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South Africa launches world's biggest anti-AIDS drive

Jacob Zuma's government rolls out massive plan to test and provide treatment.

“At a time when everyone is bemoaning the weakness of service delivery, this is a project of great scope and ambition. Far-flung clinics that have not offered decent health care in years will administer life-saving medicine,” he wrote in Johannesburg’s Sunday Times newspaper.

The campaign kicked off with President Jacob Zuma releasing the results of his fourth HIV test, a continuation of the clear break with the health policies of former president Mbeki, whose government questioned the link between HIV and AIDS, failed to provide sufficient life-saving antiretroviral drugs and instead promoted beetroot and garlic. A Harvard study linked Mbeki’s policies on HIV/AIDS to the premature deaths of 365,000 people in South Africa.

Zuma revealed his HIV-negative status at the launch of the testing campaign, to applause from the thousands of people who gathered at a hospital east of Johannesburg.

"The purpose is to promote openness and to eradicate the silence and stigma that accompanies this epidemic," he told the crowd.

But after Zuma disclosed his HIV status, some South Africans expressed disbelief. “Did you use expired HIV tests?” wondered Toni Molefe in a letter to The Times.

Zuma has been criticized for promoting unsafe sex with his well-publicized risky behavior. Zuma has three wives, has fathered at least 21 children by eight different women and came under fire earlier this year when it was learned that he fathered another child out of wedlock. In 2006, while successfully defending charges of raping a HIV-positive woman, Zuma told a court that he did not wear a condom but had showered afterwards in an attempt to prevent HIV transmission.

Kevin Kelly, director of the Centre for AIDS Development, Research and Education, a South African non-profit organization, says the campaign’s focus on “getting the numbers” — the target of 15 million tests — could be a distraction from the quality of care.

“Of course it’s important that people know their status,” Kelly said. But what is crucial, he added, is the counseling before and after the test, including follow-up visits and referrals when necessary.

Kelly worries about the standard of counselors under the broad new campaign, and says there is a risk associated with rapid-fire testing and insufficient counseling, citing a mental health survey conducted by his organization of 900 HIV-positive people that found elevated levels of anxiety, depression and other mental health issues.

“Finding out your HIV status is not in and of itself a complete intervention,” he said. “We should not imagine that simply knowing your status is going to lead to HIV prevention or to better access to care or a decrease in the degree of stigma, discrimination and denial.”