Health in 2021: Another tumultuous year in under a thousand words

It wasn’t rocket science when we predicted at the start of 2021 that South Africa’s biggest challenge this year would be to get COVID-19 shots into as many arms as possible. But the way it has played out with multiple setbacks and scrambling problem-solving is not something anyone could have predicted. In fewer than a thousand words, Spotlight editor Marcus Low takes a look back at a tumultuous year in health in South Africa.

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In-depth: What contraceptives are available in SA and which ones are most popular?

There are a variety of tools available today to prevent pregnancy including pills, intrauterine devices, subdermal implants, injections, condoms, male and female sterilisation, and emergency contraception. Statistics suggest that people in South Africa do, in principle at least, have access to and are aware of these contraceptive methods, albeit not at the desired levels. Elna Schütz looks at what contraceptive methods are available and makes some surprising discoveries along the way about which ones are most popular.

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Forty years on, HIV still taking a toll on young people

“Driving a fast car”; “getting the top three letters”; or “playing the lotto” – nearly 40 years from when HIV was first described, the virus is still a thing of euphemism and stigma. It’s also still infecting at least 4 000 people a day around the world, most of them young people, especially girls and young women. Ufrieda Ho reports.

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Are two medicines instead of three the future of HIV treatment?

One of the biggest breakthroughs in HIV treatment in the 1990s came when three different antiretrovirals were used together, suppressing viral replication in multiple ways and preventing the development of drug resistance. Now, trials are showing that certain combinations of just two antiretrovirals might be as good as three, potentially bringing an end to a quarter of a century of triple therapy dominance. Elri Voigt reports.

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Opinion: We should make it much easier for people to start and stay on HIV treatment

The top priority in our HIV programme should be to make it as easy as possible for people to start and stay on treatment. Yet, as a number of provincial reports released this year by community monitoring group Ritshidze have shown, there are many healthcare system factors that work directly against this objective. Spotlight editor Marcus Low considers some of the potential solutions.

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Opinion: Funding must be allocated to treat drivers of HIV

If South Africa wants to strengthen the prevention arm of its HIV programme, which it definitely should, providing comprehensive sex education in schools and training teachers to deliver this curriculum will be vital. It is important that the HIV/AIDS Life Skills Grant, as one of the key pieces of a broader HIV prevention strategy, be supported and strengthened, argue Mbali Baduza and Julia Chaskalson.

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In-depth: New licenses could spark manufacture of COVID-19 pills in Africa

Pharmaceutical companies Merck and Pfizer recently announced early results from clinical trials showing that two new antiviral medicines are highly effective in reducing COVID-19 deaths and hospitalisation. The Medicines Patent Pool then announced licensing deals with both companies that will allow for generic versions of the two drugs to be produced. Catherine Tomlinson unpacks the licenses and asks whether generic versions of these pills might now be made in Africa.

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Circumcision reducing HIV infections but COVID-19 caused setbacks

A UNAIDS report published earlier this year estimates that just under 4.5 million men and boys accessed voluntary male medical circumcision (VMMC) services in South Africa by the end of 2019 with 47% of these having been performed from 2016 to 2019. Thabo Molelekwa reports on the impact COVID-19 has had on VMMCs and the challenges related to resuming this service in the country.

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