TAC Electronic Newsletter
22 August 2005
- The trial of the alleged murderers of TAC member Lorna Mlofana
will resume in the Cape High Court on Monday 22 August (today). For
Mandla Majola on 072 424 7181 or 021 364 5489.
COSATU Central Committee adopts TAC proposals
on health-care and HIV prevention and treatment
On 18 August the letter below by TAC chairperson Zackie Achmat and
deputy-chairperson Sipho Mthathi, was read out to the approximately 600
delegates of the third COSATU Central Committee (CC).
TAC welcomes the decision of the CC to adopt the contents of the letter
as part of the resolutions of the CC. Amongst other things this means
that the campaign for at least 200,000 people on treatment by end of
March 2006, is now supported by South Africa's largest trade union
federation with over 1,5 million members. TAC wishes to thank COSATU
for this support and we
look forward to ongoing collaboration with the implementation of this
For comment, contact Sipho Mthathi (TAC deputy-chairperson) - 021 788
3507 or 084 3007 007.
Save lives and build a People’s Health Service
The Treatment Action Campaign salutes COSATU and we wish you success
with the deliberations of the Central Committee.
The leadership the Federation continues to ensure the freedom
of all from poverty and disease, and is the source of the resolve that
people and their movements have gained to defend their rights and
ensure that they are counted in the new South Africa.
Thus, millions of poor South Africans depend on your resolve, including
to the need to prevent and treat HIV infection. In view of this we
appeal to you to take resolutions on the following issues:
The AIDS epidemic is still growing – prevent new infections
Eleven years into democracy, South Africa’s working class and the poor
many challenges. As is correctly reflected in the CC documents,
joblessness, poverty, and poor service delivery continue to dim the
possibility of a dignified life and enjoyment of real freedom for
millions. That is why TAC considers critical, and has joined, the
COSATU-led Save the Jobs Coalition. However, HIV must be seen as a
threat of equal weight, because HIV/AIDS threatens not only people's
right to life, but the country’s ability to rebuild itself
effectively and address the imbalances of the past.
- A report by the Human Sciences Research Council indicates that
HIV is the biggest reason for absenteeism and deaths among teachers in
SA. Similar reports have indicated loss of ability to work and loss of
skills among health-care workers, particularly nurses.
- A report by Statistics South Africa in January 2005 showed that
the annual numbers of deaths had increased by 42 % between 1997 and
2002 and that this was primarily due to AIDS.
- The 2003-2004 Antenatal survey shows that HIV prevalence among
women attending antenatal clinics has increased to 29.5%. There were
500 000 new HIV infections last year alone.
Sadly, our country and our government is still failing to take this
threat seriously. We need to alert you to the fact that the country’s
existing Prevention Framework (as contained in the HIV/AIDS Strategic
Plan for South Africa 2000 - 2005) expires at the end of 2005, but at
present there is no consultation on a new prevention plan.
We call on this CC to call for an urgent National HIV Prevention Summit
to devise a new plan to be organized by the Department of Health before
end of 2005, which takes into account gender, poverty and access to
information and goes beyond the simplistic Abstain, Be Faithful,
Condomise (ABC) model. Such a meeting
must include all stakeholders.
People with HIV are still dying – treat the people!
On treatment: The Comprehensive Plan for Care, Management and Treatment
of HIV/AIDS, released by Cabinet in November 2003, stated that at least
500 000 people had AIDS and needed antiretroviral treatment. To date,
only about 50 000 people are accessing antiretroviral treatment through
the public health system. This means that hundreds of thousands of
lives are still being lost.
The initial target contained in the Comprehensive Treatment Plan aimed
to provide treatment to 53,000 people by March 2004. Eighteen months
this target has still not been achieved. Since then TAC has urged the
health department to set a new target towards which provinces and the
National Department can work. A target is necessary because treatment
an urgent need for people with AIDS for whom each day’s delay decreases
their chances of survival.
TAC is calling for a national target of at least 200 000 people on ARVs
by end of March 2006. We ask the COSATU CC to endorse this target and
actively promote HIV testing and treatment including antiretroviral
treatment among all union members.
