Mon séjour en Afrique du Sud (Cape Town)

SANDF puts best foot forward in war on AIDS pandemic Strict United Nations resolution encourages member states to implement programmes to combat the disease, often rife among soldiers Deputy Political Editor SINCE Defence Minister Mosiuoa Lekota shocked Parliament with the revelation that at least 23% of military personnel were HIV positive, the South African Military Health Service has ensured that all HIVinfected staff have access to antiretroviral medicines.

At the time of Lekota's announcement in 2003, the cabinet had just decided to initiate the Herculean task of providing HIV-positive South Africans with comprehensive clinical management of their illness.

Because the foreign deployment of troops is of strategic importance to government, which is heavily involved in peace missions on the African continent, it is essential that the South African National Defence Force implement an HIV programme to address the concerns of the United Nations (UN).

The UN Security Council passed a resolution in July 2000 calling on member states to address the HIV epidemic in the military, saying the military community was considered a high-risk environment for HIV transmission. The UN considers military populations as being among the communities most susceptible to HIV infection.

Some of the risk factors increasing their susceptibility are the fact that they are mostly young and sexually active; are often away from their homes; are governed more by peer pressure than social convention; are inclined to feel invincible and take risks; and are surrounded by opportunities for casual sex.

In addition, HIV transmission is considered to occur with higher frequency where other sexually transmitted infections (STI) are present.

Peacetime STI infection rates among military populations have been found to be two to five times higher than in civilian societies.

Evidence suggests that some soldiers consider the acquisition of an STI to be a symbol of sexual prowess and proof of their manhood. According to the UN, the military risk for acquiring STIs increases by as much as 100 times that of civilians during wartime.

The African Union (AU) has adopted the UN resolution and called on its regional bodies, the Economic Community of West African States (Ecowas) and the Southern African Development Community (SADC) to respond.

The South African Military Health Service launched Project Phidisa (Heal) in 2003, with the co-operation of the US departments of defence and health and human services; and senior defence force officers in Ecowas and SADC countries.

They devised a plan aimed at prevention, treatment, care, support, research, monitoring and surveillance.

Soldiers are not forced to take an HIV test, but those who volunteer for testing receive comprehensive support, along with their partners, at the state's expense.

However, so far the South African pilot programme has only attracted 2000 members of the SANDF. Project Phidisa operates three clinics across SA. One more will be launched on August 15 and a fifth site is planned for opening at the beginning of next year. Addressing the third annual Phidisa conference in Cape Town last week, Deputy Defence Minister Mluleki George expressed optimism that, in time, the clinics would provide the entire country with answers to difficult questions of the appropriateness, effectiveness and efficacy of the clinical management of HIV and AIDS. The clinics will serve as a research base with biomedical and public health research capacity. The SANDF is using the facilities to address other health issues of critical importance for military force preparedness and that can be of wider relevance to the South African health services, says George.

He says the project aims to find answers to the critical problems of the safe use of antiretroviral agents in the management of AIDS.

It will also build capacity within the military health services to conduct research on other infectious diseases.

SANDF spokesman Lt-Col Louis Kirstein says the soldiers are not being used as guinea pigs all participants enter the programme voluntarily with and understand its objectives.

The success rate of the project has not yet been quantified, and the defence department will not disclose the expenses incurred. However, George says it has the full support of the state and the defence ministry.

George says that the SANDF's surgeon general, Lt-Gen Vijay Ramlakan, will redouble the efforts to staff the project adequately and ensure that all six sites are performing above expectation.