TAC Electronic Newsletter 

1 July 2003


Contents



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Where do we stand with Government? Where to from here for TAC?

PLEASE DISTRIBUTE WIDELY

1 July 2003
 

A Treatment and Prevention Plan: Where do we stand with Government? Where to from here for TAC?

In late April, TAC suspended its civil disobedience campaign following our meeting with Deputy-President Zuma. However, presently there is growing concern among TAC members and volunteers that we have received very little in return from government. A commitment to a treatment and prevention plan that includes antiretroviral therapy is still far from certain. As one activist explained in a meeting discussing civil disobedience in Johannesburg, we can suspend the civil disobedience campaign, but we cannot suspend the pain of people with HIV/AIDS and their friends and families.

We are at a critical turning point in South Africa's response to the HIV epidemic. TAC suspended its civil disobedience campaign to give government the space and opportunity to commit, on its own terms, to a treatment and prevention plan that includes antiretroviral therapy. There were some positive signs that the Cabinet would soon make such a commitment. We are aware that the costing study conducted by the task team composed of members of the treasury and health departments was completed and awaited approval by Cabinet since April. Furthermore, the Treasury put aside contingency money for treatment in the 2003/04 budget clearing the way for a change in policy. The NEDLAC negotiations were also to have resumed. TAC's meetings with the Deputy-President on 25 April and with a number of Cabinet ministers at the SANAC meeting on 14 June gave hope that there were some leaders in government who recognised the urgency and the moral and legal imperatives to extend access to antiretrovirals to South Africa's poor as part of the national response. In addition, the Western Cape MEC for Health recently made it clear that it is a matter of time before government begins rolling out an antiretroviral treatment programme. In private discussions, this sentiment has been echoed by a number of senior civil servants.
 
These were tangible reasons to be hopeful and to give government the benefit of the doubt by suspending civil disobedience. It is in all our interests for a treatment and prevention plan to be attained via a voluntary change in government policy, rather than via civil disobedience and litigation at the Constitutional Court. If we have to resume the latter route, the treatment programmes that will ultimately be implemented are unlikely to be as successful as a plan implemented by a government that is politically committed to treatment. Despite protest by government that it has a "five year strategic plan", we still believe that the existing plan is inadequate and that policy to treat has to be much more rigorously monitored in its implementation if it is to be successful.

But the TAC leadership is being continually reminded that there is a limit to the patience of people confronting their own mortality. Government cannot dither any longer. The timeframe for decisions to be taken is now days, at most weeks, not months. Every delay is measured not in inconvenience, but in death and suffering. If TAC is being mislead and if government promises have been in bad faith, the subsequent return to civil disobedience will be more intense than before, involve much larger numbers of people and will not be suspended or stopped without the implementation of a treatment plan.

A report that appeared in the Star (27 June) is reprinted in this newsletter. It points out serious government delays such as the failure to date to sign the Global Fund agreements, the failure to release the costing study on antiretroviral treatment which merely needs the go-ahead from Cabinet and the failure to release the latest antenatal clinic study. To this we can add the failure to officially release the report that was produced at the HST scientists conference last year. We hope that there are no longer senior people in government who intend to scupper moves towards treatment. However, if there are, we cannot appeal to your conscience. We cannot ask you to consider the lives and suffering of hundreds of thousands of your fellow citizens. Instead we must appeal to your self-interest and ask: are you  willing to risk the sustained pressure of civil disobedience, international embarrassment and litigation through to the April 2004 general elections and beyond?

In the meanwhile, irrespective of which route government chooses and as TAC prepares for its provincial and national congresses over the next month, activists must prepare for a new phase in TAC in which we consolidate our branches so that they are better equipped to assist with the implementation of the government's current programmes and any new ones that might become policy, such as antiretroviral treatment. It would be wrong of TAC to expect government to take sole responsibility for the health interventions for which we have advocated. Our duty to ensure their successful implementation is critical.  Therefore, in this issue of the electronic newsletter, we have included two important discussion documents that are being circulated at TAC branches. One, written by Zackie Achmat, examines the role and responsibilities of TAC branches. The other, written by Sipho Mthathi, gives concrete suggestions for how TAC branches can ensure that people become educated about HIV issues.

