The third South African AIDS Conference, held from 5 to 8 June 2007 at the International Convention Centre (ICC) in Durban, adopted a Declaration on HIV and AIDS Prevention, Treatment and Care. It is known as the Durban II Declaration and fully supports the South African National Strategic Plan on HIV, AIDS and STIs, 2007-2011 (NSP)

The following activities have been identified:

1. HIV Testing Strategies

Providing access to voluntary, informed and confidential counselling and testing through:

• Starting a national “Know Your Status” campaign;
• Improving access to all vulnerable groups;
• Developing guidelines for testing of children;
• Implementing national minimum quality standards for counselling and testing that are linked to prevention, treatment and care to all communities; and
  
• Training more lay counsellors to deliver counselling and testing services.

2. Social and Behavioural Interventions

Change behaviour to prevent the spread of HIV through:

• Mobilising society and community leaders to reinforce healthy behaviours and stop substance abuse, gender-based violence, and inter-generational sex;
• Empowering women and girls to take a stand for better male involvement and responsibility for sexual and reproductive health, HIV prevention and support;
• Addressing the risks of concurrent and multiple sexual partners and inter-generational sex;
• Promoting prevention and care for all HIV positive people include men, MSM and sex workers;
• Including HIV prevention information into routine doctor visits for HIV-positive and HIV-negative individuals; and
  
• Monitoring and evaluating behaviour change programmes.

 3. Infant Feeding

Choose the most appropriate and safest infant feeding option for an HIV-infected mother according to her individual circumstances, health status and local health and sanitation services through:

• Encouraging HIV-infected mothers to exclusively breastfeed infants for at least the first six months or longer unless replacement/formula feeding is acceptable, feasible, affordable, sustainable and safe (AFASS).
• Stopping breastfeeding when a nutritionally adequate and safe diet without breast milk can be provided;
• Following up all HIV-exposed infants regularly, and continue to offer infant feeding counselling and support;
• Improving primary health care services to provide better feeding counselling, screening, treatment, care, support and supervision of lactating HIV-positive women;
• Implementing information systems to ensure continuity of care to HIV-exposed infants and ongoing counselling and support to all lactating women;
• Implementing national guidelines, policies and protocols on the supply of formula milk and food parcels; and
• Improving access to treatment, care and support for HIV-positive mothers.

4. Long-Term Effects of Antiretroviral Therapy (ART)

More and safer options of antiretroviral therapy (ART) with fewer or no side-effects are needed to improve chances of survival and quality of life through:

• Training clinical staff to recognise and manage long-term side-effects;
• Supporting further research to determine the incidence, diagnosis and optimal management of side-effects;
• Monitoring adherence and development of resistance;
• Ensuring the availability of less toxic additional antiretroviral drugs for patients prone to side effects; and
  
• Updating treatment guidelines with latest findings and availability of new drugs.

 5. Male Circumcision

Make safe circumcision available and accessible to all men before they become sexually active to reduce the risk of female-to-male HIV infection, as proven by three randomised studies through:

• Developing and implementing a national policy that ensures safe male circumcision within a human rights framework, in consultation and co-operation with traditional, religious and medical circumcision providers;
• Promoting circumcision as part of a comprehensive prevention package that includes condom use and behaviour change;
• Including male medical circumcision in prescribed medical benefits; and
  
• Encouraging men to use health facilities and take part in sexual and reproductive health programmes.

 6. Female Condoms

Encourage the use of female condoms, which are safe and effective to prevent HIV and STIs  through:

• Promoting the use of female condoms, especially among young women; and
• Increasing the supply and range of more affordable female condoms, monitoring the uptake and developing a long-term female condom distribution plan in all provinces.

7. New Prevention Technologies (Microbicides and Vaccines)

Research, test and produce vaccines and microbicides that are safe and effective in preventing HIV infection particularly among youth, women, and infants born to HIV-positive mothers, through a co-ordinated effort by civil society, researchers, and government through:

• Supporting ethical, local research for the development and testing of microbicides and AIDS vaccines,
• Increasing investment for research into new technologies;
• Establishing a national registry of HIV prevention trial participants to prevent enrolment in multiple trials;
• Increasing research on adolescent HIV prevention, and amending the National Health Act to facilitate the enrolment of minors in HIV prevention trials;
• Making prevention technologies accessible and available to adolescents;
• Supporting research on immune correlates of protection; the development of new assays for monitoring immune response, and the automation of laboratory procedures;
• Developing additional HIV prevention trial sites, particularly in under-represented regions of the country, and strengthening clinical laboratory infrastructure at clinical trial sites;
• Building capacity within the Medicines Control Council and other regulatory authorities to review and approve HIV prevention trials.

 Microbicides

• Making effective HIV-prevention microbicides available to those who are most likely to benefit; and
  
• Researching newer generation microbicides for more efficacious products.
  

Vaccines

• Establish local vaccine manufacturing capabilities by means of public-private partnerships to manufacture vaccines for clinical trials in compliance with Good Manufacturing Practice (GMP); and
• Developing local manufacturing capabilities for large-scale AIDS vaccine production.

Click here to read the full version of the Declaration.

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