Health Systems

TAC and the ALP’s response to the Free State ART moratorium and the health budget crisis

TAC has taken to the streets in the past week to demonstrate our frustration with the needless pain and death caused by ART delays, and to show solidarity with patients in the Free State who have been denied access to essential healthcare services.

TAC’s first action was a march which began inside Pelonomi Hospital in the Free State. The march was organised by comrade Sello Mokhalipi and led by TAC Chairperson Nonkosi Khumalo and Deputy Chairperson Tebogo Klaas. Activists marched to the headquarters of the MEC for Health, Sakhiwo Belot, where a memo was presented by Nonkosi to a representative of MEC Belot. The memo condemned the ART moratorium and demanded its immediate abolition. The memo also made demands for more information about the budgeting shortfall, and for far greater accountability in the Free State Department of Health.

TAC’s second action this week was a picket outside parliament in Cape Town, chosen for its proximity to Finance Minister Trevor Manuel as he delivered his annual budget speech which outlined government’s health expenditure plan for the next financial year. The picket was also attended by activists from COSATU, the Social Justice Coalition and other civil society partners.

In the last week, TAC activists have mounted two different protests against the antiretroviral treatment (ART) moratorium in the Free State. Since November 2008, a moratorium on the ART roll-out has been in place in the Free State province. This means that no new patients have been initiated onto this life-saving treatment since then. Access to other essential healthcare services, including CD4 tests, has also been drastically reduced.

Last week, representatives of the AIDS Law Project (ALP) who visited the Free State met a man who was in hospital with a CD4 count of 8, but who had not been put onto a waiting list or given any assurances that he would be granted access to life-saving ART. Evidence from the Free State strongly suggests that the supply of drugs for existing patients is also inadequate, and that patients currently on ART have already suffered interruptions to their treatment regimens.

The ART moratorium in the Free State violates the right of comprehensive access to healthcare. Government has promised that the ART moratorium will be lifted in a few days. TAC, ALP, COSATU and other civil society organizations are monitoring the situation closely to ensure that new patients are initiated onto ART. We welcome the announcement by Health Minister Hogan that a team of 20 financial experts will be deployed to every province to ensure against a repeat of the poor budgetary planning and management which have led to the ART moratorium in the Free State. But the moratorium has resulted in untold suffering and likely death.

This is why TAC has taken to the streets in the past week to demonstrate our frustration with the needless pain and death caused by ART delays, and to show solidarity with patients in the Free State who have been denied access to essential healthcare services.

TAC’s first action was a march which began inside Pelonomi Hospital in the Free State. The march was organised by comrade Sello Mokhalipi and led by TAC Chairperson Nonkosi Khumalo and Deputy Chairperson Tebogo Klaas. Activists marched to the headquarters of the MEC for Health, Sakhiwo Belot, where a memo was presented by Nonkosi to a representative of MEC Belot. The memo condemned the ART moratorium and demanded its immediate abolition. The memo also made demands for more information about the budgeting shortfall, and for far greater accountability in the Free State Department of Health.

TAC’s second action this week was a picket outside parliament in Cape Town, chosen for its proximity to Finance Minister Trevor Manuel as he delivered his annual budget speech which outlined government’s health expenditure plan for the next financial year. The picket was also attended by activists from COSATU, the Social Justice Coalition and other civil society partners.

TAC General Secretary Vuyiseka Dubula explained that the picket was a demonstration of solidarity with people in the Free State who have been unable to access life-saving healthcare services. The General Secretary confirmed that the picket was not a means of attacking the Health Minister. However, Vuyiseka stated that TAC will never remain silent in the face of the suffering and death of people in South Africa. The General Secretary delivered a memo to a representative of Minister Manuel. The memo demands an immediate end to the current moratorium on the ART roll-out in the Free State, and an independent investigation into the financial crisis which led to the moratorium.

TAC, ALP and COSATU acknowledge that the situation in the Free State is indicative of greater issues of planning, management and accountability within provincial Health Departments. We will closely monitor the way health budgets are planned and spent, and will continue to call for greater financial accountability and transparency.

As part of TAC’s campaign around the crisis in provincial health budgets, TAC will create materials to strengthen public understanding of the Public Finance Management Act. Education is essential so that activists and our communities can hold government accountable for poor budgeting practices which threaten to disrupt access to ART and other essential healthcare services.

Further details of the campaign will be decided by TAC Secretariat and the Provincial Council, in consultation with TAC staff in districts. If people living with HIV in the Free State are not granted access to ART within a matter of days, TAC will mobilise nationally along with our partners to bring an immediate end to this violation of our right to comprehensive healthcare, and to the needless suffering and death of people in the Free State.