Let us work together to implement a successful treatment and prevention plan that will build a better health care system.

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TAC National Congress


Treat the People - Mobilise Communities and Clinics for HIV Prevention and Treatment Access

The TAC National Congress will take place from 1 to 3 August at Coastlands in Durban. A critical function of this Congress will be to resolve how TAC needs to strengthen its branches to ensure the improvement of public clinics and the implementation of a treatment and prevention plan. A new TAC National Executive Committee will also be elected.

We will also mobilise support for a treatment and prevention plan at the first South African AIDS Conference in Durban.

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It's all talk, no action as people succumb to AIDS


By Lynne Altenroxel, The Star, 27 June 2003

Just a few days ago, time finally ran out for Jenny*, an HIV-positive nurse who worked at a government hospital in Southern Gauteng.

Ever since she started working at the hospital thee years ago, she had seen deaths of countless Aids patients in her care. By this year, five to 10 Aids patients were dying each week in the medical wards where she worked.     Witnessing their painful demise made her fearful of her own fate. She knew, she said a few weeks ago, that it was the same way she would go too.     Jenny died at her parents' home on June 12 without ever accessing the antiretrovirals which could have spared her from an early death at the age of 29.      A short six months after passing her staff nurse exams with distinction in November, she had become one of the 600 South Africans dying daily as a result of HIV.

She died frustrated and angered by government delays in implementing a programme to provide antiretroviral treatment to people who needed it.     "She was very, very angry. Up to the last day she was very angry," a colleague recalled, describing how she knew that Jenny was distraught by witnessing the deaths of the people she nursed.

"I would see that she was really affected. She wouldn't want to talk when she came out of there She wouldn't even want to eat when she came out of dealing with a very sick patient."   

Now, several days after Jenny's death, there is still no answer to the question of whether the government will ever provide anti-Aids drugs to people who cannot afford them.     On Wednesday the cabinet met again without discussing a report on the cost of providing antiretroviral therapy - even though more than two months have passed since the report was finalized.     For people living with HIV, it seems as if there is no sense of urgency about dealing with an issue which, for them, is a matter of life and death.     Lifeline counselor Isaac Skosana, who is HIV-positive, will tomorrow bury one friend who succumbed to the virus. On Wednesday, as the cabinet met without discussing anti-Aids drugs, be buried another.

"What I hear is only promises. Bt commitment and things that are practical, I see nothing," said Skosana, who is healthy but dreads the day when his immune system needs antiretrovirals to prop it up.     "I know there is a time when I'll need them. When that time comes, what must I do? Wait?" he asked.     Like Skosana, HIV-positive Nonhlanhla Kubheka is also watching her friends die Aids-related deaths.     "I'm willing and I'm wishing and I'm praying that they'll come with a decision today" she said.     "I feel very angry because people are dying. Last week. I buried three of my best friends because of HIV."

One of them, a policeman, died after a brave fight against Kaposi's sarcoma, a type of cancer which leaves purplish-brown marks on the skin and internal organs, and which usually only effects people with compromised immunity.

"He promised that he wouldn't die before a cure was found - and now he's dead." Kubheka said.

Kubheka is one of many HIV-infected South Africans who are angry about the lack of action. Motivational speaker Anne Leon, whose immune system has reached a crucial point at which she needs to start taking anti-Aids drugs, says she is angry too.     Blood tests have shown that her CD4 count - a measure of her immunity -
is down to 244. Experts recommend that triple therapy be started when patients' CD4 count is 350. Ideally, she should have started anti-Aids treatment a long time ago.

"I feel angry that the government isn't doing their part," Leon said. "It's all talk and no action."     Many people living with HIV are also scared.
Buhle* has been hoping to get antiretrovirals since she first heard about them three years ago.     "I'm tired of waiting. It's three years now," she said.

