South Africa’s armed forces grapple with HIV/AIDS

Nearly one in four South African soldiers is infected with HIV, putting added strain on the country’s armed forces as peacekeeping commitments grow across the continent, South African Military Health officials said on Monday.

“At this stage we do rise to the occasion as an organisation, but we are starting to get stretched,” said Brigadier General Pieter Oelofse, director of medicine for the South African Military Health Service.

“We are a mirror image of the population at large. We’ve got a challenge,” Oelofse said on the sidelines of a major AIDS conference that opened in the port city of Durban on Tuesday.

Military officials estimate about 23 percent of the country’s troops have HIV or AIDS, Oelofse said.

Overall about 5 million, or one in nine South Africans, carry the deadly virus - the world’s highest caseload. Armies often have higher infection rates due to the greater proportion of high-risk young, sexually active personnel.

With about 70,000 active members plus dependents and the retired, Oelofse said the military’s potential patient base may be as high as 350,000.

A research programme part-funded by the U.S. Department of Defense and the National Institutes of Health is now assessing how HIV/AIDS is affecting South Africa’s military readiness - a key issue for Western countries that increasingly rely on Pretoria to police Africa’s troublespots.

The programme, dubbed Project Phidisa, aims to establish which anti-AIDS drug programmes are most effective and when and how HIV-infected soldiers can be deployed.

Colonel Xolani Currie, the project’s commanding officer, said 2,779 military personnel and dependents have been screened to determine their eligibility to participate. Only those with advanced AIDS who have never taken antiretroviral (ARV) drugs are accepted.

“AIDS NOT A DEATH SENTENCE”

Currie said that while only about 771 people had so far been selected for ARV treatment under the five-year programme, its introduction a year ago was already having an effect as officers and troops realise HIV does not have to be a death sentence.

“We are beginning to minimise the effects of HIV/AIDS on the South African National Defence Force members and their families,” Currie said. “Before we started this programme, some people were just despondent at the base, with no hope…now they are up and running around.”

Project Phidisa’s objectives are mostly scientific but officials hope it will provide a blueprint for managing HIV infection across the nation’s forces, whose peacekeeping duties are expected to grow beyond current commitments in Burundi, Sudan and a handful of other African conflicts.

“We are stretched to the maximum…Clearly on the horizon is that our obligations are going to increase,” Defence Minister Mosiuoa Lekota told in an interview in April.

Oelofse said that while HIV-positive troops were not currently deployed on overseas assignments, military officials were proposing that those infected but well enough to serve be allowed to participate - even while receiving treatment.

“What we hope to get from our research project is how we can effectively use ARV drugs under operational circumstances. It is a field that hasn’t really been charted,” he said.

South Africa last year introduced its first national public sector ARV programme, but critics say roll-out has been slow.

Oelofse said the next stage in military planning was to dramatically expand the testing and treatment operation.

Now limited to six pilot sites under Project Phidisa, military officials hope to expand ARV treatment options to 65 military clinics to reach the broadest possible number of troops, Oelofse said.

“We have to do this. (AIDS) is not going away,” he said.

Provided by ArmMed Media
Revision date: June 18, 2011
Last revised: by Andrew G. Epstein, M.D.