Prof Koleka Mlisana

Our conference comes a decade after we first engaged, as a community, at the first SA AIDS conference in 2003. We have faced many obstacles since then. We have dealt with these head-on, sometimes at great personal expense. Throughout this time, however, we have also made many advances in dealing with HIV and AIDS, successes we should all be proud of.

South African scientists continue to be on the cutting edge, as recently evidenced by their contribution to scientific discoveries in the long road to finding an HIV vaccine. Understanding how broadly cross-neutralising HIV antibodies developed in two local participants opens up further strategies for HIV vaccine design.

There have also been major successes in preventing mother-to-child transmissions. A national Department of Health and Medical Research Council report on the evaluation of the effectiveness of programmes to prevent mother to child transmissions notes: “Uptake of PMTCT services is high, with more than 98% of women getting HIV tested during pregnancy and 91.7% of HIV-positive mothers receiving ARV treatment or prophylaxis.”

The theme for our conference in June is “Building on Successes: Integrating Systems”. This speaks to our challenges. While great strides have been made in PMTCT, health systems need to be strengthened to reduce the missed opportunities for Early Infant Diagnosis. Closing the gaps where they exist and ensuring that the existing systems run optimally, should remain a focus of our discourse.

In the last decade we have learnt that tuberculosis and HIV/AIDS are two sides of the same coin. For this reason, we are conscious that rapid TB diagnosis and prompt initiation of therapy remains central to the control of TB. The Department of Health with the National Health Laboratory Services (NHLS) has rolled out the GeneXpert to all nine provinces in selected microscopy laboratories.

This important development will also feature on the conference radar with a workshop focussed on the current GeneXpert Algorithm.

This conference is an important marker on our road to achieving our goals. It brings together clinicians, academics, civil society, government and the South African community at large in a gathering that will shape our dialogue in the years ahead.

We must be cognisant of the successes we have achieved, but we must guard against becoming complacent. We need to build on these successes and start ensuring that the systems we have developed are integrated into health policies and operations. I believe we are now in a very exciting season in the field of HIV and AIDS where there is a lot of hope and even the possibility of a vaccine and talk of a ‘cure’. Whilst the incidence rates in our country are still unacceptably high, a lot of progress has also been made: We celebrate the new political and positive leadership in the Health ministry PMTCT has successfully brought transmission rates to <5% Male circumcision is being rolled out as an HIV prevention modality 1,5 million people have been initiated on HAART, in South Africa alone The recent HCT campaign resulted in >15 million South Africans getting tested for HIV A hint that an HIV vaccine may be possible with the Thai trial showing a modest 31% efficacy A South African led research team demonstrated, for the first time, an ART based microbicide gel achieving 39% efficacy in preventing HIV transmission in young women 2011 was a year of a succession of trial successes showing ‘Treatment as Prevention’

It is therefore time for all of us to ‘Build on all these successes’ as we tackle TB and HIV co-infections and move to the next phase of conquering TB and HIV & AIDS through ‘Getting to zero’ - ‘zero new HIV and TB infections, zero discrimination & stigma and zero AIDS related deaths’. The HIV and AIDS epidemic has taught humanity, perhaps more than anything else before, that a threat to one is a threat to us all: rich and poor, gay and straight, black and white. Let’s keep up the good fight....we are one another’s neighbour. I welcome you and look forward to this 6th SA AIDS Conference as you all showcase the great work and contribution you are making in achieving our common goal of an HIV free world.