A People’s Health Charter to create Jobs for a Unified Health
Integrally linked to the ability of clinics and hospitals to speed up
the provision of treatment and offer quality health services, is the
presence of a Human Resources Plan for Health.
In July the Department of Health released the Charter of the Public and
Private Health Sectors of the Republic of South Africa (The Charter).
In August it released A Strategic Framework for the Human Resources for
Health Plan (The HR Framework). These are welcome moves, since both
documents have the potential to transform our current inequitable
health system into one that is affordable, equitable and unified.
It is regrettable that they have both taken too long to publish. Even
more regrettable however, is that both were born without meaningful
consultation with health care workers and health worker unions, civil
society and other stake-holders. To add insult to injury, a very tight
deadline for submissions has been set (August 15), which makes it
difficult for the stake-holders to develop properly considered
submissions. We appeal to you to support the call made by TAC, SAMA,
the SACC, NEHAWU and others to ask for an extension of the deadline for
submissions and for the process of finalizing the charter to remain
open beyond 15 August.
We believe that both the Charter and the Human Resource Plan, if they
are properly developed, are an opportunity to create thousands of new
jobs in the health sector, and to improve the quality and conditions of
service of existing health care workers. That is why we must oppose
attempts to finalise these documents without full consultation.
We call on COSATU to urgently develop concrete proposals on numbers of
health workers needed to deliver quality health services to the poor
and the conditions under which health workers should be employed.
Our commitment to social justice, full-employment, decent education,
public health, social security, dignified housing, equality and
expanding the rights and freedoms of all people ensures full support
for COSATU's struggle against unemployment, job losses and inequality.
Yours in the struggle for health, dignity and jobs!
Zackie Achmat Sipho Mthathi
Chairperson Deputy Chairperson
[END OF COSATU RESOLUTION ADOPTION - BACK TO
Health Department's misleading statements
will not rescue a poorly drafted Health Charter
The Ministry of Health has released a statement attacking TAC, SAMA,
COSATU and by implication SACC, SANGOCO, HOSPERSA, FEDUSA, NACTU, SACBC
and NEHAWU because of our criticisms of the draft Health Charter. (See
statement below.) The Department's statement is misleading and will not
rescue the poorly drafted Health Charter.
Here are the facts:
- Although the idea of a Health Charter was raised by the Minister
of Health at the November 2004 National Health summit, there was no
draft at that point. The Task Team that was appointed was not intended
to be a representative task team, but a team of experts. It did not
consult stakeholders in the process of drafting the charter.
- At a civil society stakeholder consultation held on 10 August
2005 about the process and proposed content of the draft Charter,
several of the organisations who attended indicated that the submission
deadline was too short and that public participation was being
curtailed and rushed.
- The Department states "TAC attended a stakeholder meeting where
the Health Minister presented the draft Health Charter and extended an
invitation to all roleplayers to make an input."
Indeed, the draft Health Charter was presented at a public event hosted
by the department on Monday 11 July. Although some discussion followed
the presentation of the Minister and the Director-General, it was made
clear that only written submissions on the charter would be sought.
This launch was primarily attended by government and private sector
health-care representatives. Very few trade unions and civil society
organisations were present.
- The draft Health Charter has not had any parliamentary oversight.
- The Department further states that it "is making arrangement for
these organisations [who wish to make oral submissions] to make these
But neither TAC nor the ALP has been advised of this. If past behaviour
is anything to go by, the Ministry will ignore us. Sadly, this is a
recipe for further conflict; TAC will not go away. The draft Human
Resources framework was released to a press conference on 3 August.
Again interested parties have been given very limited time to make
written submissions (by 15 September 2005). In the last week a series
of 'briefings' about the human resource plan have been hastily
conducted by the department. Again, important stakeholders have been
left out of these briefings. The trend emanating from the department is
that key policy documents and legislative amendments (e.g. pricing
regulations) are being rushed through with minimal substantive public
- A further misleading statement is "[t]he fact that these
organisations (Cosatu, SAMA andTAC) have not raised their concerns
until the Charter drafting process reached thisadvanced stage suggests
there might be an intention to derail this initiative, which is
critical in the transformation of the health system."