"I'm scared because there are a lot of people who need drugs but they didn't get then and they are dying."     Buhle buried her best friend, who was also HIV-positive, on June 14.     For health professionals such as Sister Sue Roberts, head of Helen Joseph Hospital's HIV clinic, the list of people in desperate need of antiretrovirals is growing.

The clinic diagnoses 80 to 90 new HIV infections in patients each week. More than half of the HIV patients on its database are in desperate need of treatment, with less than 5% able to afford to buy the drugs themselves.     "We've had a lot of patients who could have done extremely well on drugs. And a lot of them are no longer with us," Roberts said.

So many people are dying without treatment that nurses who suspect they are HIV infected are reluctant to acknowledge that they, too, have the virus.     "One of the biggest problems with healthcare workers is that they see that nothing is done for HIV, so they don't come forward," Roberts explained.     "They're petrified of being identified as positive... because they're seeing sick patients dying in front of them all the time." * Names have been changed to protect identity.    

THE DELAYS:

1. The Global Fund agreement
It's well over a year since the Global Fund to fight Aids, TB and Malaria
(GFATM) agreed to give KwaZulu-Natal US$72-million for a multi-pronged
approach against HIV which included the provision of anti-Aids drugs.
Global Fund head Professor Richard Feachem arrived in South Africa in April
to sign an agreement over the donation, which had been vehemently opposed
by Health Minister Dr Manto Tshabalala-Msimang. At the last minute the
government refused to sign the deal, but issued a statement which said
that: "A senior representative of the Fund will be visiting South Africa in
the course of May and the agreements will, without fail, be signed during
this visit. Programme implementation will begin by the end of May 2003."
But no signing has ever taken place.

2. The costing study
It's been nearly a year since the government appointed a task team to
investigate the costs of providing antiretroviral triple therapy. The task
team's report, which recommends provision of treatment, has been ready
since April. But a final decision based on the report can only be made by
the cabinet, which has yet to discuss the document.

3. The antenatal survey
The government's annual survey of HIV prevalence rates among pregnant
women, which takes place in October, is just three months away. Survey
results are usually released in the first quarter of the following year and
provide valuable information for planning by healthcare bodies and Aids
charities. Tshabalala-Msimang has alluded to the results in a public speech
- an indication that they are available - but the results of last year's
survey have still not been released.

Several calls were made to the Department of Health for comment on the
reasons behind the delays, but the department never responded.


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Friends of TAC Launched in Britain

Friends of TAC has been launched in Britain

London, 24 June 2003 - An organisation called Friends of TAC has been formed. Its primary purposes are to support the aims and objectives of TAC and its projects.  ANC member and former South African MP, Andrew Feinsten was elected chair. Chris Woods was elected treasurer and Rachel Holmes was elected secretary.

Feinstein was removed as chair of the Public Service and Management Accounts Parliamentary Portfolio Committee for his interrogation of and opposition to the multi-billion rand arms deal. Feinstein subsequently resigned from Parliament, but remains an ANC member. TAC is honoured that someone of Feinstein's integrity has chosen to mobilise public support in Britain for treatment.

To assist or join Friends of TAC (FoTAC) Britain, please contact Rachel Holmes on r.k.holmes@btopenworld.com

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Building Branches to Organise for Treatment


As TAC completes the first phase of our civil disobedience campaign, it is a very good time to reflect on our strategy and tactics over the next two years.  How can we ensure that people get medicines and how can we ensure that there is a decent public health system for all people?

All TAC volunteers/members and supporters believe in the rights to life, dignity, equality, freedom, health care access, social security access and social justice. These are principles we cannot compromise.

TAC has succeeded because we understand that HIV/AIDS is a political issue.  But we know HIV/AIDS is not a party political issue because it affects all people. HIV/AIDS is political because of inequality. Prevention, treatment and care remain hampered by social and political inequalities at every level of society. Gender inequality, poverty, migrant labour and sexual taboos produce vulnerability to HIV within our communities.  Personal, family, local community, provincial, national and international relations all affect whether we have access to prevention, care, treatment and how we are exposed to the risks of HIV transmission. We see the need for HIV prevention and treatment as an essential part of the struggle to ensure human rights, security, gender equality and social justice. 

