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South Africa's National Strategic Plan on HIV, TB and STI's 2017-2022

South Africa's National Strategic Plan on HIV, TB and STI's 2017-2022
Publication date: 
Mar 2017

The South African National Strategic Plan on HIV, TB and STIs 2017 - 2022 (NSP) serves as a roadmap for the next stage of our journey towards a future where these three diseases are no longer public health problems. This plan sets out the destinations – or goals – of our shared journey and establishes landmarks in the form of specific measurable objectives.

The purpose of the NSP is to enable the many thousands of organisations and individuals who drive the response to HIV, TB and STIs to act as a concerted force, moving in the same direction.

This NSP aims to achieve its ambitious targets by:

  • Intensifying the focus on geographic areas and populations most severely affected by the epidemics.
  • Using a combination of interventions that have proved to deliver high impact.
  • Strengthening systems and initiating processes to provide the foundation necessary for higher performance.

A strong focus of this NSP is improving the prevention of HIV infection among adolescent girls and young women because of the extremely high rate of infection in this section of the population. Not only does early infection irreversibly shape the lives of hundreds of thousands of women from their teens and early 20s onward, but reaching our national targets for reducing HIV is unthinkable without putting young women first.

Five-year NSPs for HIV, TB and STIs are an established tool for directing and coordinating our national effort and ensuring our interventions are relevant, based on evidence and guided by methods that have been shown to be effective. However, this particular NSP comes at a critical stage in our protracted effort to overcome HIV, TB and STIs.

We have made major gains in terms of treating millions of people living with HIV and TB, slashing the death toll due to these infections, and reducing the number of new infections. For example:

  • Deaths due toHIV dropped from 681 434 in 2006 to an estimated 150 375 in 2016.
  • Deaths due to TB dropped from 69 916 in 2009 to 37 878 in 2015.
  • The number of new HIV andTB infections hasfallen and a higher proportion of people living with these infections has been diagnosed and treated. 

This progress tells us that we are on the right track and success is possible. But we still face enormous challenges.

  • In 2016, an estimated 270 000 people became newly infected with HIV and the 2015 estimate of new TB cases was 450 000.
  • We have 3.7 million people on antiretroviral treatment (ART) for HIV but we are only reaching 53% of those who eligible for treatment under the new Test and Treat policy.
  • The number of deaths due to HIV and TB is still massive and underscores the gravity of the epidemics.
  • Public health facilities treated about 1.14 million new symptomatic STIs in 2015/16.

In a sobering statement in July 2016, UNAIDS warned that the reduction of new infections had stalled globally and, if efforts were not redoubled, the HIV community around the world could see a reversal of earlier successes.

This warning resonated as SANAC embarked on extensive consultations to develop the NSP, involving government at all levels, a range of civil society sectors, development partners, and private sector organisations. All were keenly aware that South Africa is at a tipping point in relation to HIV, TB and STIs: the actions we take in the next few years will decide whether we move forward towards victory or slide back into a state of mounting infection and resurgent death rates.

In this climate, the proposals in the NSP cannot and do not amount to “business as usual”. They are shaped by our sense of the scale of the challenge and our determination to turn this challenge into an opportunity. We have attempted to tackle the prevention and successful treatment of HIV, TB and STIs from every possible angle, with a strong emphasis on approaches that could yield the biggest gains in a limited time period.

The resulting strategic plan is extremely detailed but, even so, it needs to be translated into concrete implementation plans suited to the conditions of each province and each district. Provincial AIDS councils will take this detailed planning forward in a way that allows for broad participation by government, civil society and private sector organisations.

We urge every role player to embrace this bold national plan and identify the parts that apply to you. The national HIV, TB and STI response is, in truth, the sum of many local, regional and sectoral responses. The targets we have set can only be achieved if each of us owns the targets that apply to our work and makes these the standards we strive for tirelessly in our day-to-day work.