HIV/Aids in South Africa timeline 1940s-2009

1940s

The oldest Human Immunodeficiency Virus-2 (HIV-2) jumps from animals to humans, according to a Washington-based study in May 2003. Some sources say that the jump of the disease from animals to humans was made even earlier in the 1930s, others claim it was later than the 1940s. 

1959

In Kinshasa, Democratic Republic of Congo, a seemingly healthy man walks into a hospital clinic to give blood for a Western-backed study of blood diseases. 25 years later in the 1980s, researchers studying the spreading Acquired Immuno-deficiency Syndrome (AIDS) epidemic, take a second look at the blood and discover that it contains HIV, which is the virus that causes AIDS.

1970s

African doctors see a rise in opportunistic infections and wasting, but Western scientists and doctors remain ignorant of the growing epidemic.

1981

This year is usually referred to as the beginning of the HIV/Aids epidemic in the USA as the first cases of rare pneumonia (Pneumocystis carinii pneumonia or PCP) in young gay men are reported in California and New York(later found to be HIV/Aids).  At this stage doctors believed that the disease only affected gay men.

December, It becomes clear that the disease affects other population groups, when the first cases of PCP are reported in injecting drug users. At the same time the first case of AIDS was documented in the UK.

1982

Aids is reported in several European countries.

In Uganda, doctors were seeing the first cases of a new, fatal wasting disease. This illness soon became known locally as 'slim'.

Community organisations in the UK and USA begin promoting safer sex among gay men.

The first official case of AIDS in South Africa is reported. A South African man contracted the virus while in California, USA.

June, A report of a group of cases amongst gay men in Southern California suggested that the disease might be caused by an infectious agent that was sexually transmitted. Later on in the same month, Aids is reported among hemophiliacs and Haitians in the USA.

September, The USA’s Centre for Disease Control and Prevention (CDC) formally establishes the term “Acquired Immune Deficiency Syndrome” (Aids).

December, A 20-month old child who had received multiple transfusions of blood and blood products died from infections related to AIDS. This case provided clearer evidence that AIDS was caused by an infectious agent, and it also caused additional concerns about the safety of the blood supply. Also in December, the CDC reported the first cases of possible mother to child transmission of AIDS.

1983 

January, Reports of AIDS among women with no other risk factors suggested the disease might be passed on through heterosexual sex.

March, The CDC stated that, "persons who may be considered at increased risk of AIDS include those with symptoms and signs suggestive of AIDS; sexual partners of AIDS patients; sexually active homosexual or bisexual men with multiple partners; Haitian entrants to the United States; present or past abusers of IV drugs; patients with haemophilia; and sexual partners of individuals at increased risk for AIDS."

Luc Montagnier

May, Scientists at France's Pasteur Institute, led by Luc Montagnier, isolate the lymphadenopathy-associated virus (LAV), later to become known as Human Immunodeficiency Virus or HIV.

October, First European World Health Organisation (WHO) meeting was held in Denmark. At the meeting it was reported that there had been 2,803 AIDS cases in the USA.

November, First meeting to assess the global AIDS situation is held. This was the start of global surveillance by the WHO and it was reported that AIDS was present in the U.S.A., Canada, fifteen European countries, Haiti and Zaire as well as in seven Latin American countries. There were also cases reported from Australia and two suspected cases in Japan.

1984

Researchers who had visited Central Africa in late 1983 reported they had identified 26 patients with AIDS in Kigali, Rwanda, and 38 in Kinshasa, Zaire. The Rwandan study concluded that, "an association of an urban environment, a relatively high income, and heterosexual promiscuity could be a risk factor for AIDS in Africa". The Zairian study found there to be a "strong indication of heterosexual transmission".

In light of these findings the Zairian Department of Public Health, in collaboration with American and European scientists, launched a national AIDS research programme called Project SIDA.

First small-scale needle and syringe exchange project starts in Amsterdam, the Netherlands (more projects started in 1985 as a result of growing concerns about HTLV-III/LAV).

23 April, US scientist Robert Gallo announces he has isolated the virus, calling it HTLV-III, but it becomes clear that the agent is the same as LAV, identified a year earlier in France.

1985 

China reports its first HIV/Aids case; this means that at least 1 HIV/Aids case has been reported from each region of the world.

In many countries a separate "epidemic of fear" and prejudice begins e.g. In the US, it was feared that drinking communion wine from a common cup could transmit AIDS, and Ryan White, a 13-year old hemophiliac with AIDS, was barred from school.

"This is not a setting for AIDS" awareness campaign poster by AVERT. The copyright owner of this image is New York State Health Department ©.

The CDC removed Haitians from their list of AIDS risk groups, in light of information that suggested both heterosexual contact and exposure to contaminated needles played a role in transmission.

First deaths from AIDS occur in South Africa.

Knowledge of transmission routes changes again, when the first report appeared of the transmission of the virus from mother to child through breast feeding.

Western scientists became much more aware of the "slim disease" that had become increasingly common in South West Uganda since 1982. Studies found that most cases were among promiscuous heterosexuals, the majority of whom tested positive for antibodies to HTLV-III/LAV. The site and timing of the first reported cases suggested that the disease arose in neighboring Tanzania. Some scientists who studied slim concluded: "Although slim disease resembles AIDS in many ways, it seems to be a new entity."