TAC has succeeded because we rely on science as our best ally.  We do not have the truth. We seek the truth through good science, medicine and expertise.  In using good science and good faith, TAC does not leave decisions to experts but we educate ourselves in the best scientific traditions to understand medicines and society. We rely on rigorous research and base ourselves on real facts and experience.

Treatment and scientific literacy have become TAC watchwords. We communicate in every way possible - songs, emails, newspapers, videos, televisions, newsletters, leaflets and posters. TAC does this because many of our members cannot read, many are educated but do not understand science or health policy.  We must reach everyone in society - urban or rural, rich or poor, black or white.  We create our own media and we use every media outlet to get our message across - local newspapers, TV, radio (community, regional and national stations). As the comrades in KwaZulu-Natal say: "Knowledge is a public asset"

TAC is proud of our democracy, our tradition of struggle, our Constitution and our democratic institutions. We have educated our members about the Medicines Control Council (MCC) and the importance of the scientific and independent regulation of medicines. The role of patents, globalisation, compulsory licences, multinational corporations, the World Trade Organisation (WTO) and access to medicines remains an ongoing education process for all TAC activists and leaders. Many people in our country learnt about profiteering and patent abuse when TAC illegally imported fluconazole from Thailand.  TAC members gave the legal concept amicus curiae (friend of the court) widespread currency when we fought the multinational drug companies alongside the South African government. We won this battle because we educated ourselves and our members on the need for international solidarity - across the globe people joined our battle.  Our members and broader South Africa leant that our Constitution and the courts have a real meaning for poor people when we challenged government in the MTCT case and won. Parliament and its committees are not strange to ordinary TAC members. We have marched to parliament, we have picketed parliament, we have given evidence to Parliament, we support good legislation and we criticize shoddy laws. TAC members try to understand the budget. We learnt about the Medical Research Council and the Human Rights Commission. TAC gave the word NEDLAC meaning to many people who are not members of unions or business organisations. Many ordinary people in our country had not heard about the Competition Commission until TAC used it together with Cosatu, CEPPAWU and many allies to expose excessive prices by multinational drug companies.

Many of our members and broader society learnt the need to work together through TAC - we work with anyone who believes in the right to life, dignity, equality, freedom and access to health care.

TAC has organised marches with tens of thousands of people throughout our country. We have come to the point of civil disobedience because of the government's denial, foot-dragging, deliberate misrepresentation and allowing unnecessary deaths. Where has this strength come from?

Our strength comes from nearly 10 000 ordinary people living with and affected by HIV/AIDS who identify as TAC volunteers or members.  Most are poor. Many, many have HIV/AIDS. The majority are women but we have many young men who are willing to learn and change. Some are wealthy. Some have education. All of us have seen people die. We watch as their CD4 count declines and the HIV viral load explodes. All of us give our time, energy, love, anger, privilege and patience to the cause of preventing a holocaust against the poor.

Our strength comes from our branches, provincial and national leaders. It also comes from working with other sectors: unions, faith-based organisations, lesbian and gay groups and many others have supported TAC campaigns. Now is the time to ask how can we create a social movement that will ensure a decent public health service for all people and a serious HIV/AIDS treatment plan. TAC branch development, treatment literacy programmes and our constitutional rights are the only tools we have at our disposal for this task. We must build a TAC branch and treatment literacy programme in every health care district in the country. This will strengthen primary health care delivery, assist in local development and ensure access to a range of social services other than health.

If government signs the Treatment and Prevention Plan and begins to provide ARVs, we will need such a force to help health workers and people with HIV/AIDS. If government does not sign such a programme, we will need a force that will challenge it at every level and also ensure that we access resources to provide treatment. This means orienting all TAC forces to the development of branches in every health district in the country. It means assisting existing branches with better education, treatment literacy, activist skills and resources.

