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Western Cape Wellness Summit08 November 2011Infectious Diseases
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Priority actions to address the burden and to be considered by work groups
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• 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
Review
1. Western Cape Burden of Disease report for major infectious diseases, 2007
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Priority Actions: Group Accept Strategic Objective 4 priorities of:
•HCT
•Barrier protection methods,
•Male Circumcision,
•ART Services,
•TB case finding
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• 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
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Priority Actions
• Combination of mass communication and community mobilization to create a demand and behaviour change. Messages need totargeted• 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
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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
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• “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”
UNAIDS suggested high level strategies…
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How do we work better together as different sectors
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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
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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 researchin health seeking behaviour, social cohesion and social capital• Community strengthening – use right peopleUse community structures
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Working together
• Consensus on a uniform community M & E System
• High level from political commitment from DOE,
Department of Social Services
• Involve Corporate Sector
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Suggested amendments to the declaration and why?
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Priority Actions
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Thank you