But the facts are:
(1) TAC and many other organisations were not made aware that the
Health Charter drafting process had reached an advanced stage. In our
view this is just the beginning.
(2) The Health Charter contains no concrete transformation targets
(merely rhetoric). The only concrete targets are for BEE. We do not
intend to derail the charter, only to improve it. The charter cannot be
agreed to in its current form because there are serious flaws with it.
We make no excuse for opposing the content while actively supporting
the principle of having a charter. In our view a Health Charter should
set out the vision of health delivery in this country and provide
concrete targets, plans and frameworks for improving quality, access
and equity. While we support broad based BEE in principle we believe
that the charter wrongly equates the transfer of ownership with
- Finally the Department states "We appeal to Cosatu, SAMA and TAC
to stop misleading the public and join the rest of the health sector in
engaging constructively with the process of developing the Charter."
- We respectfully point out that without SAMA, COSATU, TAC, FEDUSA,
NACTU, their affiliates, SACC and the organisations that signed the
letter below, there is not much left of the "rest of the health
sector", except for the Department of Health and private interests. The
Department cannot maintain credibility and ignore us.
[END OF RESPONSE TO HEALTH DEPARTMENT'S STATEMENT]
Here is the Department's statement:
Hypocrisy in the criticism of the Health Charter
16 August 2005
The Department of Health is dismayed by an undue and misleading
criticism of the
process of developing the Health Sector Charter by the Congress of
South African Trade
Unions (Cosatu), South African Medical Association (SAMA) and Treatment
These organisations are misleading the public by claiming ignorance
about the Health
Charter drafting process as they were all invited and at least two of
in this process.
The worst hypocrite is SAMA. The organisation's public statements
the spirit of the two submissions that it has made on the Health
In addition to a joint submission as part of the Private Healthcare
Forum, SAMA made a
separate submission on 15 August commending the Health Sector Charter
making additional inputs.
SAMA is one of about 15 organisations that have requested to make
to the Department on issues affecting medical practitioners in
The Department is making arrangement for these organisations to make
TAC attended a stakeholder meeting where Health Minister presented the
Sector Charter and extended an invitation to all roleplayers to make an
African NGO Coalition (SANGOCO), which is an umbrella body of
organisations (NGOs) including the TAC, has submitted a written comment
and is expected
to make a (verbal) presentation to the Task Team that developed the
The Department of Health extended written invitations to the trade
Cosatu and its five affiliate-unions with interest in the health sector
Nehawu, NUM, SAMWU, SADNU) requesting comments on the draft Health
organisations have not responded.
The fact that these organisations (Cosatu, SAMA and TAC) have not
raised their concerns
until the Charter drafting process reached this advanced stage suggests
there might be
an intention to derail this initiative, which is critical in the
transformation of the
The Department is satisfied with active participation and massive
response that the
draft Charter has received from health stakeholders. More than 50
representing the views of more than 100 organisations have been
received from a variety
of groups including various sections of private health sector, labour
and civil society
We appeal to Cosatu, SAMA and TAC to stop misleading the public and
join the rest of
the health sector in engaging constructively with the process of
Charter. As SAMA puts it in its submission: "the health care system
needs to be
transformed at various levels to be more patient centred and medical
a pivotal role to play in this regard."
The Department of Health is committed to ensure the process of drafting
Charter produces a document that enjoys collective ownership by all
Issued by: Ministry of Health
16 August 2005
[END OF HEALTH DEPARTMENT STATEMENT - BACK TO
Joint letter by civil society
organisations to Minister of Health on draft Health Charter
12 August 2005
Dr ME Tshabalala-Msimang
Minister of Health
Private Bag X399
Per fax: (012) 325-5526
RE: The Charter of the Public and Private Health Sectors of the
Republic of South Africa (The Charter) and A Strategic Framework for
the Human Resources for Health Plan (The HR Framework)
We are writing to you in respect of the Charter and the HR Framework.
