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The first Southern African HIV Clinicians Society meeting that I attended was in or around 2002, at the Pharmaceutical Society in Glenhove Road. Professor Gary Maartens spoke on isoniazid preventive therapy, and the room was full (it was the last meeting in that too-small venue). The initial function of the Society was to help a group of private doctors to better manage HIV infections.

In the dark years, it seemed unlikely that ART would ever be affordable and available in either the public or private sectors. I was working in a public service clinic, and all we could do was treatment and prevention of opportunistic infections. ART was for a select few with money or taking part in research trials. Then, on 1 April 2004, the first patients accessed therapy from the government programme. For months after that, I went and opened the pharmacy cupboards – just to look at the medicines. The atmosphere at the clinic changed; while people arrived very ill, many got better. Informal support groups formed. I remember celebrating the first 1 000 patients on treatment at our clinic. Today, over 15 000 people receive treatment there.

South Africa now has the largest ART programme in the world, with some 1.5 million on treatment. The DoH, under the leadership of Dr Aaron Motsoaledi, commenced the largest-ever HIV testing campaign last year, and over 15 million South African were tested for HIV. There has been a reduction in mother-to-child transmission to 3.5%.

So do we have it all sorted out, and is there no need for a Southern African HIV Clinicians Society? What are the present challenges? What role will I play as President? I have always seen the function of the Society as pushing the boundaries and leading the way in getting the best possible care to HIV-infected South Africans. We must ensure that our guidelines for all aspects of HIV care and prevention are challenged and aligned with international guidelines. Research in South Africa is of the highest standard. Our researchers have been involved in many of the latest breakthroughs in HIV, including early treatment for infants (CHER), the use of treatment as prevention (HPTN052) and microbiocides (CAPRISA 004). As soon as any research breakthroughs are made, we in the Society need to assist the DoH to implement them. And TB must receive more attention. South Africa's TB incidence is high – second only to Swaziland’s – and we rank fourth-highest in the world in multidrug-resistant TB incidence. This huge increase in TB has been driven largely by HIV infection. It seems a great pity to have made such massive progress in HIV treatment, and then lose our people to TB.



Southern African HIV Clinicians Society


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