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Western Cape Wellness Summit
08 November 2011
Infectious Diseases
Priority actions to address the burden
and to be considered by work groups
Review
• Certain areas, characterised by a ‘deprivation cluster’ of risk
factors, carry a disproportionate burden of HIV and TB disease
• These areas are associated with ‘social vulnerability’ which
creates a high risk environment for HIV transmission
• Our armamentarium is limited to a few bio-medical interventions
• We’re not only trying to prevent new HIV and new TB infections
• We also have a large population of people who are already
HIV-infected, and in whom we are trying to prevent premature
death
• Our challenge is getting the interventions into the high-risk
communities at scale – a challenge of supply and demand
1. Western Cape Burden of Disease report for major infectious diseases, 2007
Priority Actions: Group Accept Strategic Objective 4
priorities of:
•HCT
•Barrier protection methods,
•Male Circumcision,
•ART Services,
•TB case finding
• Which led to a discussion of ‘social
marketing’ and how to do it differently
• Need to move away from the
individual as the locus of change
Priority Actions
• Combination of mass communication and community mobilization
to create a demand and behaviour change. Messages need to
targeted
• Appropriate messages and adequate marketing
• Change community perceptions e.g.
• early ART initiation – “ ARVs are no longer the last resort”
• “HIV disease is a chronic disease not a fatal disease
• Use positive role models to promote empowerment
Priority Actions
• Target key risk populations; include disability
population, prisons, youth (access to schools)
• Need a strategy to deal with migration
• Target high burden areas
UNAIDS suggested high level
strategies…
•
“Highly active HIV prevention inevitably must be combination prevention”
•
“Nothing more important than a focus on young people”
•
“investments should focus on promoting normative and social change to
reduce multiple and concurrent partnerships, and to greatly increase
availability of safe and affordable male circumcision services”
•
“The aggregate effect of radical and sustained behavioural changes in a
sufficient number of individuals potentially at risk is needed for successful
reductions in HIV transmission”
“ Understand but don’t overcomplicate.
Broad rapid brushstrokes are sufficient for action”
How do we work better together
as different sectors
Working together
• True commitment means that sectors and
government departments commit actions and
resources ( based on NSP and PSP)
• Use PAC more effectively as well as other
structures for reporting on actions at all levels
• Measure performance
• In PSP all sectors must identify planned actions – to be costed
Working together
• Invite
more members (identified today) to participate
in SO 4 Work-Group
• Invest in research to bring us together e.g.
surveillance – joint research, community research
in health seeking behaviour, social cohesion and
social capital
• Community strengthening – use right people
Use community structures
Working together
• Consensus on a uniform community M & E System
• High level from political commitment from DOE,
Department of Social Services
• Involve Corporate Sector
Suggested amendments to the
declaration and why?
Priority Actions
Thank you