Opening address by H.E Mr David Mabuza, Deputy President of the Republic of South Africa at the the 21st International Conference on Aids and sexually transmitted infections in Africa, held at the International Convention Centre, Durban, Kwazulu- Natal

Programme Director,
ICASA 2021 President, Professor John Idoko,
Premier of KwaZulu-Natal, Mr Sihle Zikalala,
Minister of Health, Dr Joe Phaahla
UNAIDS Executive Director, Ms Winnie Byanyima,
World Health Organisation Regional Office Executive Director, Dr Matshidiso Moeti
Conference Organisers,
Speakers and Delegates,
Distinguished Guests
 
 
As we gather here today, in the midst of the most devastating epidemic in our lifetime, it is my honour to welcome everyone to our country as the host for the 21st ICASA conference. In doing so, we also want to pay homage to the immense contribution of former President, Mr Nelson Mandela in putting the fight against HIV and AIDS at the centre-stage of development in post-apartheid South Africa. 
 
The passing of former President Mandela in December 2013, was a defining moment for the people of South Africa and the continent as a whole in recognising the major strides that have been made in our collective response to ensure that we continue to save lives and prioritise interventions to curb the spread of HIV and AIDS.  
 
It is therefore opportune for the 21st ICASA conference, under the theme “Africa’s AIDS response: The race to 2030 - Evidence. Scale up. Accelerate”, to be hosted at this point in time. 
As delegates to this conference, we want to use this critical platform to further engage with our continental partners and stakeholders to the review of the Post-Sustainable Development Goals framework, considering the impact of both the HIV epidemic and Covid-19.  
 
Sustainability of the response in reaching the new Global AIDS Strategy targets, which is the UNAIDS 95-95-95, will not be possible if human rights are not key priority in ensuring non-discrimination and ending inequalities. 
 
This remains the fundamental principle of leadership and care in the context of strengthening the application of Science-based evidence.
 
Six years ago, in 2016, the international community set an ambitious target to end AIDS as a public health threat by 2030. This led to the UNAIDS 90-90-90 targets that were adopted by many countries in the region. 
 
Regrettably, by 2020, most countries had still not met the 90-90-90 targets though many had reached the first 90 of all people living with HIV knowing their status. 
 
Therefore, we welcome the collective efforts of UNAIDS and its partners, as well as that of global leaders at the UN General Assembly in September this year, to adopt the Political Declaration Pledging Urgent, Transformative Action to Stop the Global AIDS Epidemic by 2030. 
 
The SADC Health Ministers, also acting in line with the 2016 United Nations Political Declaration to end AIDS in 2030, recommitted to this goal. 
 
In addition, they decided to strengthen their HIV prevention programmes to reduce incidence of HIV by 75 percent in 2020 from the 2010 baseline. The new Global target is 82.5 percent by 2025.
 
 
In this regard, the Framework for Target Setting for HIV Prevention and the Regional Scorecard for HIV Prevention, further provides guidance in measuring progress to reach the targets, and is in effect, our blueprint and a point of reference to guide the rate of our collective response. 
 
While international solidarity and community resilience has saved millions of lives to date, a lot more still needs to be done. Many of the inequalities that facilitated the spread of the AIDS pandemic are getting worse and continue to drive HIV in many parts of the world, most often affecting the most vulnerable within society. 
 
However, there is hope, and the solutions lie within the 40 years of experience in the HIV response that has provided us with evidence of what works. Some of this can be drawn from the working model known as Operation Sukuma Sakhe from this very host province. 
 
Fellow Conference Delegates
 
As Africa, it is clear that the impact of colliding HIV and AIDS and Covid-19 pandemics, have foregrounded the necessity to invest in health infrastructure to improve access to quality health care, and address inequities and structural exclusion in the provision of health care services for all our people. 
 
Our response to HIV and AIDS, TB and Covid-19 must be intertwined with our efforts to address underdevelopment, poverty and inequalities as determinants of poor health outcomes across the continent.
 
It behoves our governments and leaders to ensure more health facilities are built in underdeveloped areas to ensure that the poor and all those who feel marginalised, can access treatment and care. 
 
If we are to meet the 95-95-95 targets, we must ensure that no one is left behind. Investing in requisite infrastructure, human resources, and effective drug supply systems on the continent will be critical.
Equally, Africa must invest in research and innovation to build resilient capabilities for the development and manufacture of critical vaccines, drugs and ancillary medical supplies that will support the roll-out of our health programmes on the continent. 
 
As Africans, we have always spoken of unity of purpose beyond existing artificial borders in order to achieve development and integration of our economies and our people. 
 
This is the time to move beyond rhetoric and forge collaborative platforms for research and innovation to promote intra-Africa cooperation in the development and provision of health solutions that all the peoples of this continent need.
 
The lessons of the Covid-19 vaccine rollout programme has taught us that, as a continent, we need to invest in our own capabilities to overcome the hogging of vaccines by wealthier nations  thereby effectively responding to current and future epidemics and pandemics. 
 
Therefore, the conference of this nature, offers us a right platform to amplify our individual and collaborative efforts and responses at national and international level, towards achieving our objective of ending AIDS as public health threat by 2030. 
 
Our scientific prowess as Africa is proven. 
 
