n Southern African Journal of HIV Medicine - Building on the first decade of ART : reflections

Volume 15, Issue 1
  • ISSN : 1608-9693
  • E-ISSN: 2078-6751



There is much to celebrate at the end of the first decade of South Africa's public sector antiretroviral therapy (ART) programme. An estimated 2 million South Africans had started ART by 2012, making ours the largest ART programme globally. ART coverage in adults, according to current guidelines, was estimated at 81% in 2012. The prevalence of HIV is increasing, because people receiving ART are living longer. In rural KwaZulu-Natal, adult life expectancy increased from 49.2 years in 2003, just before the beginning of the ART programme, to 60.5 years in 2011. Tremendous strides have been made in the prevention of mother-to-child transmission (PMTCT) of the virus. Almost 90% of pregnant, HIV-infected women access antiretrovirals (ARVs) either for their own health or for PMTCT, resulting in a 67% decline in new infections in children from 2009 to 2012. Further declines in new infections in children should be seen with the new PMTCT guidelines, which include prolonged ARVs for infants during breastfeeding, and combination ART for all mothers irrespective of CD4+ counts. ART access in eligible children has increased from 17% in 2009 to 67% in 2012. We have even started a third-line ART programme.

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