We believe that both have the potential to transform the current
inequitable health system into one that is affordable, equitable and
We fully support the principle and rationale of both the Charter and
the HR Framework. However, we note that both have taken a very long
time to be drafted, developed and released in the public domain for
In addition, the deadlines imposed for making written submissions are
particularly short. In our view, both the Charter and the HR Framework
have been developed without the necessary participation of many civil
society organisations and/or their constituencies. In particular, the
concerns of health-care workers and users of the health system have not
been sufficiently addressed.
We are therefore concerned that given the above, as well as the very
short deadlines imposed for making submissions on both the Charter and
HR Framework (15 August 2005 and 15 September 2005 respectively), that
proper negotiation and discussion with organisations representing
health care workers as well as users of the health system (public
sector in particular) is unlikely. This is because so far, public
participation has been severely curtailed, and where permitted, rushed
and largely superficial. It also appears that there has been very
little parliamentary oversight over both processes. The latter is
crucial given that the Department plans to finalise both the Charter
and the HR Framework shortly.
In addition, inexplicably, the Department has chosen to have parallel
processes on issues that should be deliberated upon jointly. It makes
no sense to separate the issue of HR from the broader transformation
issues affecting the health sector.
We therefore appeal to you to ensure that all stakeholders are given a
reasonable opportunity to engage with the Department and other parties,
on these issues. For us, written submissions are a good starting point
but definitely not the penultimate step in finalising the Charter and
the HR Framework.
Therefore, while a number of organisations, are trying to meet the
deadlines for making written submissions, we believe that the real
process of negotiation and discussion is yet to commence.
For this reason, we would like to request a meeting with you and/or the
relevant task team/s with a view to having open and proper
negotiations. In the interests of participatory democracy, transparency
and bona fide negotiation, we hope that this meeting will take place as
a matter of urgency. This is especially important given the time frames
imposed for finalising the Charter and the HR Framework.
Finally, in our view:
- The deadline for making submissions should be extended.
- Proper and thorough negotiation and discussion processes should
be initiated throughout the country with all stakeholders.
- In any event, the Charter should be referred to NEDLAC for
negotiation and adoption, so that undertakings made by any of the
parties to the Charter will be properly negotiated and binding on that
Kindly note that a copy of this letter including the signatures of all
the organisational representatives listed below will be sent to your
offices shortly. In the meantime and for the sake of convenience,
please direct all correspondence to Mark Heywood (Tel (011) 717 8632,
fax (011) 403 2341).
We therefore look forward to hearing from you as a matter of urgency.
South African Medical Association (SAMA)
Kgosi Letlapa – Chairperson
Tel 012 481 2000
Fax 012 481 2118
National Education Health and Allied Workers Union (NEHAWU)
Fikile Majola – General Secretary
Tel 011 833 2902
Fax 011 833 0757
Johan Steyn – General Secretary
Tel 012 365 2021
Fax 012 365 2043
Chez Milani –General Secretary
Tel 011 279 1800
Fax 011 279 1821
South African Council of Churches (SACC)
Dr Molefe Tsele - General Secretary
Tel 011 241 7818
Fax 011 492 1449
Catholic Health Care (CATHCA)
Mr Tim Smith – Director
Tel 011 880 4022
Fax 011 880 4084
Treatment Action Campaign (TAC)
Sipho Mthati - Deputy Chairperson
Tel 021 788 3507
Fax 021 788 3726
AIDS Law Project
Mark Heywood – Head
Tel 011 717 8600
Fax 011 403 2341
Honourable James Ngculu MP
Parliamentary Portfolio Committee on Health
Per fax: (021) 403 2072 and (021) 403 2808
Ms NC Madlala-Routledge
Deputy Minister of Health
Per fax: (012) 325-5526
Mr TD Mseleku
Per fax: (012) 323-0093
MEC’s for Health
Mr Monwabisi Bevan Goqwana
Fax: (040) 635 0115
Mr Sakhiwo Belot
Fax: (051) 405 4608
Dr Gwen Ramokgopa
Fax: (011) 838 4143
Ms. Peggy Nkonyeni
Fax: (033) 395 2258
Mr Charley Sekoati
Fax: (015) 293 6150
Mr Pogisho Pasha
Fax: (013) 766 3475
Ms Eunice Shiwe Selao
Tel: (053) 830 2000
Fax: (053) 833 1925
Mr Mandlenkosi Elliot Mayisela
Fax: (018) 387 5726
Mr Pierre Uys
Fax: (021) 483 4143
[END OF LETTER TO MINISTER OF HEALTH - BACK TO
How my child lives with HIV
By TM as told to Vathiswa Kamkam
NOTES ON CALCULATING THE DOSAGE FOR CHILDREN ARE BY TM AS TOLD TO
VATHISWA KAMKAM. WE HAVE NOT VERIFIED OR EDITED THAT CALCULATION. -
My name is TM. I live in Town Two, Khayelitsha. I was born on 1 January
1971. On 25 June 1997 I gave birth to a baby girl at Karl Bremmer
Hospital. During that time I also heard that I was HIV-positive. My
little girl passed away after five days. At that time I became sick and
I was told I had double-pneumonia. I also tested positive for
Tuberculosis (TB) for the second time. I started taking my treatment
for eight months.