January, U.S Food and Drug Administration (FDA) licensed, for commercial production, the first the first HIV test for screening blood supplies.

April, First International Aids Conference is held in Atlanta, USA (Hosted by US Department of Health and Human Services and the World Health Organisation (WHO)).

October, Movie actor Rock Hudson becomes first major public figure known to have died of Aids.

1986 

Calls begin for a global education campaign on condom use and HIV/Aids prevention.  

Uganda begins promoting sexual behaviour change in response to AIDS.

By the end of the year, 85 countries had reported 38,401 cases of AIDS to the World Health Organisation. By region these were: Africa 2,323, Americas 31,741, Asia 84, Europe 3,858, and Oceania 395.

May, "The name of the virus had itself become a political football as the French insisted on LAV (lymphadenopathy-associated virus), while Gallo's group used HTLV-3 (human T-cell lymphotropic virus, type 3)." - Time Magazine
The International Committee on the Taxonomy of Viruses ruled that both names should be dropped and the dispute solved by a new name, HIV (Human Immunodeficiency Virus).

September, Clinical trial tests show that a drug called azidothymidine (AZT) slowed down the attack of HIV

1987

The first anti-retroviral drug is approved in the USA.

US President Ronald Reagan, who had been accused of neglecting Aids, delivers speech that describes the disease as "public enemy No.1." and the American government conducts a national AIDS education campaign.

US FDA sanctions first human testing of candidate vaccine against HIV.

President Kenneth Kaunda of Zambia announces his son has died of Aids, a landmark in the campaign against stigma in Africa.

The apartheid government recognized that HIV and AIDS had the potential to become ‘a major problem’, even though there were few reported infections.

African Research and Educational Puppetry Programme (AREPP) is founded as a community-based educational trust in South Africa. It is used to break down racial, cultural, language and educational taboos and barriers on HIV/AIDS at a time in South Africa’s history, HIV/AIDS posed a threat that had not yet been fully realized.

Health ministers meet to discuss AIDS and establish a World AIDS Day.

In England the first specialist AIDS hospital ward was opened by Princess Diana. The fact that she did not wear gloves when shaking hands with people with AIDS was widely reported in the press.

1988

World Aids Day first declared by WHO on 1 December.

UNAids reports that the number of women living with HIV/Aids in sub-Saharan Africa exceeds that of men. 

The AIDS Foundation of South Africa is established as an agency seeking to identify and develop initiatives, which reduce the impact of AIDS in under-resourced communities.

HIV/Aids in South Africa timeline 1990-1995

1990

Jonathan Mann resigned as the head of the WHO AIDS programme, to protest against the failure of the UN and governments worldwide to respond adequately to the exploding pandemic, and to protest against the actions of the then WHO director-general Dr. Hiroshi Nakajima. During Jonathan Mann's leadership, the AIDS programme became the largest single programme in the organisation's history.

Death of Ryan White, a young American HIV-infected haemophiliac who’s barring from school because of HIV infection unleashed a campaign against Aids prejudice.

The National Antenatal HIV/AIDS Survey is started by the Department of Health in Pretoria.

ANC leader Chris Hani, speaking from exile, warned: Existing statistics indicate that we are still at the beginning of the AIDS epidemic in our country. Unattended, however, this will result in untold damage and suffering by the end of the century.”

Worldwide protests against the ban on HIV positive people entering America.

Reports emerge that a large number of children in Romanian hospitals and orphanages have become infected with HIV as a result of multiple blood transfusions and the reuse of needles. Jonathan Mann, the head of the WHO's Global programme on AIDS, noted that 'Eastern Europe is the new frontier for the AIDS epidemic'.

1991

The South African Department of Health commissions an advertising agency to develop an advertising campaign. The agency incorporates a yellow hand and the slogan “AIDS, don't let it happen”. 

Red Ribbon

The ‘Red Ribbon’ is introduced as the International symbol of Aids awareness at the Tony Awards by Broadway Cares, Equity Fight Aids and Visual Aids.

Death of Freddy Mercury, lead singer with rock group Queen.

US basketball star Earvin "Magic" Johnson announces he has HIV.

Thailand launches Asia’s most extensive HIV prevention programme.

1992 

In the USA Aids becomes the no1 cause for death among men aged 25-44.

Soul City, a project of the Institute of Urban Primary Health Care, a South African non-governmental organization is established.

January, The Department of Health requests the South African Law Commission to investigate how the law relates to HIV-infected persons.

1993

AZT is shown to be of no benefit to those in the early stages of HIV infection.

The South African National Health Department reports that the number of recorded HIV infections had grown by 60% in the previous two years and was expected to double in 1993. A survey of women attending health clinics indicated that nationally some 322,000 people were infected.

Justice Edwin Cameron, a judge of the South African Supreme Court of Appeal founds the Aids Law Project (ALP), which forms part of the Centre for Applied Legal Studies (CALS) at the University of Witwatersrand in Johannesburg.

