TAC Electronic Newsletter


29 September 2005

Contents




Please note: We intend to release a full report of the Third TAC National Congress that took place on 23 to 25 September by next week.

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President Mbeki: lead us to save lives!


“When the history of our time is written, let it record the collective efforts of our societies responding to a threat that put the future of entire nations in the balance. Let future generations judge us on the adequacy of our response.”
-- President Thabo Mbeki on the HIV/AIDS epidemic, 1 December 1999


"These failures [to deal with the HIV epidemic] start with a failure of leadership, beginning with the presidency and the Ministry of Health. Any health ministry that presides over the spread of an epidemic like this one has much to answer for. This lack of government leadership on HIV is a betrayal of our people and our struggle." 
-- Cde Zwelinzima Vavi, Third TAC National Congress, 25/9/2005

“We come from Limpopo, Mpumalanga, KwaZulu Natal ... we are dying waiting for hope and treatment in our provinces.”

This was a sentiment expressed by many of the 700 activists who participated in the Third TAC National Congress from 23 to 25 September 2005. The need for urgency in our actions, candour and unequivocal leadership expressed by President Mbeki when he launched the Partnership against AIDS is even greater today than before, as our country faces a dual crisis of death from AIDS and increasing HIV infections.

Congress participants included NGO leaders, union representatives and representatives of TAC’s over 13,000 members (and many more supporters) from six of South Africa’s nine provinces. This included Mpumalanga, Eastern Cape, KwaZulu Natal, three of the provinces where the implementation of the government's treatment rollout is progressing most slowly.

The Congress heard from some of South Africa’s most reputable researchers and medical experts, that despite efforts to contain the spread of HIV and avert a crisis, death due to AIDS persists in our country. Multiple studies including a count of death certificates by Statistics South Africa show a massive rise in deaths due to the HIV epidemic. Over 800 people are dying of AIDS a day.  Government's annual survey demonstrates an unabated increase in HIV infections, rising in 2004  to 29.5% of women surveyed in antenatal clinics. Yet, this year there was not even a comment from the Ministry of Health on the antenatal survey.

The Operational Plan for Comprehensive HIV and AIDS, Care, Management and Treatment said in 2003 already, that at least 400,000 people had AIDS and needed treatment. Against this in 2005, we cannot be satisfied that less than 80,000 people are receiving treatment through the public health sector (61,000 according to the Director-General of Health). The original treatment target for the end of financial year 2004/5 was over 180,000 (p. 52, Operational Plan, 19 November 2003, Dept. Health).

Congress participants lamented the growing burden of the HIV/AIDS epidemic on the poor, particularly on women. They expressed that while everyone needs to commit greater effort to the fight against HIV/AIDS, greater leadership on the side of government is needed and that the President now has to provide this leadership.

The statement made by Zwelinzima Vavi, which is now a source of much debate,  reinforced sentiments of people living with HIV and those who bear the heaviest brunt of the epidemic: poor people and particularly poor women.   

The participants regretted that the despite timely invitation to address the TAC congress, the Department of Health decided to decline all invitations.
  
The inaction of the health ministry and government on the issue of Mathias Rath’s undermining of  government's policy to provide antiretroviral treatment is one of the signs that politically endorsed denial has not ended in our country. The persistent prevarication by our Minister of Health, which goes unchallenged by President Mbeki, is a source of demoralisation and despair for many people and communities in our country whose lives are threatened by HIV.

We believe that politically supported denialism is a major factor  in our country’s inadequate response to the HIV epidemic. Institutions such as the South African National AIDS Council are rudderless and dysfunctional. Unless HIV prevention and treatment is said to be a priority by the President, then the present often hopeless situation will continue.

It is for these reasons that TAC fully supports the truth-telling done in the statement by Comrade Zwelinzima Vavi, General-Secretary of COSATU at the National Congress. Similar statements were made at the Congress by reverend Molefe Tsele, General-Secretary of the South African Council of Churches, and veteran ANC activist Cheryl Carolus.

We believe silence about this crisis and the political failures that underlie it are a failure of morality and a betrayal of the lives of thousands in our country who are affected by HIV.

