Sub-Saharan Africa is the most HIV-affected region in the world. But it is also the region which has registered the sharpest drop in new infections and AIDS-related deaths. As therapy and prevention strategies are starting to trigger results, new cooperation initiatives are underway to tackle the epidemic.

The UN World Aids Day report 2011 announced a possible breakthrough in the AIDS response. In 2010, the number of new HIV infections was 21 % below the number of new infections at the peak of the epidemic in 1997. Meanwhile, a total of 2.5 million deaths have been averted in low- and middle-income countries, including many African ones, since 1995 thanks to antiretroviral therapy.

Yet the situation in many African countries remains dramatic. South Africa has more people living with HIV than any other country: in 2010, an estimated 5.6 million people carried the virus. To build on and increase the positive impact of HIV responses, the EU launched a €126 million Primary Health Care Sector Policy Support Programme for South Africa. One of the largest EU health programmes in the world, it aims to support the South African government in its efforts to improve access to healthcare and to raise the quality and management of the health system. It thereby hopes to contribute to the fight against HIV/AIDS and tuberculosis and to increased life expectancy and reduced maternal and child mortality.

“Although South Africa has the largest antiretroviral therapy programme in the world, there is still a large unmet need of more than 1.5 million people. It is also one of the world’s high-burden TB countries. We therefore welcome the EC’s new programme to fight HIV and TB in South Africa which will help to further intensify the fight against the two diseases”, says Victor Bampoe, the Regional Team Leader for Southern Africa at the Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria.

The burden of the epidemic for sub-Saharan Africa is increasing even more through HIV/TB co-infection, while at the same time levels of multi-drug resistant TB are increasing. TB is a major cause of death among HIV/AIDS patients. The Global Fund has helped finance the fight against HIV and TB in South Africa since 2003 through providing grants to government agencies and non-governmental and private sector organisations.

A multisectoral approach

We know that poverty, unemployment, poor housing, gender-based violence and gender inequalities are all factors driving the epidemic in South Africa

Maureen Van Wyk

The funding is also used to address the factors driving the epidemic: “We know that poverty, unemployment, poor housing, gender-based violence and gender inequalities are all factors driving the epidemic in South Africa”, says Maureen Van Wyk, director of NACOSA, a South African civil society network which is among the recipients of the funding provided through the Global Fund. She explains that part of the money is used to implement the multisectoral national strategic plan, a task jointly carried out by various government departments as well as business, civil society and local authorities: “We are starting to address health in a comprehensive way”.

The NACOSA network covers over 1500 organisations active in the fight against HIV, AIDS and TB. It runs training and mentoring activities and works to ensure that there is a united response to maximise the impact of the different organisations’ activities.

Speeding up progress towards halting the disease

The support provided to South Africa is part of a wider EU effort to halt the epidemic and help those who have contracted the virus. Contributions from the European Commission and EU member countries together represent more than 50 % of the contributions to the Global Fund. As at 31 December 2010, the EU had contributed a total of € 923 million.

To develop a coherent policy framework, the Commission launched the European Programme for Action to confront HIV/AIDS, TB and Malaria through external action (2007-11) covering all developing countries.

It is complemented by geographical and thematic instruments supporting actions at country or regional level. HIV prevention is also mainstreamed into interventions in other sectors such as education, infrastructure and transport.

Halting and reversing the spread of HIV/AIDS by 2015, and achieving universal access to treatment for HIV/AIDS for all those who need it by 2010, had been set as the initial targets of the 6th Millennium Development Goal. Under the Africa-EU Millennium Development Goals Partnership, accelerating progress towards these goals is a major priority.