Ivor Powell
Experts and activists in the fight against HIV/Aids are up in arms over the composition of the government’s new National Aids Council (NAC), unveiled last week to spearhead the fight against the pandemic.
The NAC – slotted as a body that will marry efforts by the government and civil society to combat the disease – excludes not only South Africa’s top experts in the field but also leading HIV/Aids non-governmental organisations.
With four million South Africans already infected and nearly 2 000 new infections per day, South Africa is currently at the epicentre of the disease, classified this month by the United Nations as a threat to security on the continent.
But the NAC, officially announced by Deputy President Jacob Zuma, is riddled with anomalies. These include:
l The crucial NGO sector is represented by a little-known American national, Dr Mark Ottenweiler, a fundamentalist Christian, not representing South African Aids NGOs.
l The country’s largest Aids NGO umbrella body, the Aids Consortium, which represents 230 NGOs, has been completely excluded.
l No researchers or scientists were named to the council.
l While two members were designated as representing the community of traditional healers, no member represents the community of doctors or health professionals in general.
l Despite the fact that they also function on an inter-ministerial committee within the presidency, no fewer than 15 government ministers have also been included in the NAC.
Other members include representatives of the women’s lobby, parastatal Escom deputy chief executive Bongani Khumalo (who will represent the business sector), youth representatives, sporting personality John Moeti, a representative of the disabled, a little-known SABC producer to mobilise ”celebrities”, and Congress of South African Trade Unions (Cosatu) general secretary Zwelinzima Vavi, who will represent trade unions.
The composition of the NAC was decided in the presidency from a shortlist submitted by the Department of Health’s Aids Directorate after a process of public nomination.
”With the exception of ministers and people linked up with government, the NAC is a bunch of nonentities,” said the Pan African Congress’s fiery health secretary Dr Costa Gazi. ”There is too narrow a spectrum of opinion for the NAC to have any kind of independence.”
Morna Cornell of the influential Aids Consortium said: ”We support a National Aids Council, but we are still unclear on just how the council was composed and how to ensure that it will not just be a talk shop.”
Helen Schneider, director of the Centre for Health Policy at Wits University, said: ”We’re watching to see if it will turn out to be a place for honest and meaningful discussion between the government and civil society.
”We’re also keeping an open mind on whether the NAC – as it has been composed – will be able to mobilise people in the fight against HIV/Aids.”
One health professional suggested that the composition of the NAC was ”dictated more by exclusion – who they wanted to keep out – than by who were the best people for the job”.
The backdrop to this sardonic assessment lies in a long-running conflict between Aids experts and the government, fuelled recently by the government’s controversial rejection of the anti-retroviral drug AZT despite significant evidence that it is effective in preventing the transmission of the HIV virus in pregnant women to their unborn fetuses.
The rubbishing of AZT has been spearheaded by President Thabo Mbeki on the basis of subsequently questioned research discrediting the drug and highlighting its toxicity.
But despite this campaign against AZT, there have been mixed signals from the government about the drug. The Mail & Guardian has learned that late last year, bowing to overwhelming opinion in favour of AZT in the prevention of mother-to-foetus HIV transmission, Minister of Health Manto Tshabalala- Msimang agreed to set up pilot projects for the use of AZT by March this year. However, two weeks ago, in another apparent about-turn, she reaffirmed the government’s policy of rejecting AZT.
The AZT issue is not the only source of conflict. NGOs and scientists associated at the time with advising the government on strategies of dealing with the Aids pandemic took a strong stand on former minister of health Nkosazana Dlamini-Zuma’s resolute sponsorship of the controversial Virodene treatment. Virodene was little more than industrial solvent – with far higher toxicity levels than AZT.
Aids experts’ confidence in the government’s strategy against the disease sustained its biggest blow – Zuma’s backing of the R14- million Sarafina II Aids musical.
Tensions also arose over the announcement by Zuma that HIV/Aids be made a notifiable disease, one where the government and other players would be informed once it was diagnosed.
In the midst of these tensions, the Aids Advisory Group – a body of experts and NGO representatives until then involved in the formulation of government policy – was summarily disbanded.
When it was first mooted, the NAC was envisaged as a body which, though more representative than its predecessor, would perform many of the functions of the old advisory body.
Repeated attempts by the M&G to secure the government’s explanation of the appointments met with no success.