Feature Story

Why do you see the need for “Uniting for HIV prevention”?

If people become infected it shortens their lifespan, it has an impact on quality of life and it undermines family relationships, society, and impacts on broader issues like the economy. In our country [ South Africa] every day more than 1000 people become infected and more than 900 are dying from AIDS-related illnesses. From that perspective alone, if we don’t scale up prevention effectively we will increase the death rate, increase the illness and increase the social disruption that can come with HIV.

Who do you think needs to be involved in this movement?

For so many years efforts have been focused on the AIDS community – and frankly, the AIDS community is tired of prevention. Millions of new people have to be garnered for prevention and so we have to turn to how do we bring in new people – how do we bring in the priest, the trade union, the traditional leader, traditional healer, the banker? We have to look beyond the traditional HIV communities.

At the same time, at the centre of all this has been the absence of people living with HIV leading the struggle for HIV prevention. The critical thing has to be, that at the forefront of prevention has to be people living with HIV assisting through their very unique understanding of prevention.

Often we hear that pushing on prevention is going to compete with calls for access to treatment – what do you think about this?

Treatment has given us a unique opportunity to scale up prevention. It has shown that it works and it is working because people who are affected by it have begun to understand and address the access barriers to HIV treatment. Very few people understand the barriers to access to prevention and this is where work is needed now.

I think [treatment and prevention] are marvelously self-reinforcing. From my point of view, the most scandalous thing is that we have so many ARV programmes that don’t ensure that part of the essential package of treatment is to have 6 condoms a week planned as part of the essential package.

So, treatment activists have a great role to play in “Uniting for HIV Prevention” as well?

I think probably the most critical role, because we know the cost of treatment and the future costs this will incur if prevention isn’t scaled up massively. If you take South Africa for example, it’s going to cost our country close to about 5 billion dollars a year in 10 years time, just for treatment. That is a significant amount of money and on a long term basis it’s unsustainable for families and healthcare systems. We don’t want to live in a permanent emergency in our healthcare systems and our society as regards to our health. So, I think that treatment activists should understand best the need for scaling up prevention.

If you could give one message about “Uniting for HIV Prevention”, what would that be?

I would like two messages – firstly, immediately scale up mother to child prevention. It is tragic that all of us have not taken the opportunity that this has given us to scale up healthcare and antenatal services for all women. And the second thing is – it’s everyone’s duty to recognize that this is not a short term battle and so [we all need] to prepare ourselves in the long term by reading, studying and acting on the knowledge we get—urgently.