At the moment TAC has more than 110 branches in Eastern Cape, Free State (pending), Gauteng, KwaZulu-Natal, Limpopo, Mpumalanga and Western Cape. We also provide support to very large numbers of HIV/AIDS support groups. Branches vary in strength and in leadership quality. Sometimes provincial leaders (staff and NEC members) see the power and potential of our branches, other times we see it as a burden.

Our entire national apparatus must be organised to realise the potential of strong branches in every health district.

WHAT DO BRANCHES DO?

In various ways, all branches have at least eight identifiable and inter-related functions: Education (Treatment Literacy and Political Education); Public awareness and mobilisation; Local Network building; Health Service support and monitoring; Creating and developing support groups; Lobbying with MPs, councils and other institutions at local level; Supporting development and social security campaigns.

EDUCATION

Education is the first and most important function of a branch. Knowledge is one of the most important benefits any TAC member/volunteer receives.  We learn about medicines; about TAC history; about the science and the political economy of HIV and many other issues.   TAC branch education takes two forms: (a) Internal education that combines political education about HIV/AIDS and treatment literacy. (b) Public treatment literacy work is provided to community groups, religious organisations, trade unions at local level. We also learn about the law, the enforcement of rights and good governance. TAC's national and provincial treatment literacy co-ordinators provide the human and material resources for this work. 

Every branch must develop an internal and external education plan with their treatment literacy co-ordinator.  Treatment literacy must be integrated with organising work and the building of TAC.

PUBLIC AWARENESS, LOCAL MEDIA AND MOBILISATION

Branches distribute material (and condoms) at taxi ranks, shopping centers and clinics. Branches paint murals and conduct door-to-door visits.  This raises public awareness on treatment issues and the role of TAC. Branch leaders work with local media such as community radio stations, newsletters and drama groups. We also use video, organize marches, petitions and support provincial and national mobilization.  Youth, schools, clinics, clubs, shebeens, shopping centers, churches, mosques, synagogues and temples are vital to developing public awareness on HIV/AIDS treatment and prevention.

Every TAC branch must have a serious mobilization strategy. We must recruit new members, volunteers and supporters. Every member and branch must write for and distribute Equal Treatment, the TAC newsletter

LOCAL NETWORK BUILDING

Many TAC branches have good working relationships with other community-based organisations.  We work together.  There are children's organisations, women's groups, religious youth groups, AIDS organisations, development organisations and many other bodies. We must have a plan to visit and educate all organisations. TAC branches must support at least one event sponsored by a local ally or organisation every month. For instance, if a local children's organisation organises an event to promote children's health, we must ensure that the whole branch supports it as if it was a TAC event.  But, we must not take over other people's work.

Every TAC branch must have a list of local organisations. We must visit them regularly based on a branch work-plan. TAC branches must ensure that local organisations have information about our campaigns and that they participate regularly in treatment literacy work.

HEALTH SERVICE SUPPORT AND MONITORING

Our clinics are over-worked. Sometimes, they have too few nurses, no medicines, phones that do not work and many other problems. This demoralises health care workers and people who use the clinics.  TAC members and volunteers must change this. Every branch must adopt at least one clinic.  At the moment TAC is organising a clinic survey.  This is to ensure that TAC members know what is available in their clinics. TAC members must also help their clinics get the staff, budget, information, medicines and training that it needs to serve the local community. Provincial co-ordinators must learn about and explain the district health system to all branches. In this way, we must ensure that clinics and hospitals serve the interest of all people in our communities. Later in the year TAC will organise provincial meetings of nurses, doctors and other health workers in the public sector to join hands in campaigning for better health care for all.

 
SUPPORTING SUPPORT GROUPS

Many support groups are active in TAC. We support the work of many support groups. Why? There are many personal, social, emotional, legal and health problems that individuals with HIV/AIDS face. It is our job to ensure that every support group has the tools that it needs to do this job. We must make sure that support groups become centers of strength for people living with HIV/AIDS.  Every branch must have a list of support groups or where there are no support groups, branches must start support groups.  TAC branches must compile a list of good doctors; bad doctors; clinics; pharmacies; good religious leaders; children's organisations; paralegals and other local and provincial agencies that can assist the work of support groups.

