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1 December 2006

Programme Director
Distinguished guests
Ladies and gentlemen

December 1 is annually commemorated across the world as World AIDS Day. This day is dedicated to provide opportunities to recommit ourselves to the crusade for the defeat of HIV and AIDS. It is therefore very apt that the theme for this year's commemoration "Stop AIDS. Keep the Promise" place emphasises on accountability. I am pleased to see so many of our youth there today as I would like especially to focus my attention on the important part our prevention programme plays in their lives.

Ladies and gentlemen, today we join people, organisations and countries around the world to promote enhanced accountability from leaders on their commitments and generate greater public awareness and engagement on the problem of AIDS worldwide. The challenge of combating the HIV and AIDS pandemic remains and we are convinced that at no stage of our efforts to keep our promise must we show signs of despair and hopelessness.

We must draw courage and inspiration from the tremendous progress we are making. We are working hard to keep the promise. The Free State has a population of approximately 2 914 201 people of which it is estimated that more than 487 000 people are living with AIDS. It is estimated that there will be more than 62 000 births, of which more than 4 000 babies will be infected with HIV at birth. These statistics serves to remind us about the grim reality of the promise we made.

Programme Director, our comprehensive HIV and AIDS programme is the largest in the world and our government has been commended for tripling its resource allocation for HIV and AIDS programmes since the adoption of the United Nations Declaration of commitment on HIV and AIDS in 2001. Our promise to the people of this province is contained in the Comprehensive Care, Management and Treatment Plan for HIV and AIDS. This plan stands firmly on four legs and as government we promised to provide facilities, services to people affected and infected by and with HIV and AIDS, as well as to commit other resources to fulfil our promise.

1. Implementation of government's Comprehensive Care, Management and Treatment Plan for HIV and AIDS. The implementation of the antiretroviral (ARV) portion was introduced nationally in November 2003 as part of the Comprehensive Care, Management and Treatment Plan for HIV and AIDS. It is being supported by the primary healthcare approach, which means that an ARV treatment site is defined as one hospital with three referring clinics as assessment sites. The first ARV site became operational on 3 May 2004.

The number of ARV sites has been increasing each year in all the districts as we seek to expand implementation of the Comprehensive Plan to ensure access to services for the people of the Free State. With the implementation of the Comprehensive Plan on HIV and AIDS, more than 12 000 patients are currently on the programme of which more than 4 700 are receiving ARV treatment from the Department of Health and its partners. There are 31 ARV assessment sites and 14 other service points are dispensing antiretroviral treatment.

The Mangaung Prison has been accredited for ARV treatment and is the only Department of Correctional Services (DCS) facility accredited in the country. A private HIV care and ARV site have been established at Medicross Clinic, College Square. This private site is a combined treatment and assessment site and provides an ARV service for patients with medical aids that qualify according to the nationally agreed-upon criteria.

No national review regarding the Comprehensive Plan on ARV treatment has been done yet. For this reason, we are unable to compare how the Free State programme is doing in relation to other provinces.

2. Implementation of HIV and AIDS Prevention and Support Programmes
With the focus on prevention, treatment, care and support, the following programmes are in place in the Free State, as part of the Comprehensive HIV and AIDS Care, Management and Treatment Plan:

The Prevention Programme
a) Sexually Transmitted Infections (STIs) and Barrier Methods
In the Free State, primary condom distribution sites increased from 10 to 15 sites distributing on average 1,7 million condoms per month, compared to 1 million condoms in 2004/2005. To date, 23 registered functional female condom distribution sites have been established in the Free State.

Ten HIV/High Transmission Area (HTA) intervention sites have been established in the province with the main aim to distribute condoms and to educate on prevention and management of Sexually Transmitted Infections (STIs).

During the 2006/07 financial year, the Department of Health is training personnel on Syndromic Management of STIs at 80 primary healthcare facilities in the Free State. Condoms are also distributed in ablution facilities of other government departments such as Local Government and Housing, Education and the Provincial Treasury.

b) Voluntary Confidential Counselling and Testing (VCCT) Services
The VCCT programme is available in all five districts with 97% coverage of health facilities in the Free State. To date, the service has been implemented at 235 primary healthcare facilities, 23 mobile clinics and nine non-medical sites in the province with a total of 334 active lay counsellors on the VCCT programme.

More than 100 000 clients were seen through the VCCT programme this year. As we reach 100% coverage of VCCT in all towns, the department will increase the number of non-medical VCCT sites from 10 to 15. A further 72 lay counsellors were trained and placed on the VCCT programme.

c) Prevention from Mother-to-Child Transmission (PMTCT) of HIV
The PMTCT programme is being rendered by the Department of Health. To date, the Free State extended the PMTCT programme to have one PMTCT facility per district with 140 feeder clinics and 30 hospitals participating.

The Department of Health is continuing support to the provision of the Prevention from Mother-to-Child Transmission at all levels of care. Furthermore, 60% of all facilities have trained health workers and lay counsellors to implement the relevant policies and guidelines. 60% of pregnant women are to be enrolled on the PMTCT programme in the current financial year.

