WORLD AIDS DAY in South Africa

What is it all about and how do we make this day have personal meaning for us? It's really a day about solidarity, standing up and showing support, encouragement and understanding to those living with HIV/AIDS.

I have to be honest, I was extremely impressed with some of the announcements that came out on 1 December. Particularly from our President Jacob Zuma. He delivered an unambiguous and clear statement that left no room for doubt. It made me proud to be South African again, as for so long, 'South Africa' and 'AIDS denialism' have been a matching pair.

Particulalry exciting is the raising of the bar on the CD4 cut off levels for treatment. Pregnant women with CD4 counts below 350 cells/mm3 automatically qualify for lifelong HAART/ARVs. Part of me is singing from the roof tops and ululating that we will be able to drive down mother to child transmission and prevent more infection of babies and protect them from being orphaned. Another part of me is rolling my eyes in exasperation, thinking " about bloody time. The World Health Organisation has recommended this for a number of years". And another part of me is sighing anxiously at the likely doubling of workload in my own clinic at Chris Hani Baragwanath Hospital in Soweto. Currently, our clinic is pretty full just dealing with the advanced cases of HIV in pregnant women with CD4 counts under 200. Now we will need to accommodate all the pregnant women with a CD4 under 350 which will certainly double of number of patients. With no increase in health care staff, and no additional work space.

So, it's all a bit overwhelming. Don't get me wrong. We will make it work, and I think the additional stress and burden on the clinic will certainly be worth it if it means that for every pregnant woman we treat, we are preserving the future of that mother to raise her unborn child and to protect her child from HIV. It is really two for the price of one and that is reward in itself. But there will be teething problems no doubt, and we will have to 'vasbyt' and tackle the problems as the arise and maintain our standards.

It really is encouraging, at last, to hear the voices of denialists quelled, because now we can start to embrace the nitty gritty of how to get people well, rather than arguing the question of whether they are sick at all.

Live positively and in peace
Gail