[Read more: Cameron, E (date unknown) Legal and Human Rights responses to the Hiv/Aids epidemic, prepared for a Court of Appeal exposition]

The South African Law Commission reports that the Constitutional Act, 200 regulates the protection of the fundamental rights of the individual and prohibits unfair discrimination against any person infected or affected indirectly/ directly by HIV/AIDS.

1994     

Studies show AZT can dramatically cut mother-to-child transmission of HIV.

Talking Hands Puppet Company works with over 100 pupils in schools in Grahamstown to outline the issue of HIV/AIDS in South Africa.

Infant HIV infections begin to fall in developed countries, due to use of AZT.

1995 

The Joint United Nations Programme on AIDS (UNAIDS) is established.

First protease inhibitor saquinavir (which reduces the ability of AIDS to spread to new cells), is approved in the USA ushering in a new era of highly effective anti-retroviral therapy (HAART).

The Department of Health in South Africa introduces the ‘red ribbon' logo, which implies a new struggle in the fight against HIV/AIDS.

HIV/Aids in South Africa timeline 1996-2000

1996 

Ms Rose Smart is appointed as Director of HIV/AIDS and Sexually Transmitted Illnesses (STIs) in the South African Department of Health. 

Brazil becomes the first developing nation to distribute ARVs. In other developing countries, only a small minority could access treatment for HIV.

International Aids Vaccine Initiative, an NGO, forms to help speed the search for an effective HIV/Aids vaccine.

Aids related deaths in the USA decline by more than 40% compared to the prior year thanks to HAART.

AIDS researcher Dr. David Ho is named Man of the Year by Time magazine. Recognizing the dynamic nature of HIV replication in the body, Dr. Ho and his coworkers were early proponents of combination antiretroviral therapy, including protease inhibitors.

Dr David Ho, Man of the Year, December 1996 TIME magazine cover

1 December, The Department of Health hosts a special event; the National World AIDS day in Bloemfontein, Free State. In Pretoria, the theme is “One world, One hope”.

1997

Number of Aids deaths drops in the US for first time since 1981.

25 March, The Department of Health's National HIV/AIDS and STI Directorate hosts a Workplace Forum on HIV/AIDS in Johannesburg.
8 August, The Department of Health hosts a Johannesburg press conference for the National consultation on HIV/AIDS and STI review, to develop a common vision for an expanded response to the epidemic.

October, Dr N C Dlamini-Zuma establishes the Interdepartmental Committee (IDC) as a mechanism to facilitate and strengthen the response to HIV/AIDS by Government departments at all levels.

1998 

First large scale human trials for an HIV/Aids vaccine begin.

Despite early optimism several reports indicate growing signs of treatment failure and side effects from HAART.

16 June, The National AIDS Programme in the Department of Health and National Youth Commission launches an HIV/AIDS youth awareness initiative. 

2 October, Members of Executive Councils of Health from various provinces take a decision not to introduce an Azidothyminide (AZT) regimen to AIDS sufferers in South Africa.

27 October, Research shows that about 34% of pregnant women pass on the HIV virus in the last stage of their pregnancy and through breastfeeding.

10 December, The Treatment Action Campaign is launched at St George Cathedral, Cape Town on International human rights day. This grassroots movement begins pushing for access to treatment.

1999 

Nevirapine becomes the drug of choice for preventing mother-to-child transmission.

First human vaccine trial in a developing country begins in Thailand.

Zapiro cartoon. Source: google images

Manto Tshabalala-Msimang becomes South Africa’s Health minister (until 2008), her term is riddled with controversy  because of her emphasis on treating South Africa's AIDS epidemic with vegetables such as garlic and beetroot, rather than with western antiretroviral medicines, was the subject of international criticism.

29 September, Religious leaders partner with government against HIV/AIDS. (initiative by Rev. S Tshelane)

9 October, The religious leaders pledge to take HIV/AIDS to the pulpit and other places of worship as part of activities to observe the first birthday of the Partnership Against HIV/AIDS.

2000 

Southern Africa becomes the epicenter of what is now a global pandemic.

In Botswana, up to one in four adults and 40% of pregnant women have HIV.

The Clinton Administration formally declared HIV/AIDS to be a threat to U.S national security. The United States government believed that the global spread of AIDS was reaching catastrophic dimensions that could topple foreign governments, spark ethnic wars and undo decades of work building free-market democracies abroad. It was the first time the National Security Council was involved in fighting an infectious disease.

Drugs companies start to cut prices of AZT for poor countries. But Treatment provision remained non-existent in South Africa.  

January, The partnership is formalized by South African National Aids Council (SANAC) to review its two years of work against HIV/AIDS, under the leadership of Deputy President Jacob Zuma.

9 July - 14 July, 13th International AIDS conference is held in Durban, KwaZulu-Natal (The first time the conference is held in a developing country), heightening awareness of the global pandemic. Nkosi Johnson, an eleven year old HIV-positive boy, gave a speech in the opening ceremony of the conference and called for the government to give AZT to pregnant HIV-positive women. Mbeki used his opening address at the conference to stress the role of poverty in explaining the problems faced by Africa.

