S Afr Med J. 2014 Mar;104(3 Suppl 1):249-51. doi: 10.7196/samj.7700.
The story of the AIDS response in South Africa over the past 4 years is one of great progress after almost a decade of complex and tragic denialism that united the world and civil society in a way not seen since the opposition to apartheid. Today the country can boast > 2 million people on antiretroviral therapy, far and away the largest number in the world. Prevention efforts appear to be yielding results. The estimated number of annual new HIV infections declined by 79 000 between 2011 and 2012. New HIV infections among adults aged 15-49 years are projected to decline by 48% by 2016, from 414,000 (2010) to -215,000 (2016). The national incidence rate has reached its lowest level since the disease was first declared an epidemic in 1992, translating into reductions in both infant and under-5 mortality and an increase in life expectancy from 56 to 60 years over the period 2009-2011 alone. This is largely thanks to a civil society movement that was prepared to pose a rights-based challenge to a governing party in denial, and to brave health officials, politicians and clinicians working in a hostile system to bring about change.
过去 4 年来，南非艾滋病应对工作取得了长足的进步。在此之前，南非政府曾对艾滋病问题长达 10 年之久的否认，令全世界和民间社会团结一致，这种情况自反种族隔离运动以来尚属首次。如今，南非有超过 200 万人接受了抗逆转录病毒治疗，这一数字远超世界上其他任何国家。预防工作也初见成效。2011 年至 2012 年间，每年新增艾滋病毒感染人数减少了 7.9 万人。到 2016 年，15-49 岁成年人中新的艾滋病毒感染人数预计将减少 48%，从 2010 年的 41.4 万例降至 2016 年的 21.5 万例。自 1992 年宣布艾滋病为流行病以来，南非的艾滋病发病率达到了历史最低水平，这使得婴儿和 5 岁以下儿童死亡率都有所下降，2009 年至 2011 年期间人均预期寿命从 56 岁增加到了 60 岁。这在很大程度上要归功于民间社会运动，该运动敢于以基于权利的方式向否认艾滋病的执政党提出挑战，也归功于那些在敌对体系中勇敢地为实现变革而努力的卫生官员、政治家和临床医生。
