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2014 SONA claims revisited: Zuma on HIV/Aids

South African president Jacob Zuma is due to deliver his eighth State of the Nation Address in parliament on Thursday. Last year he delivered two State of the Nation Addresses – one before and one after the country’s national elections in May. This report looks back at the claims he made about service delivery.

The claim: “Mother to child transmission of HIV has declined sharply and we have doubled the number of people who are receiving antiretroviral treatment, from one million to 2.4-million people in 2013.”

Our verdict: Largely correct

Mother-to-child transmission of HIV in South Africa dropped from 8.5% in 2008 to 3.5% in 2010 and 2.7% in 2011, a 2013 study published by the World Health Organisation showed. The latest data, released after this speech, shows that 2.2% of infants tested positive for HIV in 2013/2014, a sustained drop.

The second part of Zuma’s claim was misleading. It could have been read to mean that during 2013 the number of people on antiretroviral treatment doubled from 1-million to 2.4-million. That was not the case.

If we assume Zuma was counting from the beginning of his term, the numbers he used start to make sense. Stats SA estimated that there were 1,058,399 adults and 105,123 children receiving antiretroviral treatment in 2010. Using data from the Department of Health, the 2012/13 District Health Barometer estimated that 2,161,170 adults and 148,342 children were on antiretroviral treatment by the end of March 2013, a total of just more than 2.3-million.

However, as the barometer pointed out, the number of adults on antiretroviral treatment could be overestimated if patients are not excluded from counts when, for example, they die or fail to adhere to the programme. Other concerns about the counts had also been raised.

In addition, issues with data quality caused the numbers to be revised downwards in the latest District Health Barometer – to 2,036,666 adults and 140,471, meaning that the actual number for 2013 was only 2.2-million. The 2013/14 barometer showed that in March 2014 a total of 2.6-million people (2,520,206 adults and 150,321 children) were receiving antiretroviral treatment.

The claim: “More than 20 million South Africans have taken the HIV test since the launch of the campaign in 2011 which indicates confidence in the health system.”

Our verdict: It’s actually higher

South Africa’s HIV counselling and testing campaign was launched in April 2010, not 2011. According the country’s health department, the available data suggested that 9.7-million people had been tested by the end of 2010/11.

In 2011/2012 the department claimed that 8.7-million people were tested. In 2012/13, it said close to 9-million people were tested for HIV.

These figures tallied to 27-million people tested, well above Zuma’s claim. However, in April 2013 the department of health introduced a more sensible way of reporting HIV testing – by expressing the people tested as a percentage of all the people in the target group of 15 to 49 years.

This yielded a national HIV testing coverage of 22.8% in 2013/14, which was below the target of 36%, but the department attributed some of the shortfall to the growing pains of recording data in a new way.

Additional reading

Report: President Jacob Zuma’s sixth State of the Nation address fact-checked

Report: Wrapping up the [7th] State of the Nation

Report: Has Jacob Zuma hurt the fight against AIDS more than Thabo Mbeki?

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