Later, Mbeki stated in an interview with the Time Magazine that he did not think that HIV alone caused AIDS.
"Clearly there is such a thing as acquired immune deficiency. The question you have to ask is what produces this deficiency. A whole variety of things can cause the immune system to collapse”¦ But the notion that immune deficiency is only acquired from a single virus cannot be sustained. Once you say immune deficiency is acquired from that virus your response will be antiviral drugs. But if you accept that there can be a variety of reasons, including poverty and the many diseases that afflict Africans, then you can have a more comprehensive treatment response." – Thabo Mbeki

Mbeki’s staments cause a national and international outcry.

October, President Mbeki announced his withdrawal from the scientific and public debate on the causes of AIDS after admitting that he had created confusion in South Africa.

HIV/Aids in South Africa timeline 2001-2005

2001 

Indian drugs company Cipla vows to make cheap generics of Aids medications, putting pressure on multinationals to cut prices further.

HIV/Aids protest in Pretoria, 2001.

UN Secretary General Kofi Annan calls for an Aids "war chest" of between seven to 10 billion dollars per year, compared to the one billion currently being spent.

Aids becomes leading cause of death in sub-Saharan Africa.

13 March, Mr. Tony Leon, Leader of the Democratic Alliance, speculates on the declaration of an AIDS-related national emergency from the Department of Health and the Presidency. 

18 March, The Department of Health declines the offer of a large donation of HIV test kits made by Guardian Scientific Africa Incorporated.

28 March, Dr Molefi Sefularo, MEC for Health in the North West province claims that North West province shows a decrease in HIV infection.

11 April, Pfizer Inc. agrees to supply AIDS patients attending public hospitals with an unlimited two-year supply of fluconozale.

World renowned aids activist, Nkosi Johnson

June, World renowned aids activist, Nkosi Johnson (right), born 4 February 1989 dies.

4 July, South Africa comments on United Nation's session on HIV by declaring highlights of poverty, underdevelopment and illiteracy as main contributing factors to the spread of HIV/AIDS. 

August, AIDS activists took legal action against the South African health ministry over its continuing refusal to supply antiretrovirals to prevent mother-to-child transmission (MTCT) of HIV.120 In December, it was ruled that the South African government should give pregnant women free access to the drug nevirapine. The judge ordered the government to set up a nationwide MTCT programme with a deadline for an implementation report to be handed back to the court by March 2002.

September, A national HIV and Syphilis sero-prevalence survey is made in South Africa. The survey reports that care and support will sustain the momentum in prevention activities. The objective of the survey is to estimate the HIV prevalence in South Africa in 2001 and current trends in HIV prevalence from 1990 and 2001 among pregnant women. 

October, Mr. Trevor Manuel announces in his Medium Term Budget Review that HIV/AIDS funding would be increased through funding for the dedicated national AIDS programmes (communication, research & condoms)

9 October, Partnership Against AIDS 3rd anniversary is celebrated by communities at New Brighton, Port Elizabeth (President Thabo Mbeki launches)

11 October, Statistics SA leads the Interdepartmental Task Team on Mortality to give effect to a Cabinet decision to prioritize work on the collection of HIV/AIDS related mortality data.
16 October, The South African Medical Research Council releases a report on AIDS-related mortality in adults. 

19 October, The Presidential AIDS Advisory Panel, which conducted the bulk of its work in 2000, identifies a number of potential areas for research and the first one is the study of HIV testing.  

21 November, The South African Government unveils World AIDS Day 2001 campaign, “I care enough to act, do you?” which is derived from the international theme “I care, do you?” 

28 November, The South African Government and the South African Broadcasting Centre have a newly strengthened partnership in recognition of the socio-economic impact of HIV/AIDS in South Africa. 

2002

HIV/Aids is the leading cause of death worldwide among those 15-59.

The Global Fund is established to boost the response to AIDS, TB and malaria.

Botswana became the first African country to begin providing antiretroviral treatment through the public sector.

The WHO published guidelines for providing antiretroviral drugs for treating HIV infection in resource poor countries. They also released a list of 12 essential AIDS drugs. These two moves were seen as "vital steps in the battle against the AIDS pandemic [that] should encourage both industrialised and developing country governments to make HIV treatment more widely available."
31 January, Dr Eric Goemaere of Medicine Sans Frontieres claims that Khayelitsha was setting a good example for effective antiretroviral therapy with a pilot programme that started in May 2001.

February, 18 National Prevention of Mother-to-Child Transmission (PMTCT) pilot sites are implemented to help improve the effectiveness and efficiency of PMTCT services and to inform any planned expansion of the programme.

22 February, Minister Manto Tshabalala-Msimang and Gauteng premier Mr. Mbazima Shilowa meet to clarify recent public pronouncements around the issue of HIV/AIDS and the programme against mother-to-child transmission.
March, The Traditional leaders AIDS programme, joining traditional leaders and other sectors, is launched.

17 March, The date (2 May) is set for the National Constitutional Court to address the South African government's appeal against a High Court order that the public health sector provide the anti-retroviral drug Nevirapine, to reduce mother-to-child transmission on HIV.

