Berlin) and Enhancing Care Foundation (Durban), who jointly provide advisory services.
Through workplace programmes with HIV prevention measures, the programme reaches out to thousands of employees in the automotive industry in Nelson Mandela Bay as well as citrus farm workers in the Sarah Baartman District. This is achieved by health teams deployed by the partner organisation Automotive Industry Development Centre Eastern Cape (AIDC EC), which works closely with the Nelson Mandela Bay Chamber of Commerce. Alongside this, the Human Sciences Research Council (HSRC) is working to document success factors in HIV prevention in the world of work in South Africa.
- Functional institutions. The National AIDS Council and the provincial AIDS councils are establishing effective structures. They now have the basic tools forstrategic planning,development of operational plans, and monitoring and evaluation instruments instrumental in effective coordination,.
- Improved HIV prevention measures. The NGO loveLife offers comprehensive HIV prevention services for young people. The quality of the counselling services through its call centres has improved substantially. Over 90 per cent of callers expressed satisfaction with the counselling offered..
- Successful outreach to students. Eight higher education campus radio stations in the provinces of Eastern Cape and Mpumalanga regularly report on HIV issues and reach about 40,000 students.
- Civil society involvement. Section 27, an NGO supported by the programme, and the weekly newspaper Mail & Guardian regularly comment on the state of implementation of the national strategy, highlighting any shortcomings. The relevant ministries and organisations respond accordingly.
- More HIV testing. Since its inception in 2009, the AIDC EC wellness programme has reached close to 10,000 employees in the automotive and agriculture sectors in the Eastern Cape. Through its culturally sensitive approaches, it has increased the uptake of HIV counselling and testing among its clients to 85 per cent and 70 per cent respectively, in the automotive and agriculture sectors.