POLITICAL LOBBYING

Every councilor, MP (provincial and national) who has an office in your branch area must be visited. Priority must be given to the ANC because it is the party that rules the country and has the power to change things. But, all political parties must be lobbied. Make sure they understand TAC and they know about HIV/AIDS treatment and care.  Ask them to help monitor health services and to ensure that the needs of poor people and poor communities are always a priority.

SOCIAL JUSTICE CAMPAIGNS

As an organization, TAC supports every effort to end poverty, to create jobs, to improve health, housing, education, water and transport for all people. TAC is affiliated to campaigns to improve the grant system. We support the extension of the child support grant to all children under 18 and the abolition of the means test. We also support the campaign for a basic income grant (BIG).  TAC branches must be actively engaged in campaigns for social and food security for all people.

THE ROAD FORWARD

All branch infrastructure must be strengthened.  How can branches get access to computers and other information? Every TAC branch needs the following:

Every branch must discuss this document and send a list of suggestions on how to build branches to Zackie Achmat and Mandla Majola. We also need ideas for a code of conduct for members and office-bearers.


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TREATMENT EDUCATION - NOW MORE THAN EVER!


Since its inception, TAC has struggled in different ways to make treatment available to those who will die without it. We know that about 200 000 people died in our country in 2002 due to AIDS related infections.  There are many reasons people die of AIDS related illnesses: it can be because (1) they or those caring for them do not know that HIV Opportunistic Infections (OIs) can be treated, (2) they know that OIs can be treated but do not have access to the medicines as they are not available at clinics or hospitals, (3) they do not know about antiretrovirals that can prolong life of people living with HIV or (4) they know of antiretrovirals but cannot afford them.
TAC has tried to address some of these problems by advocating for a National Treatment Plan. But TAC has not only asked government to implement this plan and waited. We have already started implementing aspects of it including: going to clinics and hospitals to make sure that the medicines needed by people living with HIV are available, educating people living with HIV, their carers and communities about their rights and the treatments themselves so that they know what to ask for when they go to clinics. We do this education through our Treatment Literacy programme.

One of the big problems is that many health care workers have just seen people with HIV die and for them HIV/AIDS is a disease people die from and not one which people can live with for long. Therefore, when activists say people must be given treatment some health care workers and people in charge of our health care system think we are misleading people or are trying to cause trouble.

This continues to be a problem of many in our government. As a result, we see our government, especially health departments, spending a lot of money on home based care and not on ensuring that our clinics have regular supplies of medicines or that health care workers are trained to diagnose illnesses and treat them accordingly or that communities are educated about HIV treatments and how they work so that people do not die from illnesses that can be treated with medicines that are available.  
As we move towards the co-ordinated and collective implementation of a National Treatment and Prevention Plan, our responsibility as people living with HIV/AIDS, those caring for us, Priests and Bishops, Teachers and Students, community members, government departments, workplaces and especially TAC activists becomes more difficult and easier at the same time. 

Our task is difficult because we must now all learn about: the science of HIV, how our bodies are made and how they work, the immune and other systems, the relationship between our bodies and gems that can make us ill, how medicines work - their benefits, side effects and limitations, antiretroviral therapy, the potential benefits and limitations of "alternative or herbal home remedies" many of us have grown to trust, etc.  For long we have been able to rely on doctors, nurses, scientists and others to take charge of our health.  But HIV puts a new challenge on all of us. We have to take charge of our own health; we have to become experts in HIV/AIDS and how we can use medicines to improve our health. With Medicines like antiretrovirals, the nurse or the doctor are an important part but just one part of what is needed to make them work. For medicines to be effective, we have to know how and how not to take them, with what kinds of foods or other medicines, what short and long term effects the medicines have, what to do to prevent side effects and how to manage them when they do occur.

Our biggest job is ahead of us. To do this we will need lots of support. Our communities need to be educated and mobilised to be ready to give this support when South Africa starts implementing a national treatment and prevention plan that includes antiretrovirals.