27 March, National Health Minister Manto Tshabalala-Msimang approaches the National Constitutional court on the ordering of the anti-retroviral drug nevirapine to the South Africans who need it. 

April, A programme is launched to form a partnership with organizations operating in high-risk environments, such as taverns, bars and shebeens.

17 April, The South African National Government Cabinet receives a comprehensive briefing on the implementation of government policy on HIV/AIDS. The meeting reiterates government's commitment to the HIV/AIDS and STI strategic plan for South Africa. 

19 April, Health workers will continue to get HIV/AIDS anti-retroviral drugs for needle stick injuries, despite a decision by the ANC's National Executive Committee that this practice should stop.
May, An awareness campaign is launched with commuters and drivers in trains, taxis and buses on HIV/AIDS-related issues.

20 May, Health Minister Manto Tshabalala-Msimang announces at a meeting of the World Health Assembly in Geneva that South Africa pledges R20 million to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. 

28 June, Cosatu and the Treatment Action Campaign (TAC) are to table a national HIV/AIDS treatment plan in the National Economic, Development and Labour Council (Nedlac) following the first national treatment conference, which concluded in Durban.

10 July, Based on existing resources, South Africa can ‘easily afford’ to provide HIV/AIDS anti-retroviral therapy to between 60 000 and 70 000 people in the next five years. This is the conclusion from a study by Dr Chris Kenyon of the Health Systems Trust and Dr Andrew Boulle, a registrar in the School of Public Health at the University of Cape Town, presented at the 14th World Conference on AIDS in Barcelona.

An international group of AIDS specialists finalize the setting up of a clinic in Sharpeville that will offer services such as the prevention of mother-to-child transmission, treatment of opportunistic infections and anti-retroviral therapy.

15 July, Former president Nelson Mandela calls on government and business leaders worldwide to find ways to provide access to treatment to those who need it, for all people living with HIV/AIDS.

30 July, Instead of waiting for resources from national government on how to deal with HIV/AIDS, McCord Hospital in Durban implements its own fund-raising plans, driven by people living with the disease.

8 August, The South African National Government Cabinet announces the go-ahead for an HIV/AIDS anti-retroviral roll-out plan.

9 August, South African women continue to make strides in their attempts to find HIV/AIDS health care solutions in needy communities. Two women doctors from two South African provinces win the 2002 Shoprite Checkers/SABC2 Woman of the Year Awards for their dedication to the communities they serve.

12 August, South Africa added three signatures to the document authorizing the Global Fund to release a multi-million Rand grant to combat AIDS, TB and Malaria. The recipients are the Enhanced Care Initiative in KwaZulu-Natal, LoveLife and Soul City.

25 August, The Medicines Control Council (MCC) threatens to de-register the HIV/AIDS anti-retroviral Nevirapine unless further studies and appropriate documentation can show its efficacy in the prevention of mother to child transmisssion of HIV. Dr. Glenda Grey of the Peri-Natal HIV Research Unit at Chris Hani Baragwanath Hospital argues that enough evidence has already been presented.

9 September, Dr Khwezi Matoti who runs the AIDS clinic at the Gugulethu Day Hospital publicly explains when antiretroviral drugs become necessary.

15 September, An antenatal survey is conducted by the Department of Health the first since 1990. An internationally recognized tool for estimating the magnitude, growth and spread of the HIV epidemic over time, the latest South African survey reveals that 5,3 million people in this country are living with HIV or AIDS.

9 October, On the 4th anniversary of the Partnership Against AIDS, a campaign initiated by the Cabinet, an appeal is made to all to build on the progress that has been made in the fight the epidemic.
10 October, SA President Thabo Mbeki is publicly opposed to the provision of AIDS drugs in South Africa, rguing that they are dangerously toxic and still questioning whether HIV or poverty is the true cause of AIDS. Click here to see a ‘letter from the president’ on health and poverty (April 2002) Jonas please put a picture of Thabo Mbeki in here

25 October, During a period of great controversy over HIV/AIDS treatment in South Africa, health minister Manto Tshabalala-Msimang attends the 2nd National Health Providers' Prayer Day, which is intended to take care of the ‘inner person and uplift the soul’.

21 November, The South African Government issues a statement on mortality statistics, taking the five leading underlying causes of death among South Africans as HIV, TB, Influenza, Unnatural causes, and Ill-defined causes. 

5 December, The results of the survey by the Human Sciences Research Council (HSRC) and Nelson Mandela Foundation give cause for hope as well as reason to intensify action to combat HIV/AIDS through implementation of a comprehensive programme.

2003 

US President George Bush unveils plans to spend 15 billion dollars over five years to combat Aids in Africa and Caribbean.

First HIV vaccine to undergo a full trial proves to be a flop.

New WHO Director General Lee Jong-Wook names Aids his top priority, calls for three million poor people to get access to antiretrovirals by end of 2005.

Cost of antiretrovirals falls, helped by World Trade Organisation (WTO) deal allowing poor, vulnerable countries to import generics. SA Government announces a new ARV treatment programme.