We therefore call on all civil society and organisations, including big business, to demand leadership and a new partnership against AIDS based on urgency and compassion. Particularly, we ask the following of our President:

  1. Declare that the HIV epidemic is an emergency.
  2. Acknowledge the crisis of death due to the HIV epidemic in South Africa.
  3. Acknowledge the impact of the HIV epidemic on the rights and health of women in particular.
  4. Acknowledge the crisis of HIV prevention in South Africa and take urgent steps to reduce new HIV infections.
  5. Take steps to meet the treatment targets of the Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment for South Africa (Operational Plan), targets which government is failing to meet.
  6. Denounce HIV denialism and, in particular, charlatans like Matthias Rath and Tine van der Maas who cause confusion and death.


TAC notes the disappointing and defensive response by the Ministry of Health to Vavi's speech. It wilfully misrepresented his comments, instead of referring to what he actually said. The Ministry's statement contains no substantive response to his main challenge: that politically supported HIV denialism has resulted in inadequate HIV prevention, a struggling health system and far too few people on treatment.

Instead, the Ministry chose, once more, to launch a gratuitous attack on TAC and COSATU through statements such as the following "Vavi has abdicated his responsibility and allowed COSATU's policy positions to be driven by an antiretroviral drug lobby group - the TAC."

The Ministry should realise that COSATU and Vavi's support for TAC are informed by the effect of the HIV epidemic on COSATU members. Referring to TAC as an antiretroviral drug lobby group is wishful thinking. TAC is more than a 'lobby group'; it is a movement of over 13,000 members and thousands more supporters. The Minister of Health knows that TAC’s activities have also included extensive community education efforts, nutrition, prevention and campaigns to bring down the prices of opportunistic infection and antiretroviral medicines. It is tragic that the Ministry of Health cannot honestly claim to have made a successful effort on any of these issues.

When the history of our time is written, let it record that our country found the courage to confront its fears and the monsters which stood in the way of a future it had fought for and defended with everything it had.  Our President must lead us in finding that courage.

We endorse the demands made by Comrade Vavi and believe that these should be publicly endorsed by all those fighting HIV in our society:


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Speech by COSATU General-Secretary Zwelinzima Vavi at Third TAC National Congress


25 September 2005

Chairperson of the TAC Zackie Achmat, Leaders and activists of the TAC Comrades and friends,

To start with, let me express my gratitude and congratulations to TAC and its leadership. In the past few years, you have set the agenda for the nation on this critical challenge of HIV and AIDS. At the same time, you have built an organisation that plays a critical role in giving people a voice on this subject. This type of activism and participation is crucial for our democracy and our revolution.

As your chair's report points out, however, there is still a very long way to go. The report makes clear that the crisis around AIDS remains. The data paint a chilling picture.

Let me again highlight some of the issues. This should not be necessary, but the fact is that denialism means that the impact of HIV and AIDS is all too often ignored. As a result, too many people sit by in silence and even ignorance while our people are decimated by the failure to provide treatment and support for people affected by the AIDS pandemic. To start with, analysis of death certificates shows a shocking increase in the rate of death, at around 10% a year in the five years to 2002. Deaths due to TB and respiratory diseases like pneumonia and influence, which are largely due to AIDS, have doubled or tripled. In 2001, these diseases account for almost 30% of the official reasons given on death certificates for people aged 15 to 49, up from 15% in 1998.

The fact that the figures are so out of date points to the failure of our society even to monitor the progress of AIDS adequately. Even more tragic is that many of these deaths are today unnecessary. With decent treatment, most people with HIV should live decades longer. The rows of gravestones in the cemeteries, like the data on death, point to our failure as a society to deal with this challenge.

A further indication of our failure emerges from the continued rise in the infection rate. According to returns from antenatal clinics, the infection rate climbed 3% between 2002 and 2004. Today, HIV affects every segment of our society, indeed every family.

Comrades and friends,
The causes of the HIV epidemic can be traced, ultimately, to public
health policy failures and the structures of our society.

It starts, first, with the failure to ensure a comprehensive education and prevention campaign. By now, every South African should be well informed on the nature of this infection, how it can be avoided and how it can be treated.

Yet we all know that many people in our townships and villages still fall prey to a host of myths and legends. The media continues to spread sensationalist stories and vicious rumours. And con men like Dr Rath are allowed to report on fake cures and treatments without any adequate rebuke from the authorities. That ignorance can literally kill us: by exposing us to infection, and by leading to vicious stigmatisation of people with HIV. The government in particular continues to lag in education and prevention. It has left this core campaign largely to rich advertising companies that think they can sell AIDS information like they sell luxury cars or cellphones. The dependence on LoveLife has wasted hundreds of millions of rand on glossy publications that provide almost no real information and that seem geared to selling a lifestyle of consumerism for the rich.

