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Speech by Premier Stofile on the challenges of HIV/AIDS in the Eastern Cape
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 EASTERN CAPE PROVINCIAL GOVERNMENT
SPEECH BY PREMIER STOFILE:
 THE CHALLENGE OF HIV/AIDS IN EASTERN CAPE
ON 1 DECEMBER 2000



INTRODUCTION

The time has come for all of us regardless of our differences to join hands together and commit ourselves to fight the scourge of HIV/AIDS 
which is not only killing our brothers and sisters and the young generation but threatens the survival of humanity in our country 
especially in Eastern Cape. People have died, developed psychological problems and economies have dwindled. This virus has declared war 
against humanity. The Government and the Department of Health in particular has also declared war against the virus. Today I would like to 
know whether you as an individual have declared war against this virus. I would like to know what have you done to stop the spread in your 
area.

The World Aids Day should not just be another day for us to engage in speeches but a day when we as individuals commit ourselves to the 
fight against HIV/AIDS. It should be a day when we look back and evaluate ourselves as to how much have we advanced in dealing with this 
dread disease and also what can we do in future so that the strategies we have embarked bear fruits.

HIV/AIDS is not only the world’s greatest killer disease and a threat to humanity, but also a unique disease. What makes it unique and 
problematic is the following-:

(a) It is incurable – there is still no cure for HIV/AIDS, but it can be controlled.

(b) It is an infection by virus. Unlike other diseases, which are spread by other organisms like malaria wherein the spread would be 
prevented by killing mosquitoes, human beings spread it and you cannot kill people with a view to control it.

(c) HIV/AIDS, except in few cases is transmitted through sexual intercourse. Sex is still a taboo to talk about in public.

(d) Males are the most transmitters of HIV. On the other hand women are prone to be carriers hence there is a high percentage of women 
infected with HIV. The situation is also exacerbated by the status of women. It is an undeniable fact that no female has power – financial 
or otherwise. They depend on males for their livelihood.>

(e) The virus attacks the immune system that is the main protector against antigen. However, poverty kills the immune system. The rate of 
transmission in poverty-stricken areas is faster than other areas.

(f) It thrives well when there are other diseases like TB.

OTHER FACTORS THAT AFFECT THE SPREAD OF HIV/AIDS ESPECIALLY IN EASTERN CAPE

* High rate of illiteracy amongst our people. The majority of our people especially in rural areas have had no access to education; hence 
they cannot be able to interpret the information available to them. We need to empower the people so that they can have access to 
information that is vital to their survival.
* Migrant Labour System. This is one of the major problems facing our country at present. The fact that women in rural areas are the most 
affected indicates that males who come from the mines and other industries carry the virus with them.

* The gender inequalities in education, employment, wages compounded by poor access to reproductive information makes women prone to being 
the worse affected than males. In many instances women find themselves being victims of the deteriorating economic situation when they are 
forced to use desperate measures to survive. There have been reports in some institutions of higher learning that female students have 
resorted to selling sex so as to pay for their fees.

* Our cultural inclinations sometimes create a conducive environment for the spread of HIV/AIDS. Though this might be controversial it must 
be mentioned that polygamy in certain situations could result in many people getting infected with the virus. This equally applies to those 
who still believe that to prove manhood is to have as many women as possible. Talking about sexual activity in many communities is a taboo. 
This is a barrier we must overcome. It is a painful departure from the practices that the older generation, but it is a necessity. Gone are 
the days when parents wouldn’t &#145;t talk to their children about sexual activities. Equally important is how we manage our prestigious 
custom i.e. traditional circumcision. There are people who still do not believe that the transmission could occur during the process. If 
the custom has to be preserved we should make use of sterile instruments. Parents must take responsibility of ensuring that their children 
are safe when they are going to the school.>

* Stigmatisation. As long as we continue to put a stigma on people infected with the virus we will not be able to control the disease. 
People living with HIV/AIDS are human being too. They do not need to be discriminated against. Under the circumstances voluntary testing is 
not possible because of the fear that people infected with the HIV will be discriminated against.
* That the collapse of immune systems in our people who live mostly in our Third World part of the province convinces us that there is a 
need to look beyond issues of treatment and containment.There is a vicious cycle that we have to explore. The inequities that exist in 
these parts of the world indicate to us that those living in poverty-stricken areas are more likely to have their immune systems destroyed. 
Perhaps the scientists will have to tell us about the link.