HIV transmission through injecting drug use was said to have been almost eliminated in France, Germany and the UK, and significantly reduced in Spain and Italy.

Vatican cardinal Alfonso Lopez Trujillo stated that condoms were not safe and did not protect against the transmission of HIV. In response the WHO said that it was "totally wrong" to claim that condoms did not protect against HIV.

January, Reports suggested that the rate of HIV in Swaziland was the world's highest with almost four out of ten adults infected. Prime Minister Sibusiso Dlamini said that prevalence had risen to 38.6% from 34.2% in January 2002. Although this figure was just under Botswana's rate of 38.8%, health officials said that Swaziland's figures were already out of date.

21 January, Health minister Manto Tshabalala-Msimang and the SADC Health Sectoral Committee meet and discuss the nutrition management of debilitating diseases including HIV/AIDS.
26 February, The cost of a state supported HIV/AIDS anti-retroviral programme in its most expensive year could be below R10-billion and still be highly effective, according to calculations by the Treatment Action Campaign (TAC) and researchers at the University of Cape Town (UCT).

27 February, It is announced in the National budget documents that investigations into the introduction of a national anti-retroviral programme for South Africans living with HIV/AIDS are far advanced and recommendations are close to finalization.

March, Treatment Action Campaign (TAC) filed manslaughter charges against the health minister and the trade and industry minister in South Africa. The TAC held the ministers responsible for the deaths of 600 people a day whose lives could have been saved if they had had access to antiretroviral drugs.

20 March, Universal access to Highly Active Anti-retroviral Therapy (HAART) will become an inevitable reality in South Africa over the next three to seven years, according the South African Health Review.

10 April, Health activists address the R13-million shortfall faced by the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria. By launching the “Fund the Fund” campaign they aim to pressure wealthy nations to contribute urgently needed funds.

13 May, The Minister of Health presents her budget speech to the National Assembly outlining that free health care will be extended to people with disabilities.

19 June, The South African AIDS Vaccine Initiative (SAAVI) announces that the South African Medicine Control Council had approved the first human clinical trial for a Phase I HIV vaccine trial in Durban and Soweto, South Africa. 

24 June, Government's budget of R92 million for Khomanani, the government's HIV/AIDS communication campaign, is due to end in three months. The announcement is met with queries over whether the money was well spent.

4 August, Protesters with placards reading "Save Our Youth, Save Our Future, Treat AIDS Now" jeer and heckle Health minister Dr. Manto Tshabalala-Msimang at a national AIDS conference in Durban, to protest the government's response to the disease, which, it is estimated, kills 600 South Africans a day. 

8 August, A South African cabinet meeting decides to roll out a national treatment plan for HIV/AIDS sufferers.

12 August, Two long accepted facts across the globe: that HIV causes AIDS, and that anti-retroviral drugs can retard the progress of the disease, are for the record, at last acceded to by the South African government. 

September, ‘Personally, I don't know anybody who has died of AIDS', President Thabo Mbeki tells The Washington Post. Click here to read more...

25 September, Treatment Helpline Direct stated that a person with the Human Immuno-deficiency Virus (HIV) could live healthily for a number of years. Anti-retroviral (ARV) drugs are needed only at a certain stage of the disease, when a person's immune system becomes too weak to resist infection. Blood tests to measure the strength of a patient's immune system (CD4 count) and the amount of HIV in their body (viral load) need to be done before taking ARV drugs.

26 September, Two South Africans are appointed to a high-profile Commission on HIV/AIDS and Governance in Africa (CHGA). The University of Natal's Professor Alan Whiteside and World Bank managing official Dr Mamphele Ramphela are members of the 20-person commission, chaired by Executive Secretary of the Economic Commission for Africa K. Amoako, and established at the behest of United Nations Secretary-General Kofi Annan. The Commission's mandate is to study the impact of HIV/AIDS on African state structures and economic development and to identify threats to governance. It will report back in June 2005.

3 October, Justice Edwin Cameron says ‘a miracle happened and I want that miracle to be available to other people where they can be given their lives back'. He advocates rolling out of ARVs to HIV/AIDS sufferers.

6 October, The HIV/AIDS activism organization Treatment Action Campaign, is awarded the prestigious Nelson Mandela Award for Health and Human Rights.

7 October, At least one-fifth of South Africa's military is infected with the virus that causes AIDS, and Defense Minister Mosiuoa Lekota states that ‘the South African National Defense Force is no longer accepting HIV positive people into their ranks'.

Treatment Action Campaign chairperson Zackie Achmat starts antiretroviral therapy but lives with the guilt of having access to the life-prolonging drugs while fellow South Africans wait for the roll-out of ARVs in the public health sector.

8 October, According to the Washington Post, South Africa is one of the countries most affected by HIV and AIDS. About 4.7 million people (±11 % of the population) are infected with the virus. Between 600 and 1,000 die each day from the disease and related complications.

15 October, A young Pretoria couple start legal action against 1 Military Hospital for at least R800 000 for trauma and shock, when a doctor admitted a mistake after telling her she was HIV positive. 

