Johannesburg - Despite having made great strides against the HIV/Aids pandemic, South Africa recorded 200 000 infections and 72 000 deaths last year.
This is according to a new report authored by Matthew Kavanagh in his 2020 Global HIV Policy Report. It was released on World Aids Day, December 1. Kavanagh, PhD, works at the intersection of global health, politics and law at Georgetown University in Washington.
A political scientist by training, with a long history of work in global health policy and politics, his research and writing focuses on the political economy of health policy in low- and middle-income countries and the political impact of human and constitutional rights on population health.
According to the Joint UN Programme on HIV/Aids (UNAids), South Africa has the biggest HIV epidemic in the world, with 7.7 million people living with HIV. HIV prevalence among the general population is high, at 20.4%. Prevalence is even higher among men who have sex with men, transgender women and sex workers People who inject drugs count for about 10% of all Aids- deaths in the world.
Kavanagh said that while South Africa leds the world in the adoption of key policies to fight HIV, it had failed to adopt key policies that would improve access to HIV services for vulnerable populations and speed up progress in the fight against Aids.
“While the rate of new HIV infections in South Africa has fallen by 36% in the last five years – more than any other country in the region – South Africa still has the highest number of people living with HIV in the world. Only 70% of people living with HIV in South Africa are on lifesaving treatment, falling short of the international target of 90%,” he said.
The report shows that South Africa’s policies do not allow those on HIV treatment to receive six- month supplies of medication, which is especially important during Covid-19.
Kavanagh said that even though harm-reduction programmes were included in the national policy and service packages for people who inject drugs, personal drug use was criminalised.
This is particularly notable because more than 20% of new HIV infections in South Africa last year were among people who inject drugs.
“There are still too many new infections and Aids deaths. South Africa can halt its Aids pandemic but it needs to act even more aggressively, especially to improve the quality of HIV services. Progress is still not fast enough and far too many people are not being retained in care, because of challenges in the quality of public health services.”
Kavanagh’s research shows that South Africa aligned more policies with international standards than any country in the world, yet it has not fully adopted the policies recommended by the World Health Organization and UNAids.
Sex work is criminalised, which undermines the HIV response, and South Africa's patent laws do not take advantage of all the flexibilities in international law that could make medicines more affordable.
Kavanagh said the battle against HIV/Aids would be won only when citizens across the world held their governments accountable.
Kavanagh is assistant professor of Global Health, visiting professor of law, and directs the Global Health Policy & Politics Initiative at the O’Neill Institute for National and Global Health Law.
He has done research and policy work in South Africa, Malawi, Haiti, Lesotho, India, and Thailand and was a visiting researcher at the South African Institute for Advanced Constitutional, Public, Human Rights, and International Law in Johannesburg. Grants for this work have come from the National Science Foundation, US State Department, World Health Organization, amfAR:and the Foundation for Aids research, among others.
Kavanagh is a member of the UNAids Scientific & Technical Advisory Committee and the council of the American Political Science Association Health Politics and Policy Section. Prior to his academic positions, he led transnational policy efforts at NGOs in the US.