In 2003 I fell pregnant, I didn’t get AZT and I only got Nevirapine
during labour pains because I delivered at six months of pregnancy. AZT
is one of the ARVs that are given to pregnant HIV-positive women at 34
weeks to prevent her baby from infection in the Western Cape.
On the 23 March 2004, I gave birth to a baby boy, SM, who weighed 1,5
kilograms. He became sick and lost weight.
I was worried about SM and I had no hope that he would survive. I
stayed with him in hospital from April until June 2004. After three and
a half months, he was tested for HIV with the Polymarase Chain Reaction
(PCR) and he was HIV-positive. He started taking antiretroviral
treatment. His daily combination is 9ml stavudine (d4t) , 4ml
lamivudine (3tc) and 1,2ml of lopinavir/ritonavir syrups. The dosage
for a child is calculated according to the child`s weight and age and
the CD4% which is determined by weight x height / 3600 (uqikelelo
lwamajoni omzimba omntana) and the square root of the answer. This is
called the body surface area.
SM used to cry and kick the bottles when I gave him the medication but
now he grabs me when I have the bottles and he doesn’t cry at all. I
think he is used to the medication. He had been on the medicines for
one year on 10 June 2005. His weight now is 9,4 kilograms.
It is not difficult even for me to take my antiretrovirals as I started
them on 10 April 2005 because we took them at the same time (eight
o’clock). I would like to say to other mothers: Don’t be afraid when
your child needs to start ARVs. They help. I saw this from my child. I
lost hope but now I have gained my hope back.
[END OF HOW MY CHILD LIVES WITH HIV - BACK TO
Brief discussion on truck driver story
from previous newsletter
The story of a HIV-positive truck driver, FS (as told to Sibongile
Mashele), who continued to have sex with his wife and impregnated her
raised some controversy. One reader wrote:
"I found the interview with FS a little problematic. I just wondered
about several aspects in the article. For example, after being
diagnosed with HIV, he apparently does not disclose this to his wife,
has unprotected sex with her, she falls pregnant, loses the first child
and then falls pregnant again and now they have an apparently healthy
11-year-old. His wife fortunately tested negative on two occasions. She
is thus very fortunate indeed! He continues to have sex with many
partners and does not disclose his status to them but insists on using
a condom – this is good! He emphasizes the importance of always using a
condom if you are HIV+ (except with his wife, at least on the occasions
she wanted to fall pregnant …) – this is good. I just wondered about
the message that this interview is putting out. I wondered if a brief
commentary on such an interview might not be in order – esp. related to
the risk to his wife and/or child when having unprotected sex with her."
Editor's response: We agree that the story raised some controversial
issues. TAC certainly does not condone FS having unprotected sex with
his wife without informing her of his status in order to have a child.
Nevertheless, we think it was an interesting story about a transport
worker, a class of people at high risk of HIV who seldom have a voice.
But the reader's point is taken that this should have been accompanied
[END OF TRUCK DRIVER DISCUSSION - BACK TO CONTENTS]
[END OF NEWSLETTER]