HOW AND WHERE DO WE LEARN ABOUT ALL THESE THINGS?

The Treatment Action Campaign has produced a lot of materials that can be used by people without much medical background. To put posters up, if you do not have wall paper glue, you can make a runny mixture of the white flour we use for bread, smear it all over the back of the poster and paste it on a wall. Try not to use Prestik as it dries up quickly and the posters will not stick for long. As a branch, you can turn this into an activity and invite willing community members to help you. This way you get your community involved in your work as a branch and you can attract more members. You can plan to cover all the places you choose over a month and have a special day every week where you cover an area and finish it. As we put up the posters, we must tell people who are watching what we are putting up and invite them to come and read. It can help to put contact details for your local branch neatly written on the poster or on a visible piece of paper next to the poster.

Ask your Provincial office for other materials you can put up in your community in this way.

If there is a support group in your area make sure that they have copies of all these posters and discuss them with members of the support group.
You can also make your own posters about an issue you feel your community needs to know about. You do not have to wait for the national office to do this.    

HIV IN OUR LIVES: A BOOK OF INFOSHEETS ON HIV/AIDS

TAC, together with the AIDS Law Project, has developed a book of information sheets dealing with many different aspects HIV/AIDS. It is called HIV IN OUR LIVES and will soon be available from all TAC offices and branches. This book is developed for use by all those interested in learning about HIV/AIDS, especially people living with HIV in support groups. It is in English at the moment. When money becomes available, we will translate and print it in different languages. However, in the meantime, your branch can translate the infosheet you want to use and discuss it with your members. The idea is that TAC branches, doctors, nurses in clinics and hospitals and other organisations will make photocopies of single infosheets and make them available to patients who come to clinics and hospitals. Anyone can do the same in their church, school, etc.

YOUR DOCTORS, NURSES, COUNSELLORS ARE YOUR ASSETS

Although TAC takes responsibility for educating its members through structured training workshops and discussion sessions, we do not have capacity to reach all our branches at the same time. But all our members must know these things if we are going to campaign effectively for the services to be implemented where we are.  Therefore, even though not all Nurses, Doctors and Counsellors have accurate information about HIV/AIDS and treatment, some do have the information or know someone who does and we must ask them to help us. You can make a list of all doctors in your area whether they work in private practices or in local public clinics or hospitals.

Make a list of all the things you want to know about HIV/AIDS and treatment. Introduce yourselves to the doctor, nurse or counsellor as a TAC branch and ask them to help you with training where they can. Tell them about the things you do in your community and that you do your work for free. This will encourage them to help you and show you where you can get extra assistance.

If the doctor, nurse or counsellor does not know something, contact your Provincial or National office to assist them to find the information you need.
You can have a schedule of days when you want to do workshops. 

HOW DO WE DO TREATMENT EDUCATION IN OUR COMMUNITY?

The posters and visual materials will help a lot, but you can do many other things as well.

SONGS

TAC activists have made many songs about HIV illnesses, HIV treatments, Testing for HIV, using condoms, using our rights to ensure better services, etc. In many communities, music has a special place. It is the one medium all people can relate to and we must use it to assist our work. For people who cannot read, a song can be very effective to teach about an issue. Songs are also good because all age groups can relate to them. Once you have discussed an issue as a branch, you can make different songs to simplify the messages and scientific concepts.

An example is the song TAC activists sing about preventing Mother To Child Transmission of HIV. It goes:

AZT siyayazi, ikhusela bantwana kwiHIV, jikekele
Nevirapine siyayazi, ikhusela bantwana kwiHIV, jikekele
MTCT Prevention, MTCT Prevention

(we know AZT and Nevirapine can protect children from HIV, MTCT prevention,  everywhere)

You can sing these songs at clinics, schools, taxi ranks as you do education to complement your presentations. They are good because you can easily teach to the whole group and the whole group can become involved in your education. People remember songs more than words. You can make your own book of songs as a branch and even record these for your branch. If there is a local radio station, you can ask them for a short slot and play these songs now and then as part of your mass education.
You can decide to have a community health day every second week of the month where you march around wearing your HIV positive T-shirts, carrying posters, distributing condoms and singing your songs. Remember to distribute a short pamphlet with contact details for your local branch when doing these.  The community will remember the messages in your songs and will join your march because the songs attract them.