19 October, The South African Competitions Commission finds two giant pharmaceutical companies, GlaxoSmithKline South Africa and BoChringer-Ingelheim guilty of abusing their documented prices for their anti-retroviral drugs. 

November, South Africa approved the long-awaited provision of free antiretroviral drugs in public hospitals.

1 December, World Aids Day. Statistics at the time: more than 50 million people living with HIV/Aids globally, 60% of these are in Sub-Saharan Africa. Estimates conclude that about 28.1 million deaths worldwide have occurred, with 5 more people dying every minute. On World AIDS Day the WHO announced a new plan called '3 by 5' to provide HIV/AIDS treatment for many resource-poor countries. The plan had many different elements, but the WHO were not planning to provide the drugs themselves. The WHO was hoping to have 3 million people in resource poor countries on AIDS drugs by the end of 2005.

2004

G8 summit calls for a Global HIV Vaccine Enterprise that will beef up coordination and exchanges of information among the world's vaccine scientists.

The Global Fund to Fight Aids, TB and Malaria holds the first ever “partnership forum” in Bangkok, Thailand. 400 delegates from around the world take part.

UNAids launches the global coalition on Women and Aids to raise the visibility of the epidemic’s impact on women and girls around the world.

South Africa begins the programme to give out free HIV/AIDS drugs after years of confusion and delays. The program starts in Gauteng, where five major hospitals, including Chris Hani Baragwanath, the largest in Africa, were selected to administer the drugs.

A study found that the HIV prevalence rate in Uganda had been reduced by 70% since the early 1990s. It was estimated that half a million Ugandans were HIV positive in 2004, compared with 1.5 million a decade before. It was believed that the reduction in HIV prevalence was due to people having fewer sexual partners as well as to effective prevention efforts in local communities.

President Bush's $15 billion initiative to combat the global AIDS pandemic, by now known as PEPFAR (President's Emergency Plan For AIDS Relief), began full implementation in June, having received its first funding in January.

March, US Food and Drug Administration approved the first oral fluid rapid HIV test

2005

Big scale up in antiretroviral access in poor countries, although result is set to fall far short of WHO's ‘3 by 5’ goal.

In the UK at least, 2005 had been hailed as the ‘Year of Africa’ - the year in which real progress would be made towards relieving poverty and disease in that continent. The UK held the presidency of the European Union for the second half of the year, and in July the UK hosted the G8 (Group of Eight) summit of world leaders in Gleneagles, Scotland. At the summit the leaders promised to double aid to Africa by 2010, and to cancel the debts of 18 poor countries, but no progress was made in improving trade justice, which many groups considered to be the most important issue. However, the leaders were praised for pledging to ensure as near as possible to universal access to antiretroviral treatment worldwide by 2010.

UNAIDS and WHO, in their annual estimate, say Aids killed 3.1 million people in 2005 and some five million people became infected.

The total living with HIV or Aids stands at a record of 40.3 million.

Nelson Mandela announced that his eldest son Makgatho had died of AIDS, aged 54.

Publication of death certificate data from South Africa reveals that the total number of reported deaths had increased by 57% between 1997 and 2002. Among those aged 25-49 years, the rise was 116% in the same six year period. Based on an analysis of a sample of death certificates, the South African Medical Research Council estimats that nearly two-thirds of deaths related to HIV had been misclassified (wrongly attributed to other causes) during 2000-2001.

Skepticism about the cause of AIDS is still thriving in South Africa. The Democratic Alliance gives a list of the country's twelve most influential "AIDS dissidents" (people who question the theory that HIV causes AIDS), whom it said had an "ongoing and bizarrely powerful" influence on national HIV/AIDS policy. The list is headed by attorney Anthony Brink, the convener and national chairperson of the Treatment Information Group and spokesperson for the Dr Rath Health Foundation, an organisation dedicated to promoting the use of vitamin supplements rather than antiretrovirals to treat AIDS. Also featured are President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang.

Zimbabwe, one of the countries worst affected by AIDS, was suffering from a severe economic crisis made worse by droughts and the government's controversial land redistribution programme. One consequence was a sharp rise in the price of AIDS drugs in the public sector.

HIV/Aids in South Africa timeline 2006-2009

2006

UNAids says more than 25 million people have now been killed by Aids. But it revises downwards to 38.6 million the total living today with HIV/Aids and suggests that, except in some countries, the overall infection rate has now stabilised.

UN General Assembly holds special session to assess progress since 2001 Declaration of Commitment.

The first one-a-day pill for effectively treating HIV infection was approved for sale in the USA.

March, The final results of the 3 by 5 initiative are revealed. By the end of 2005, only around 1.3 million people in low- and middle-income countries had been receiving antiretroviral treatment – less than half of the 3 million target. Though this result was highly disappointing, the WHO stressed that it still represented a more than three-fold increase within two years. Of the 152 countries involved in the initiative, only 18 met the target of 50% treatment coverage. Among the worst performers were Russia and India, and among the best was Botswana, where coverage had reached around 85%.

Controversial cartoon or Jacob Zuma which appeared in the Sunday Times, by Zapiro, arguably South Africa’s most prolific, outspoken, best-known and much-awarded cartoonist) Read Guardian article ‘The Price of Free Speech’ about these cartoons.

