TAC Releases Details of Government Costing Study
14 July 2003
Leaking details of report is a moral obligation - not "mischief"
Download the documents TAC released to the media from http://www.tac.org.za/Documents/TreatmentPlan/slideshowongovernmentcostingstudy.pdf
Several weeks ago TAC Chairperson, Zackie Achmat obtained a copy of
slides presented by Health Director-General Dr Ayanda Ntsaluba to the
Health MinMEC, setting out the approach and findings of the
Health/Treasury Task Team looking at the costs of antiretroviral
treatment. The TAC NEC decided that this information was in the public
interest and authorized the Chairperson to release it to church, trade
union, business and civil society leaders with a request that they
implore Cabinet to speed a decision to commence ARV programmes. This
weekend the information was also given to the press by Achmat.
Since the Director-General of Health made this presentation, and, the
MinMEC forwarded this report to Cabinet and a further delay by another
"committee" thousands of people have died unnecessary and premature
Today the TAC has been accused by the government of acting
mischievously by making public parts of the "secret" report prepared for
the Cabinet that looks into the costs and potential benefits of adding
an antiretroviral programme to existing interventions to prevent and
treat HIV infection. TAC has also been accused by Advocate Rams
Ramashia, the labour director-general of breaching "state security" and
"undermining and possibly de-railing the Nedlac process".
We reject these accusations. On a matter of such fundamental importance
to millions of people's lives, the Constitutional right of access to
information and the Constitutional duties that govern public
administration are paramount. The notion that state security has been
breached is ludicrous: in fact it is the personal security of millions
affected and infected with HIV that is threatened by government
TAC has acted morally and responsibly. Making parts of the report
public comes during a long, painful and unnecessary period of
unjustifiable delays by the Health Department and Cabinet. In
particular, we draw attention to the following:
· In November 2001, the Department of Health's
National Health Summit made the recommendation that antiretroviral pilot
projects should commence in the public sector.
· In April 2002, the Cabinet publicly recognised
that antiretroviral drugs are effective.
· In August 2002 a 'Scientific Summit' convened by
the Department of Health "unanimously" recommended introducing
· In October 2002, the Cabinet announced the
formation of a task team to investigate costs and benefits of an ARV
· During negotiations at NEDLAC on a national
framework agreement for treatment and prevention, the Director-General
of the Health Department indicated that the task team report would be
complete by February 2003. This is reflected in the text of the draft
· Because of the delay in the Cabinet's
consideration of this report, the NEDLAC process has been derailed for 8
months. To date, labour, community and business are still awaiting
government's response to the proposals set out in the draft framework
· On 9 May 2003, the Health Minmec meeting accepted
the report. In an interview on 14th May 2003 on AM Live, the Minister
of Health indicated that a Cabinet decision on the proposals would be
taken during May.
· Between late April and July, the TAC suspended its
civil disobedience campaign, partly upon the expectations that upon the
report's completion by May, its progress through Cabinet would be
expedited. The need to do this has been repeatedly raised in our
interactions with government. However, to date, Cabinet has still not
discussed the report.
· In April, government undertook to finalise the
Global Fund Agreements and guaranteed the beginning of their
implementation by the end of May. Yet this has not happened.
· On 14 June, a joint statement by SANAC and TAC was
released by the Deputy-President Jacob Zuma with the agreement of the
Health Minister. the Minister in the office of the Presidency, Mr.
Essop Pahad and the Minister of Arts, Science and Technology Dr. Ben
Ngubane. This statement stressed the urgency of finalising the NEDLAC
process and the costing report.
According to another official report (which has still to be released)
ante-natal HIV prevalence in SA in 2002 reached 26,5%. HIV related
deaths number over 600 a day. Our actions only publicly express the
frustration and pain of people who die quietly at home and in our
hospitals, in the face of a torrent of excuses and delays. Given the
contents of the Health/ Treasury report, which indicate the possibility
of saving tens of thousands of lives, and given the fact that the report
is commissioned by the government itself, all of these delays are
unconscionable and, in our view, run directly counter to the spirit and
obligations of the South African Constitution.
When the report was given to the TAC Chairperson, we kept it
confidential until it became clear that Ministers Pahad and
Tshabala-Msimang have "referred" it back to the drafters to answer
questions on "infrastructure". This left us with no reasonable choice
other than to make it public. Despite this, we did not do so initially,
hoping that the placing of the report before Cabinet would make this
unnecessary. This has not happened and this is the justification for
our release of this document.
"Theatrics" is a generous description of politicians who will ignore
people's right to life until just before the 2004 elections.
The controversy around antiretrovirals exists because of government
delays. Announcing and implementing a programme that starts to provide
treatment to people in need is the surest and quickest way to end the