South Africa, trying to overcome years of denial and delay in confronting its monumental AIDS crisis, is now in the midst of a feverish buildup of testing, treatment and prevention that United Nations officials say is the largest and fastest expansion of AIDS services ever attempted by any nation.

President Jacob Zuma’s H.I.V. test on April 8 appeared in newspapers across South Africa. He disclosed that his test was negative.

The undertaking will be expensive and difficult to pull off, but in the past month alone the government has enabled 519 health facilities to dispense AIDS medicines, more than it had in all the years combined since South Africa began providing antiretroviral drugs to its people in 2004, South African health officials said.

And on Sunday, President Jacob Zuma, who recently admitted to having unprotected sex with a much younger woman, inaugurated a campaign to test 15 million of the country’s 49 million people for H.I.V. by June 2011. In a speech at a hospital east of Johannesburg, he disclosed that his own fourth test again showed he was negative and he said he made the result public “to eradicate the silence and stigma that accompanies this epidemic.”

To hoots and laughter from the audience, and with a touch of humor, Mr. Zuma said, “I’m sure South Africans know I’m open about my life generally.” A photograph of his personal doctor drawing blood from Mr. Zuma’s arm for an H.I.V. test on April 8 had appeared in newspapers across the country.

To broaden access to services, the government has trained the hundreds of nurses now prescribing AIDS drugs — formerly the province of doctors — and will train thousands more so that each of the country’s 4,333 public clinics can dispense the medicines, a step Health Minister Aaron Motsoaledi called essential to combating “this monster amongst us” in a country short of physicians.

Michel Sidibé, executive director of Unaids, the United Nations AIDS agency, said South Africa’s undertakings offered hope to the continent. “It’s the first time one country has scaled up so quickly, to so many people,” he said.

South Africa, the region’s richest nation and a symbol of democracy, has an estimated 5.7 million H.I.V.-positive citizens, more than any other country.

The South African Finance Ministry said it expected that the broadened access to drugs would put a million more people on treatment in the next few years, roughly doubling the current case load. It has budgeted an extra $1 billion for it. Dr. Motsoaledi said that Mr. Zuma reopened the budget to get more money for AIDS when it became clear that costs would be higher.

For the full article: The New York Times


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