THE EASTERN CAPE PROFILE

With population of ± 7 million, nearly 63% is rural. 54% of the total population lives below poverty line. Being a labour reservoir for 
richer provinces, has not only robbed the province of its human resources, but also has further impoverished the province. We are the 
recipients of economically inept people from these provinces and this impact negatively on our health budget. Today most of the people with 
chronic diseases are those from the mines, the farms, the fishing industry, the chemical and other heavy-duty industries. 80% of the people 
in Eastern Cape depend on Public Health for their livelihood.

Recent poverty indicators have shown that Eastern Cape is also the poorest province in South Africa, with unemployment rate at 48% and 
illiteracy souring at 79%. Apart from having to address the inequities of the past, which the government cannot do it alone, Eastern Cape 
is also faced with a mammoth task of attracting investors who could help to rebuild the economy of the province.

HIV/AIDS STATISTICS IN EASTERN CAPE

Having outlined the economic situation of the Eastern Cape, it doesn’t come as a surprise that the breakdown in statistics is indicative of 
the province’s economic status.

18%      500 000 (from sexual active population)
Region A         22.1%(PE-Uitenhage Metropole)
Region B         15.1%(Queenstown Area)
Region C         17.1% (Mdantsane)
Region D         17.5%(Umtata)
Region E         22.%(Bizana and Umzimkulu)


Whereas the statistics give a gloom picture of the Eastern Cape there is an indication that our strategies are beginning to bear fruits, 
for example, there has been a 2% decrease in the infection rate amongst the 22 year olds. Some of the contributing factors include amongst 
other things the increased awareness and the condom usage. People especially the youth have began to talk openly about HIV/AIDS. We have 
also observed a decrease of the Sexual Transmitted Diseases including STI’s and Syphilis.

HIV/AIDS AS A CHALLENGE TO SUSTAINABLE DEVELOPMENT

The rate of infection affects the socio-economic development negatively. A large amount of household income is spent on health care for 
adults and children, who are ill because they are HIV positive, have AIDS or AIDS related diseases. The household capacity to sustain 
itself is significantly reduced as members infected become economically inept. Many African families are stretched to the limit, as they 
have to accommodate children whose parents have died of AIDS.

HIV/AIDS poses a threat to investment in Eastern Cape as well as the rest of the country. Companies form abroad are sceptical of investing 
is a country where social responsibility exceeds the returns on investment. As is the case now, since HIV/AIDS affects mostly the 
economically active population group, this means a large amount of money will be used on training and replacement of personnel. Above all 
the rate of absenteeism due to sick leaves.

Of particular concern is the strain that is going to exact in our limited Health Budget. The economic situation in our province has led to 
80% of the people depending on public health sector meaning that the management of HIV/AIDS in the Province will deplete our Health Budget. 
The Health Budget is also affected in a sense that a large percentage of HIV infected people are prone to opportunistic diseases like TB. 
Most of them are admitted to our hospitals and they stay in some cases longer than 30 days.

MANAGEMENT OF HIV/AIDS

Treatment of infected people

There is still no cure for HIV/AIDS that is available. There are those who continue to mislead the public that there are drugs that are 
available and the government doesn’t want to provide them. This is mischievous political opportunism. The drugs mostly referred AZT and 
Niverapine. It is believed that these drugs prevent HIV/AIDS. This is not the case.

Contrary to the allegations and accusations that the government does not want to give these drugs to HIV pregnant women, the clinical 
trails that are being conducted at present of which the results will link them to the challenges of breastfeeding options are a clear 
indication of the government’s commitment to deal with this pandemic.

There are two sites in Eastern Cape that have been identified for trials, that is, Umzikulu in the north and Mdantsane in the central. The 
projects have already been started with the identification of volunteer counsellors and their training. All the necessary logistical 
requirements are being looked at. The actual administration of the drug, which is part of the project, will begin once capacity has been 
established.

Whereas, pregnant women could use the drug, there are still lots of considerations. These include -

* Drug dependency – if a drug is taken for longer period, as this will be the case chances are that the virus might get used to it 
requiring that large amounts of drug should be taken.
* The Medical Control Council approves drugs before they can be used. First, they are tested for side effects, etc. This also applies to 
any drug regardless of its successes in other countries
* Drugs are generally expensive. With the limited resources we have it is not possible at this stage to use these drugs. If a drug costs 
R30 a day and with 1.1 million people affected in Eastern Cape it means the government will spend R31.1 million a day which is R372 million 
a year. Clearly this money could have been used for other developmental projects.

