Johan Viljoen, SACBC AIDS Office

1 December is World AIDS Day – an opportune moment to evaluate the past and assess the future. AIDS has been with us for more than 30 years. During that time it has killed millions worldwide – cutting short lives, destroying families and bringing about unimaginable suffering. Sub-Saharan Africa has borne the brunt. Some countries have come close to seeing an entire generation of productive young adults wiped out, leaving behind the elderly and young children. The SACBC territory has been particularly hard hit. South Africa remains the country with the largest number of people living with AIDS (around 5 million).

Swaziland is the country with the largest percentage of HIV positive people. At the height of the pandemic, 1 000 people daily were dying from AIDS-related disease in South Africa alone. Life expectancy had plunged to just 54 years. The situation was exacerbated by the denial of the then President and his Minister of Health. According to some studies, government denial and inaction was directly responsible for the death of 300 000 people.

In all of this, the Catholic Church was in the vanguard of the struggle against AIDS. The Church was the largest single provider of residential palliative care as well as home based care to dying people. The Church’s treatment program initiated well over 45 000 people on antiretroviral treatment in Catholic facilities. The Church’s programmes have provided comprehensive care and support to over 40 000 orphans, and continue to do so. All out of public view (the left hand, after all, shouldn’t know what the right hand is doing), whilst quietly enduring criticism from secular activists for its refusal to advocate the use of condoms. (These activists seem to think that this refusal is the sum total of the Church’s response to AIDS).

The government’s roll out of antiretroviral treatment for all, and Prevention of Mother to Child Therapy (PMTCT) for pregnant women marked a turning point. Treatment is now available in every health district in the country, and PMTCT in every ante-natal facility. Very few babies are born HIV positive. Life expectancies are back in the mid 60’s. From being widely ridiculed during the Mbeki years, the country is now lauded internationally for rising to the challenge. As a result, there is a general perception that the crisis is over.

Unfortunately it isn’t. South Africa remains the country with the largest number of HIV positive people. The rate of new infections stubbornly refuses to decline. More than 2 million children have been orphaned, and will remain with us for the foreseeable future. People living with AIDS still have enormous spiritual, psychological and social problems to deal with.

In response to the new reality, the Church’s response to AIDS is changing – from being a provider of clinical care and services to the sick in an emergency situation, to being a bearer of spiritual and pastoral care to people with AIDS, and of ongoing care to orphans and children made more vulnerable by the context in which they live. Some would see this pastoral care as the Church going about its “core business”. Whatever the case may be, the Church’s changing and evolving response provides exciting new opportunities for every Catholic to express his/her faith through care and compassion to “the least of their brethren”, and to truly be “good news to the poor”.