– Don’t treat SANAC as a circus
On Saturday November 8th 2014 a plenary meeting of the South African National AIDS Council (SANAC) will take place in Secunda, Mpumalanga. Leaders of the Treatment Action Campaign (TAC) will participate in the plenary but we will also picket before the plenary to draw attention to the on-going health crisis in Mpumalanga and to protest at the fact that one year has passed since the TAC handed then Deputy President and SANAC Chairperson evidence and a memorandum on the crisis is Gert Sibande district and almost nothing has been done.
A draft progress report from SANAC shows that serious cracks are emerging in our national response to HIV. If these are not addressed they will widen dangerously. However, judging by the agenda of the plenary SANAC itself seems unwilling or unable to address the severe problems facing our public healthcare system and thereby our AIDS response.
SANAC has for example remained silent on the collapse of the Free State, Mpumalanga and Eastern Cape healthcare systems and on the ongoing severe problem of medicines stockouts. The national TB conference’s call that MDR-TB be treated as a public health emergency has not even been discussed.
We see severe challenges in our communities; declining adherence to treatment, demoralised community health workers, high rates of teenage pregnancy. Reaching the targets of the National Strategic Plan on HIV and TB (2012-2016) is threatened by these developments. Yet the agenda for Saturday’s SANAC plenary appears disconnected and irrelevant. Rather than driving a more effective AIDS response, SANAC seems content to paint over the widening cracks. It is particularly jarring given that this plenary meeting is held in Gert Sibande district of Mpumalanga, one of the provinces where the dysfunction in the public sector is most acute and HIV prevalence the highest. The two are connected.
In this context we are deeply concerned about the watering down of SANAC and its apparent side-lining by the Department of Health. In particular:
1. The Department of Health seems to be acting independently of SANAC and does not seem to be engaged in any meaningful consultation with SANAC. For example, Health Minister Aaron Motsoaledi announced a change in the HIV treatment initiation threshold in his budget vote speech on 23rd July, this change was not discussed with the SANAC treatment task team, which provides expert clinical advice on such issues. It would also have been important to consult with people with HIV so that our communities could have been prepared for the new policy. This failure to consult sends the message that the Department of Health has no confidence in SANAC and does not see a reason to consult with its partners.
2. We do not believe that Deputy President Cyril Ramaphosa has yet shown any real commitment to his vital role as the chairperson of SANAC. He has also ignored requests from the TAC to meet with him to discuss our concerns with SANAC. Mr Ramaphosa has the power and influence to help address the serious problems facing our health systems. He should use this power.
3. We are concerned that both the Minister of Health and the chairperson of the parliamentary portfolio committee of health has suggested that the TAC should exclusively raise issues through SANAC and not raise issues with the portfolio committee or in the media. The TAC has a Constitutional right to raise our concerns regarding poor healthcare service delivery through any and all lawful channels. Given the disregard with which SANAC is treated and the dysfunction in SANAC civil society, we will certainly not restrict ourselves to only working through SANAC. We will not be co-opted in this way.
4. Finally, we strongly oppose the fact that Adcock Ingram, a pharmaceutical company, has sponsored elements of Saturday’s plenary relating to civil society. While industry has a role to play in discussions at SANAC, it is not appropriate that pharmaceutical companies be allowed to sponsor such events. SANAC must remain independent of industry since it will at times have to play a watchdog role over industry.
Despite all the above we stress that the TAC remains committed to making SANAC work. Our leaders will continue to participate in AIDS Councils at all levels – national, provincial and district.
We now need the Deputy President to show whether he is committed to the struggle to end AIDS and TB or not. We cannot afford for a new denialism to take hold – a denialism about the shameful state of our public healthcare system and the growing consequences it is having on the implementation of the NSP.
We therefore call on Deputy President Cyril Ramaphosa to:
– Acknowledge the severe problems in our provincial healthcare systems and to take urgent steps to address it. This must include using his influence within the ANC to remove Benny Malakoane from his position as MEC for Health in the Free State (Malakoane is currently facing multiple charges of fraud and corruption).
– To provide SANAC with the strong and decisive leadership it needs and to ensure better cooperation between SANAC and the Department of Health.
– To meet with the TAC leadership before World AIDS Day 2014.
As Archbishop Desmond Tutu said earlier this week, in his appeal for support to the TAC, AIDS is not over. Watch Tutu’s message here tac.org.za/news/special-message-you-archbishop-desmond-tutu
For media comment please contact:
Anele Yawa, TAC General Secretary, 079 328 1215
Sindi Blose, TAC Deputy General Secretary, 078 718 2786
Note: The next issue of the TAC/SECTION27 NSP Review will be published on Monday November 10. It will include in—depth investigations into the situation in the Free State and the problems plaguing the National Health Laboratory Service. It will be available at www.nspreview.org.