All hospitals and some clinics in the Free State, provide antiretrovirals for Post Exposure Prophylaxis to rape survivors and personnel, within 72 hours after exposure. Integration of PMTCT to other programmes has commenced in the Free State.

d) Information, Education and Communication Programme
Various programmes are being conducted in support of the Khomanani Social Mobilisation Campaign, to improve the flow of information, education and communication in the Free State. All HIV and AIDS calendar days are being used as Information, Education and Communication awareness campaigns which includes amongst others, STIs, Candlelight Memorial days, TB Partnership days.

e) The HIV and AIDS in the Workplace project is supported by policies implemented in the departments of Health, Public Works, Roads and Transport, Provincial Treasury, Local Government and Housing and Education.

f) Employee Assistance Programmes (EAPs) have been established in the Departments of Health, Provincial Treasury, Local Government and Housing and Education.

3. Care and Support Programmes
a) Community Home Based Care Services (Expanded Public Works Programme) provides an effective, integrated community home based care programme for the majority of patients with AIDS and other debilitating diseases. All towns in the Free State provide community home based care services in partnership with 137 civil society organisations.

R21 494 million has been allocated for Home Based Care in the 2006/07 financial year. Currently, the service is being expanded to 11 farms around Van Stadensrus and Smithfield in the Free State. A total of 2 500 volunteers (including Department of Transport supporters are receiving stipends from the Department of Health, with an average of 80 091 beneficiaries over a three-month period. To date, 1 600 carers have already gone through the 59-day accredited course and an additional 129 were trained this year to render a comprehensive service to all patients and clients.

b) Step down facilities
There are eight functional step down facilities with a total of 84 beds in the Free State. A total of 108 trained volunteers render the service under supervision of professional nurses and to date, more than 2 007 clients are benefiting from this service.

4. Provision of an integrated service to people affected and infected by HIV and AIDS is embodied in successful partnerships and support groups have been established which is embodied in the provincial AIDS Council and expressed in action through joint initiatives involving government, communities, non-governmental organisations, faith based organisations and organised bodies of civil society. In addition to the provincial AIDS Council, there are the following partnership structures and support groups:

* five district AIDS Councils and 18 local AIDS Councils within the 20 Local Municipalities
* a provincial Men's Forum, a provincial Traditional Leaders and Healers Forum, and a faith-based organisation forum
* hospice and AIDS Training, Information and Counselling Centre (ATICC) Partnerships
* traditional leaders in Motheo and Thabo Mofutsanyana districts are also on board in a firm partnership
* in the provincial government, all social sector government departments have recognised the need to firmly address HIV and AIDS through the millennium goal programme
* a firm partnership against tuberculosis (TB), the "Partnership Against Tuberculosis" or (PAT) was established in September 2004 in order to address the double burden on health services caused by the combination of tuberculosis and HIV and AIDS. The main objective with the establishment of PAT, is to mount sustained and highly visible campaigns that will unite all the Free State communities in the fight against tuberculosis. A provincial HAST (HIV/AIDS/STI and TB) Committee as well as five district HAST Committees have been established and are responsible to ensure that TB and HIV integration activities take place in the province.

Implementation of the Health Promotion Strategy

To date, one Health Promotion and Quality Assurance Centre (RTC) has been established in the Free State.

Programme Director let me make a special mention of the important partnership, the Free State Department of Health in the fight against HIV and AIDS have, with men. Men have to be seen in the forefront of this fight in trying to remove the stigma of the community regarding men as perpetrators only, instead of caring protectors of women and children.

Ladies and gentlemen as part of the awareness campaign, testing events were organised at taxi ranks in Qwa-Qwa and Bloemfontein, where those willing to be tested, received confidential counselling and were tested free of charge. During this past week, I made a special call on all men and women to go for confidential counselling and testing for HIV and AIDS, which is available free of charge at all clinics. This is but one of the services we provide at primary healthcare clinics and I am proud to say that we are successful in fulfilling this promise.

In conclusion, let us all remember that a promise you make is a promise you keep. There is no known cure for AIDS. We cannot therefore afford to lower our guard. Prevention remains the cornerstone of our promise. Let us all strengthen the hand of the nation in fighting HIV and AIDS in keeping with the mandate of building a better life for all.

To this extent, we will continue to, in partnership with all our people encourage people to seek voluntary counselling through the VCCT programme as the results will assist in behaviour change and promotion of healthy lifestyles as well as step up the prevention campaign so that those who are not infected remain negative. We need to sustain the community education and mobilisation programme so as to strengthen the partnership against HIV and AIDS and will expand programmes aimed at boosting the immune system and slowing down the effects of HIV infection, including the option of traditional healthcare for those who prefer this service.

Programme Director, we are confident that together with all our people and bound our promise of as better life for all, we shall build the Free State into the province and a land of our dreams!!

Thank You.

Issued by: Department of Health, Free State Provincial Government
1 December 2006