This should not be interpreted as saying the government will not do anything to curb the scourge. This is for the same reason that 
President Thabo Mbeki has called an international panel of experts on HIV/AIDS to advise him on the proper strategies to manage the spread 
of HIV/AIDS.

Home-based Care

The government in partnership with other stakeholders is encouraging home-based care. The objective of Home-based Care is to assist the 
families of those infected by the virus to deal with those infected and also chronic patients thereby reducing the number of patients in 
our hospitals. There are centres that have already been in operational e.g.

* UMzimkulu – a multisectoral centre
* Maluti and Mt. Frere – Pilot project
* Intergrated Plan – Health and Welfare – Qumbu – for children infected and affected
* NGOs – St. Bernards Hospice in East London and St. Francis Hospice in Port Elizabeth.

The Eastern Cape AIDS Council

The establishment of The Eastern Cape AIDS Council in July 2000 has been another landmark in the government’s commitment to fight HIV/AIDS. 
The HIV/AIDS Council

As part of the government’s effort to fight the epidemic the South African AIDS Council has been established. Months of discussions between 
the government and other stakeholders led to the establishment of the Council in July this year. The Council acts as an advisory body 
submitting recommendations to the Premier and the Cabinet. The overall aim is to strengthen the partnership between local and national and 
non-governmental bodies and to act as a platform for dialogue between all sectors. Some of the objectives of SANAC include advocating the 
involvement of all sectors and organisations in the implementation of programmes and prevention strategies, monitoring and co-ordinating 
implementation programmes, providing overall guidance to create and strengthen partnership; ensuring periodic reviews of the provincial 
AIDS strategic plan; mobilising resources; and recommending appropriate research.

The Financial Commitment of the Eastern Cape Government.

Currently the Eastern Cape government has approved R100 million budget for a period of three years that will be used for HIV/AIDS 
activities. The funds have been taken from various departments.

Ladies and Gentlemen: it must be pointed out that the fight against HIV/AIDS is not the government’s responsibility alone. As a nation we 
have to come together to help to combat the spread of HIV. In doing so we need to identify certain misconceptions that many people have. 
These include -:

* HIV/AIDS brings pain. There is a pain of frustration and there is pain of resentment. A pain of frustration comes when one realises that 
he or she cannot enjoy sexual activity in a natural way i.e. without using a condom. Nobody likes to use a condom hence the pain of 
frustration.
* There is another pain, that is, a pain of resentment. This pain comes when one regrets for not using a condom. Unfortunately this happens 
after one realises that he or she is HIV positive because he could not overcome the pain of frustration. The pain of regret or resentment 
lives with you for the rest of your life.

* There is a large percentage of people who die of depression and other stress related diseases as a result of being diagnosed as HIV 
positive. People who are HIV positive must be aware that this is not the end of the road but a beginning of a new life for them. They must 
first accept their status and begin to find a way that is going to keep them healthy, as there is no cure for the disease at this stage. 
Above all these people need acceptance by their families and the communities in which they live.

The fight against HIV/AIDS calls upon all of us to act in unity. We call upon

1.Religious community to strengthen its resolve to increase public awareness.

2.Organised labour to educate its members about the consequences increasing infections.

3.Business community and organised labour to continue to find solutions that will contribute to investments.

4.It is also imperative to change the attitudes of males so as to change their social behaviour, which is a main contributor to increasing 
infection.

5.Women must be empowered so that they can play an active role in the economy thereby reducing high level of dependency on men.

6.The world’s biggest killer and the greatest cause of ill health and suffering across the globe, including South Africa, is extreme 
poverty. While we continue with the sustained public awareness encouraging safe sex and the use of condoms, there must be a better-focussed 
programme targeted at the reduction and elimination of poverty and the improvement of nutritional standards of our people.

In conclusion, I want to request all South Africans young and old; Black and White; rural and urban, and of various denominations and 
political affiliations to seriously consider the consequences of their decisions. No matter what can be said and how many times, if we do 
not change our sexual behaviour, the tragedy of the entire family being wiped out will not be a story afar but a reality. A lot of people 
have died, some very close to us and some being bread winners, etc. the time has come for all of us to work together and fight the scourge. 
We only have one option, i.e. to collectively declare war against HIV/AIDS. Females have made history, can they once again make history 
with HIV/AIDS by helping us change our attitudes, our behaviours, etc.

Thank you.

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