Despite insufficient funding, the South African National AIDS Council (SANAC) presented a series of measures aimed at combating the pandemic. Dr. Thembisile Khulu, CEO of the SANAC Trust, expressed concern regarding the rate of adolescent pregnancy in South Africa.
During a briefing before the National Council of Provinces on Wednesday, SANAC highlighted three key issues for HIV/AIDS countermeasures. The Council also raised concerns about trends in HIV and sexually transmitted infections (STIs), particularly among individuals aged 13 to 50. It was noted that provinces such as KwaZulu-Natal, Mpumalanga, Free State, and Eastern Cape register the highest number of people living with HIV in the country.
SANAC also identified the main factors contributing to dual infection with HIV and STIs, including adolescent pregnancy, as well as prevention methods for such infections, such as addressing adolescent pregnancy.
Dr. Thembisile Khulu, who leads the SANAC Trust, noted that South Africa has made significant strides in its response to HIV, but progress remains uneven. SANAC identified three priorities: establishing a unified national or provincial coordinating body mandated by the Cabinet; developing a National Strategic Plan (NSP), Provincial Implementation Plans (PIPs), and Municipal District Implementation Plans (MDIPs); and implementing a unified Monitoring and Evaluation (M&E) system for standardized tracking and accountability of results.
Khulu also addressed the interconnected issue: HIV, tuberculosis, STIs, as well as childhood and adolescent pregnancy share common structural, behavioral, and interrelated causes. She called for a multi-sectoral response where prevention integrates biomedical, behavioral, and structural actions across government, the private sector, and civil society.
Furthermore, SANAC proposed an implementation imperative whereby strong and adequately resourced national and provincial AIDS councils, including local structures, must translate the national strategy into coordinated local action. Khulu focused on concentrating the burden, the adequacy of integrating prevention measures, and ways to strengthen SANAC's financial capacity to enhance its effectiveness.
At the NCOP meeting, it was reported that SANAC's annual budget requirement is 84 million rand, funded by the Department of Health and the Department of Social Development (DSD). However, for the 2026/2027 financial year, SANAC only received 50 million rand, which is 60% of the required amount. Khulu stated that they had to seek funds from donors.
According to statistics, South Africa accounts for approximately 20.5% of all people living with HIV (PLHIV) globally. Approximately 8 million people live with HIV in the country, of whom 83% receive antiretroviral therapy (ART), and the country bears 31.2% of the total HIV burden in Sub-Saharan Africa. Khulu noted that the decline in incidence indicates a reduction in new HIV cases over time, suggesting a positive impact from preventive interventions, antiretroviral treatment, and behavior change programs.
According to SANAC data, 6,600 children were newly infected with HIV in 2024. The organization expressed concern over new HIV cases, which are highest in the Eastern Cape, Free State, Mpumalanga, and Limpopo. The increase in births among women aged 10 to 19 was also emphasized—in 2024/2025, 117,195 girls aged 10–19 gave birth. The Eastern Cape, Northern Cape, KwaZulu-Natal, Mpumalanga, and North West provinces remain above the national average. Conversely, the Free State, Western Cape, and Gauteng provinces recorded fewer births among women aged 10 to 19 compared to the national average.
Khulu stated: 'Pregnancy among very young adolescents requires a legislative response approach. The extensive network of the SANAC civil forum needs dedicated, predictable funding to sustain democratic structures and public oversight.' She added that South Africa employs a comprehensive prevention approach that integrates biomedical, behavioral, and structural interventions to prevent HIV, tuberculosis, STIs, and unintended adolescent pregnancy.