In the real world, where most live, two out of five workers still earn under R1000 a month, and unemployment is running over 40%. Where are the LoveLife publications and broadcasts for workers and the poor? Where are the education programmes to reach all our people where they are - in the townships, in villages, in schools and in the workplace? Every government department should be informing our people about HIV. Every civil society organisation should be pulled into the struggle.

Second, the public health system is still failing to treat people with AIDS system on an adequate scale. For every ten people who need anti-retroviral treatment, only one is getting it through the public sector, and another one through the private sector. The failure to give our people hope of survival makes it harder to ensure effective prevention. It condemns tens of thousands to an unnecessary death, leaves their children orphans and leaves our communities poorer.

We in COSATU saw the initial commitment to provide anti-retrovirals through the public system as a major victory. But what do we see? True, in the richest provinces - in Gauteng and the Western Cape - treatment is now available to many. But in too many others, the waiting lists are growing while roll out remains painfully slow. Our people still die because they are workers, while the rich still survive on private care.

A third factor is the refusal to ensure serious sex education in our schools, and to ensure that the realities of sexuality are dealt with openly and honestly across our society - in the media, in government policies and statements, and in our clinics. Educators are still not adequately equipped to ensure that learners understand the facts of life in the time of AIDS. For its part, the press makes no effort to assist in open and frank discussion of the issues.

A fourth reason for the failure to deal adequately with the HIV epidemic lies in the persistent underfunding and poor management of the public health sector. The difficulty of rolling out anti-retroviral treatment in itself demonstrates the deep-seated problems. Indeed, while South
Africa spends more on health care as a share of its economy than most developing countries, the public health situation is far worse. That reflects the waste of billions on private health, while the public sector lacks beds, medicines, decent buildings, trained personnel and
management. Finally, two more fundamental social failures contribute to the spread
of HIV.

On the one hand, there is an extraordinarily high rate of unemployment amongst our young people. Today, close to two thirds young people under the age of 30 have never had a job since graduating from school. Life is cheap when you don't see a future for yourself, when it is so hard to find a way to participate meaningfully in society.

On the other hand is the subordinate position of women. As long as women depend economically on men, they cannot make the choices they need to avoid HIV. They cannot fight against the silence that makes it harder to stop the AIDS epidemic and to get treatment. The situation is compounded
by the persistent violence against women both inside and outside their homes.

Comrades and friends,
Ultimately, these failures start with a failure of leadership, beginning
with the presidency and the Ministry of Health. Any health ministry that presides over the spread of an epidemic like this one has much to answer for. This lack of government leadership on HIV is a betrayal of our people and our struggle. We are sitting by while the biggest threat to our nation since apartheid is ruining our families and our communities. We have to turn this situation around. With the destruction trail that is so evident - when last did any of us hear our President mentioning
the words HIV and AIDS? When last did we hear our Minister talking about the need to implement government policy including provision of the antiretrovirals and or accounting for failure of government to meet targets set by the government? Too many times we hear her speaking about
the spinach. There is nothing wrong with encouraging our people to eat healthily and to live healthily. But there is something very wrong when there is silence about the other government policy such as the need to ensure that people have access to cheap antiretrovirals.

COSATU itself must gear itself up for this battle. We have to acknowledge that our own efforts remain inconsistent. We need to ensure that every COSATU affiliates takes forward the struggle against HIV as a central priority for the working class. We must ensure that every workplace has policies to deal with HIV and AIDS. We have to ensure more of our shopstewards have training to counsel people with HIV. And we need to provide stronger back up for TAC campaigns that seek to ensure better prevention, testing and treatment for working people. I am happy to inform you that we have agreed with the TAC leadership to meet very soon after this congress and plan a much more tightly coordinated campaign of COSATU and the TAC.

To start with, we need to end the culture of denialism across society. HIV and AIDS should be core issues in every Alliance campaign, including the upcoming local government elections. Every major government speech should help increase awareness of the HIV crisis and fight the stigmatisation of people with AIDS. If LoveLife can't come up with an effective education campaign, the funds should be redirected to organisations that are more in touch with the majority of our people.