April, While on trial on a rape charge Jacob Zuma makes his infamous comment about ‘taking a shower straight after sex with his HIV-positive rape accuser as a way of reducing his chances of contracting the virus’. This caused a national and international outcry.

June, The Gates Foundation – the world’s largest private source of funding for HIV and AIDS – receives a substantial boost to its finances, when billionaire Warren Buffet promised to donate $31 billion over ten years. Bill Gates announces that he is stepping down as head of Microsoft to concentrate on the work of the Foundation.

August, The XVI International AIDS Conference is held in Toronto. One major talking point is how to accelerate the expansion of antiretroviral therapy worldwide and in particular how to alleviate dire shortages of healthcare workers in the neediest countries. The conference provided a platform for critics of the South African government’s response to AIDS. Activists protested at the country’s exhibition stand, which was dominated by unproven nutritional remedies, with almost no reference to effective medication. Conference co-chair Mark Wainberg said it was “unconscionable” that South Africa’s leaders would not talk openly about AIDS.

Shortly after the conference, more than 80 prominent international scientists write an open letter to South African President Thabo Mbeki calling on him to sack health minister Manto Tshabalala-Msimang, whom they blame for “disastrous, pseudo-scientific policies” on HIV/AIDS. Instead, the South African government sets up a new inter-ministerial committee to take charge of the national AIDS response, to be headed by the deputy president.

December, South Africa’s deputy health minister Nozizwe Madlala-Routledge decides to speak out against her own government, admitting a “denial at the very highest level” over the country’s AIDS crisis.

US National Institutes of Health reveals the results of two African trials of male circumcision as an HIV prevention method. The studies were halted early for ethical reasons.

2007

January, Dramatic announcement by President Jammeh of The Gambia that he had found a cure for AIDS. Soon revealed to be unfounded.

March, South African Government and representatives of labour, civil society and the private sector, through SANAC, finalised a new Strategic Plan for HIV and AIDS and STIs in South Africa, for 2007 to 2011. Headed up by the deputy president, Phumzile Mlambo-Ngcuka, and the deputy health minister Nozizwe Madlala-Routledge, the plan aimed to try and reduce the number of new infections by fifty percent, and bring treatment care and support to at least eighty percent of all HIV-positive people and their families. The new plan was welcomed by national and international health experts, although it was made clear that in order for the new goals to be realised there needed to be a fast track restructuring of the health care system.

First publication made by the World Health Organisation (WHO) and the Joint UN Programme on HIV/AIDS (UNAIDS) regarding recommendations on circumcision and HIV. The guidance came three months after trials in Uganda and Kenya provided conclusive evidence that circumcision reduces the risk of transmission from women to men by around 50-60%.

July, Reports made of counterfeit antiretroviral drugs (ARVs) flooding the market in Zimbabwe, potentially putting many lives at risk.

August, Optimism regarding South Africa’s response to the AIDS crisis is short lived after as Deputy Health Minister Nozizwe Madlala-Routledge is fired. The official reason for Madlala-Routledge’s dismissal was cited as her inappropriate labeling of infant deaths at Frere Hospital as ‘a national emergency’ and accusations of her attendance at an AIDS conference in Spain without the President’s permission. But it was felt that the underlying motive for her dismissal was her ongoing conflict with Tshabalala-Msimang, the Health Minister, and in particular their contrasting opinions on how to confront AIDS. Manto Tshabalala-Msimang, whose reluctance to embrace lifesaving AIDS drugs had by this stage provoked international rebuke and the derisive nickname Dr. No.

October, It is revealed that hundreds of South Africans who had been involved in an AIDS vaccine trial might have an increased risk of HIV infection as a result.

2008

UNAIDS chief Michel Sidibe, left, reacts with South Africa's health minister Barbara Hogan, right, in Khayelitsha Township, South Africa, February 2009.

A controversial Swiss study claims people adhering to ARVs have a "negligibly small" risk of transmitting HIV through unprotected sex.

June, A team of scientists in South Africa were tried and found guilty by a South African court for conducting unauthorised medical trials and selling unregistered vitamin supplements as a treatment for AIDS. One of the supervisors of the illegal trials, Matthias Rath, was already widely criticised for his promotion of vitamins as a substitute for antiretroviral drugs. The South African court halted the medical trials and banned Rath from advertising his natural AIDS remedies. It also highlighted the responsibility of the South African government and its failure in not preventing Rath from distributing his products.

July, The American PEPFAR funding program was renewed on 30th July, committing $48 billion to HIV/AIDS, malaria and tuberculosis for fiscal years 2009-2013.

September, Thabo Mbeki resigns as South African President and his successor, Kgalema Motlanthe, appoints Barbara Hogan as Minister of Health. She immediately committed government to a concerted and decisive response to the epidemic.

November, Barack Obama is elected President of the United States of America. Obama pledged that he would substantially increase funding to both PEPFAR and the Global Fund. However, commentators have questioned the likelihood of this pledge being followed through in the context of the unfolding international financial crisis.