/ 11 April 2003

This is everyone’s fight

Zackie Achmat’s article in last week’s edition of the Mail&Guardian, “A long walk to civil disobedience”, deserves consideration and a response that is rational and measured. It will be a serious mistake if anyone, in his or her right-thinking mind, would stoop to the level of the author and personalise the important subject of HIV/Aids.

The country needs to be made aware that both the African National Congress and the government have, for a long time, and long before 1994, committed themselves to a better life for all. The HIV/Aids policies that are in place now are a result of years of evolution and years of struggle at the helm of the people of South Africa.

All the answers to Achmat’s concerns are contained in public documents that are published by both the government and the ANC. The resolution on HIV taken by the ANC’s national conference in December last year should serve as a point of departure. The latest and most comprehensive statement by the Cabinet is freely available both electronically and in print — that is the statement by the Cabinet released on March 19. It is interesting and ironic that none of the influential media organs have carried these important documents and statements. It is also ironic that Achmat preferred to ignore these important statements.

The government’s policy is based on decisions of various forums of the ANC. Among the decisions and resolutions of the most recent conference on HIV and Aids, the following can be regarded as very important:

  • To strengthen and accelerate the implementation of the national Aids strategy, as amplified in the Cabinet statement of April 17 last year.

  • The ANC is to be at the forefront of community mobilisation and leadership around HIV and Aids, especially around awareness, prevention, voluntary testing and counselling, treatment and care.

  • To accelerate research and testing on vaccines, as well as immunity boosters.

  • To strengthen the functioning of national, provincial, district and local Aids councils with appropriate accountability mechanisms.

  • To investigate making HIV and Aids a notifiable disease, taking account of the issues of patient confidentiality and stigmatisation.

  • To continue to fight the continued discrimination by insurance companies against dependants of people who have died of Aids-related diseases.

    All those who are committed to the struggle against HIV and Aids are asked to consider seriously the ANC resolution and Cabinet statement referred to above. The statement is available for all to interrogate, though its most important points include the following gains on the prevention front.

    Prevention of HIV infection is critical, because there is no known cure for Aids. Surveys confirm a high level of awareness of the disease among South Africans, and the youth in particular. The Khomanani campaign, with R98-million of government funds, is reinforcing this.

    Voluntary HIV counselling and testing is now available at nearly 1 000 public health sites, and more funds have been allocated.

    The government’s programme to prevent mother-to-child transmission of HIV, already the largest on the African continent, is being expanded towards universal access to nevirapine.

    Provision of anti-retroviral drugs to survivors of sexual assault is now national policy and sites are being expanded.

    Although an HIV vaccine is still many years away, progress is being made with government support.

    The following gains have been made on the treatment front.

    Public health facilities must treat opportunistic infections irrespective of HIV status. The government is working with pharmaceutical companies to lower the cost of drugs for these infections. Tuberculosis treatment is free in the public health sector.

    Nutrition is central to strengthening the immune system. It is essential for effective drug therapy.

    We have said that anti-retroviral therapy can improve the health of people living with HIV/Aids if used appropriately. The government continues to address barriers to introducing it — high drug prices, weaknesses in health infrastructure and treatment compliance.

    A joint Department of Health and National Treasury task team looking into resource implications of an expanded treatment response, including anti-retrovirals, is finalising its work for the Cabinet’s consideration — the response has to be sustainable.

    The Medicines Control Amendment Act will facilitate more affordable drugs when it comes into force this year. South Africa continues to work for an agreement in the World Trade Organisation that will provide new opportunities.

    I’ve outlined the essence of the Cabinet’s statement. The cause of the Treatment Action Campaign (TAC) is noble. It is in line with the efforts of the ANC and the government: that of getting safe and affordable drugs for our people.

    The greatest flaw of the TAC campaign is that it appears to be aimed at attacking individuals and groups who do not agree with it, while ignoring all points of convergence between the TAC and other organisations, and between the TAC and the government.

    The constant attacks by the TAC and Achmat on the ANC, the president, ministers and other members of the ANC are unwarranted. The viciousness of Achmat’s actions is matched only by the statements that were made after the tripartite alliance’s march at the World Summit on Sustainable Development, which frustrated the TAC and its ilk because of its demonstration of our partnership and unity. I hope that Achmat will consider more constructive ways of communicating his anger.

    Dr Confidence Moloko is the deputy chairperson of the ANC’s national health committee. He is writing in his personal capacity. This response is drawn, in large measure, from a Cabinet statement made in March