On the ground, every public servant should be trained to educate and help people affected by HIV and AIDS. The lifeskills curriculum must deal explicitly and openly with HIV and sexuality, and must be available for every student on a consistent basis. The whole education and prevention campaign by government must be redirected to meet the needs of ordinary South Africans. This campaign must be backed up by making counselling and testing part of routine healthcare in the public system.

We will of course continue to support the campaign for access to anti-retroviral treatment. We look to this congress to help define more effective tactics and strategies to achieve this aim. Every day lost is a death sentence for some of our comrades and friends. We need to come from here with a programme of action that will end the delays. 

Together with TAC and other partners in civil society, we need to develop effective strategies to deal with SANAC. This organisation was supposed to be the main way that all stakeholders can take a strong stand on HIV. Instead, it has become a toothless extension of government, and wholly ineffective. We have to either turn it around or withdraw from it.  These are all critical short-run strategies. In the longer run, we will continue to struggle for a more just society, where unemployment and oppression of women are no longer a crisis. The fight for decent work for all will be taken forward through our jobs and poverty campaign, which will hold general strikes at provincial level through the month of October. I know that you will be in the front rows of the marches taking place in the Western Cape and Eastern Cape on the 3rd of October 2005 and later in all other provinces.

Comrades and friends,
We look to this congress to identify stronger strategies for the fight against the AIDS epidemic. We cannot continue in denial while thousands are dying unnecessarily. We are sure your deliberations here will mark the beginning of a new stage in this new struggle.

Amandla

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Letter to MEC for Health Pierre Uys by Western Cape health-care workers


Minister Pierre Uys
Western Cape Ministry of Health
PO Box 2060
Cape Town, 8000

Dear Minister Uys

RE: Call by concerned health workers demanding action against the Dr Rath Foundation

We are health professionals involved in the Provincial antiretroviral programme. This is probably one of the largest challenges our health services have ever been confronted with. We hereby voice our outrage at the unhindered activities of the Dr Rath Health Foundation. In the name of this Foundation, our patients are being inundated with propaganda encouraging them to stop life-saving medicine. Many of us have had experiences with HIV-infected patients who have had their health compromised by stopping their antiretrovirals due to the activities of this Foundation. We are deeply concerned that materials distributed by the Dr Rath Health Foundation claim to have the support of our government.

For patients with advanced HIV disease, stopping antiretroviral medicine, even for a few weeks, can be the difference between life and death.

For patients who are relatively well on antiretroviral medication, interruptions in treatment are known to increase the likelihood of viral resistance and treatment failure, and could in turn lead to premature death.

For our community at large, infected and uninfected, any intervention which increases the chances of circulating strains of drug resistant virus are a public health risk, putting patients who are presently infected and those at high risk of infection in danger of becoming infected with an untreatable and fatal form of infection.

In addition, the Foundation is in breach of many of the ethical principles we, in our professions, adhere to in order to protect our patients. They have conducted unregistered clinical experiments on patients, and distribute unregistered medicines with potentially harmful effects.

Our patients are vulnerable because of the burdens of illness and associated stigma and we believe, as state-employed health professionals, that it is the duty of our government to protect these patients by ensuring that the medical care that they receive conforms with the requirements of the law and is based on widely accepted scientific data. It is our belief that this would ensure that their constitutional rights of access to health care are realised. We are bound by conscience to make this call on our government.

We are writing to you to request that action be taken at your instigation, whether by your office or the appropriate arm of government or some other appropriate body, immediately against the Dr Rath Health Foundation, for the following contraventions:

1) The conduct of human clinical trials without application to and authorisation from the Medicines Control Council as required by the General Regulations to the Medicines and Related Substances Act 101 of 1965 (regulation 34 of the General Regulations No. 510, dated 10 April 2003), and without ethical approval from an appropriate ethics committee for human subjects research.

2) The sale of unregistered medicines which are subject to registration, in contravention of section 14 of the Medicines and Related Substances Act. In terms of the Act “sell” includes the distribution of medicines without financial reward.

3) Publishing and distributing false advertisements concerning medicines, in contravention of section 20 of the aforementioned Act.

In spite of numerous protestations to government officials and bodies such as the Medicines Control
Council, we are dismayed at the failure to respond to these infringements. If there is no evidence of
action against the Dr Rath Health Foundation by 27 September 2005, we will publicly voice our objection at the failure of government to provide protection to our patients. We look forward to immediate action against the Dr Rath Foundation and to hearing from you in regard to this dangerous situation.

(signed by approximately 200 Western Cape health-Care workers)

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