That is why our scientists were able to detect and sequence the genome of the Omicron variant and its mutations with precision, and in the process contributing to global efforts and initiative of understanding and defeating the Covid-19 pandemic and its mutations. 
 
As African countries, we have always understood that in this world we are interdependent and no one is safe until everyone is safe. Therefore, there is no need to adopt antagonistic positions towards one another. We are not enemies – HIV and AIDS is our common enemy that we must unite and defeat.    
 
Global cooperation and solidarity in times of unprecedented crises like the pandemic we are faced with, necessitates that we work together to find answers to important public health questions of the moment.  
 
We are in full support of the comments made by the Executive Director of UNAIDS, Ms Winnie Byanyima, who said that despite the disruptions caused by the Covid-19 pandemic, we must act urgently to prevent a resurgent global AIDS pandemic and to quickly recover our progress towards ending AIDS. 
 
These comments are also in concurrence with the Political declaration that was agreed upon at the United Nations High-Level Meeting, calling for urgent and transformative action to end the gender inequalities, restrictive laws and all forms of discrimination that fuel the global AIDS epidemic. 
 
This is particularly important for countries, including South Africa, that still have relatively high levels of sexual and gender-based violence and femicide, continued high levels of stigma against people living with HIV as well as stigma and discrimination against the LGBTQI+ community. 
 
In the case of South Africa, the National Strategic Plan 2017-2022 states in Objective 3, that NO one should be left behind in the HIV, TB and STIs interventions. To operationalise this objective, we launched the Human Rights Plan, updated and re-launched the Sex Worker Plan while still implementing the LGBTQI+ plan. 
 
These plans contribute towards guiding our holistic implementation of services to ALL, as well as sensitisation of health care workers in all public health facilities and implementing partners. 
 
Fellow delegates
 
Globally there has been remarkable gains across the HIV testing and treatment cascading towards the 90-90-90 targets and transition to the 95-95-95 targets. 
 
In 2020, 84 percent of people living with HIV knew their HIV status, and more than two thirds, 73 percent, were on antiretroviral therapy, while 66 percent were virally suppressed. This progress shows more than triple growth since 2010. 
 
Gains in treatment effectiveness, as well as increases in the number of people who know their status and are on treatment, are reflected in the fact that viral load suppression levels among all people living with HIV increased by 18 percent between 2015 and 2019. 
 
Almost 66 percent of people living with HIV globally had suppressed viral loads in 2020. Regrettably though, even with these great strides, the global target for 2020 was not met. 
 
The South African government provides millions of male and female condoms to prevent acquisition and or transmission of HIV and Sexually Transmitted Infections as well as unplanned pregnancies. 
 
We are also implementing innovative strategies for HIV testing services for all and comprehensive interventions that contribute towards reduction of incidence of HIV, STIs and TB.
 
Recent data from our dashboard, shows that South Africa is currently at 93-72-89 of the cascades for the total population serviced through the public sector. Broken down amongst the sub-populations, the following variation is noticeable:
 
•       Adult females at 95-76-90,
•       Adult males at 92-65-90, 
•       Children at 80-66-65.
 
To achieve 90-90-90 targets, South Africa must increase the number of
 
•       Adult men on Anti-retroviral Treatment by 548,531
•       Adult women on Anti-retroviral Treatment by 437,728
•       Children on Anti-retroviral Treatment by 70,494
Data available in the private sector indicates that additional
 
•       4,789 Children,
•       90,515 Adult Females, and
•       112,472 Adult Males are receiving ART through private medical aid schemes.
 
This progress shows that like our regional counterparts, we still have a long way towards reaching sub-populations including children. Innovative interventions are needed to ensure that we reach our 90-90-90 targets as we transition to the 95-95-95 targets. 
 
In the midst of the Covid-19 pandemic, self-care interventions such as HIV self-screening have shown to be critical to ensure that the under-tested and test-averse populations, including key populations, youth and men in general, are reached with testing services. 
Prevention is however, the mainstay of every intervention whether in public health, social ills or any other adverse scenarios. 
 
That is why we welcome the pre-conference event involving young people as their participation is crucial in this fight, as we seek to accelerate their leadership, resilience and innovations to end AIDS as a public health threat by 2030.
 
As a conference, we are required to emphasize transdisciplinary approaches in order to transcend the artificial barriers between government, civil society, academia and business and to collectively identify resource-tailored interventions for all affected populations in our respective countries, more especially those that change and improve the lives of women, children, adolescents and key populations.
 
 
If anything, the lessons from these colliding pandemics especially Covid-19 are teaching us, is the importance of strengthening our health systems to integrate high impact interventions on co-morbidities, emerging infections and non-communicable diseases. 
 
Therefore, the success of this conference, would be on how we institutionalise concrete and actionable resolutions that give meaning to the political declaration made at the United Nations level. 
 
Alongside Covid-19 challenges, we should not lose momentum in our fight against HIV and AIDS but we should ensure that all our HIV and AIDS programmes are embedded in our overall response to the Covid-19 pandemic. 
 
 
Covid-19 will remain with us for the foreseeable future, and therefore it’s critical to integrate our delivery systems and platforms in such a way that the fight against HIV and AIDS continues to be a policy priority to achieve population health. Compliance with- and practicing what we know, including public health safety measures, will protect us from these colliding viruses.
 
Once more, on behalf of the government and people of South Africa, we welcome you all.
 
THANK YOU