MAKE A DRAMA AND ACT IT OUT FOR THE COMMUNITY

Short dramas can help a lot to make things clear for people and help communities see a different picture of something. Dramas are one of the ways in which many communities communicate to each other. You can take the community's experiences and highlight them for the community to reflect on through a drama. For example, if there is a problem with stigma and discrimination of people living with HIV in your community you can make a drama that shows one example of this and then also show how and why this is wrong and give an alternative way of responding through your drama.

As another example you can show someone who is diagnosed HIV positive, does not know that HIV opportunistic infections can be treated and thinks he or she will die. Then show through your drama that if he or she goes for treatment as soon as he or she becomes ill, he or she will not die unnecessarily.  You can do the same to publicise services like social grants and highlight other problems like women abuse if it is a problem in your community. 

There are also other forms of drama that involve the community in shaping the responses called Forum theatre. In this form of drama, you come as a group with a situation. You act it out and then you invite members from the audience to come and act how they would do things differently or solve the problem presented in the short drama. As many people as possible from the audience can come to show their views and as the group facilitating this you can drive things to the desired conclusion.
In many communities, there are people who have gone to school to learn how to do drama so again you can work with these people to help you make your dramas as good as possible. This way you can develop relationships with many people in your community and maybe they can also join your TAC branch.   

CREATE A LIBRARY FOR YOUR BRANCH

In your branch, you can have a person specifically responsible for education activities. This person must start a library of reference materials on topics on or related to HIV/AIDS. You can start by keeping two sets of all the materials TAC, the AIDS Law Project, Department of Health, Soul City or other organisation has produced and a register of who takes what out when.  The branch education officer can then make sure that at every meeting one person reads something new and gives a short input before or after the other agenda items of the meeting. Many TAC branches have started what they call "UMRABULO" which is a series of education discussions where old and new TAC activists come and educate each other on key topics of HIV/AIDS and related things. This can be once every week or fortnightly. We can invite experts from universities or other organisations, as well as our parliamentary constituency office or doctors and nurses to help us discuss a certain topic, e.g. social grants that already exist such as the disability grant or child support grant or grants that we are campaigning for such as the basic income grant. But we can also find documents on the topics and give responsibility to a branch member to read the document and explain to the others. All members can take turns to do this and this will help develop a culture of reading in our group. The topics we discuss do not have to be on HIV alone or social grants alone. People can also take a good novel like "Things fall apart" by Chinua Achebe, read it and explain what is happening in the book and what lessons we can learn from it for our community. Remember HIV is related to other things that happen in our society and that the main function of a TAC branch is to build a new society. We must therefore also discuss other things that affect our community. But understanding treatment is our primary responsibility and challenge now, so we must read as much as possible on HIV and HIV treatment.

We can all learn about HIV treatments, science, legal concepts, economics, etc and we have the opportunity now. By learning about these things we can beat HIV together. 

Government must lead us by signing the Nedlac Framework for a National Treatment and Prevention Plan and by adopting a policy to use antiretrovirals in the public sector. This will help guide all of us and get rid of the confusion and uncertainty. This will help us as TAC branches and communities to do the work we already do even better  - and save lives. 

We must prepare the ground for HIV treatment to work now by educating ourselves and everyone else in our community about these treatments.  Then once it is started, it will be more successful.
   
For further assistance with doing treatment education in your community you can call the Treatment Literacy co-ordinator at the following TAC office numbers:

National office: 021 788 3507    (Sipho Mthathi)
Gauteng: 011 339 8421    (Johanna Ncala)
Kwa Zulu Natal: 031 304 3673     ( Bongiwe Mkhutyukelwa)
Eastern Cape: 043 760 0050     (Linda Mafu)
Western Cape: 021 364 5489     (Nomfundo Dubula or Vuyiseka Dubula)


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