Civil-society organisations in South Africa are preparing to push government to meet its commitment for setting national targets on HIV/Aids, made at the recent United Nations General Assembly Special Sessions on HIV/Aids (Ungass).
The first special sessions on HIV/Aids were held in 2001, when UN member states signed a declaration of commitment on HIV/Aids that recognised the need for concerted action against the pandemic. This was in acknowledgement of the fact that HIV prevention and treatment initiatives were failing to reach many of those most vulnerable to HIV.
Ungass then convened from May 31 to June 2 2006 to enable countries to report back on their progress in achieving earlier commitments.
South African Aids activists went to the 2006 Ungass meetings in New York with high expectations, hoping the final declaration of the conference would include clear global HIV/Aids targets according to which nations around the world could be held accountable. The targets were expected to put pressure on governments to set corresponding national goals, central to measuring authorities’ performance in HIV prevention and treatment.
But at the end of the conference, no clear objectives had been set.
Wealthy countries rejected setting targets because they did not want to commit to specific amounts of money for poor nations’ HIV/Aids programmes, while many African governments were reluctant to set exact numbers concerning improved access to treatment.
South African officials at Ungass promised to set national HIV/Aids targets by the end of the year, however, a pledge that civil society organisations now want to ensure they keep — claiming government’s current approach to HIV/Aids is not delivering the goods.
“At the moment, [South Africa] is not managing the pandemic in a comprehensive, coordinated way,” said Sipho Mthathi, general secretary of the Treatment Action Campaign (TAC), a Cape Town-based non-governmental organisation (NGO) that has been campaigning for the provision of anti-retroviral drugs (ARVs) and the reduction of HIV infections for almost a decade.
“Infection rates are on the increase in South Africa, and therefore targets are crucial for action planning,” she added.
Fatima Hassan, a lawyer with a Johannesburg-based NGO, the Aids Law Project, said benchmarks were also needed for ARVs. “We need to know how many people will be treated where, and by when,” she noted, adding that not only “the quantity but also … the quality” of services needed attention. Patients receiving ARVs require considerable support with regards to counselling about the possible side effects of their treatment, and related issues.
Aids activists complain that previous targets set by government for ARVs were too low, and that separate targets for adults and children are necessary to measure the extent of children’s access to the life-saving drugs.
However, government has already had difficulty in meeting these earlier targets. Although its treatment plan aimed to have 381Â 177 people on state-funded ARVs by the end of 2005, only 85Â 000 people were receiving treatment by September 2005. No new targets for 2006 and beyond have been set as yet.
The Joint United Nations Programme on HIV/Aids estimates that about 80% of South Africans in need of ARVs were not receiving them at the end of 2005.
As a step towards targets, the TAC is joining other civic groups to organise a national civil society conference in October. This meeting will bring NGOs from around the country together in the commercial hub of Johannesburg to write an HIV/Aids consensus statement that will be handed to government.
The document will demand, in part, target-based planning for efforts to counter the pandemic, and a more comprehensive national audit of the spread of Aids. “Without knowing the true extent of the pandemic we cannot make budget decisions,” explained Mthathi.
Even as preparations for the national conference move ahead, however, activists are voicing concerns over confused messages from government as to whether it is really prepared establish national Aids targets.
Deputy President Phumzile Mlambo-Ngcuka has given assurances that authorities will stand by their commitment to set the goals.
However, at the Annual Implementers’ Meeting of the United States President’s Emergency Plan for Aids Relief held in the South African coastal city of Durban recently, Minister of Health Manto Tshabalala-Msimang reportedly said that setting targets for ARVs stood against the right of each South African to decide whether he or she wanted to receive treatment or not. (Repeated efforts by IPS to get comment from the Department of Health on the minister’s alleged remarks were unsuccessful.)
Aids activists are also intent on making the South African government honour its commitment at Ungass to consult NGOs in the campaign against Aids — even though the past relationship between authorities and civil society has been a troubled one.
Activists have repeatedly described government’s response to the pandemic as inadequate, with some NGOs, such as the TAC, taking authorities to court to demand better access to ARVs.
President Thabo Mbeki’s questioning of whether HIV causes Aids has also caused controversy in South Africa, while Tshabalala-Msimang has been criticised for giving out what is seen as confusing information on the treatment of Aids and safety of ARVs.
Earlier this year, NGOs complained that government had not considered their views when writing its country report for Ungass, although it had been stipulated that this document was to be jointly compiled by the administration and civil society.
“While we have to believe that government wants to operate in good faith and hold up democracy, we are prepared to go to court and launch international campaigns to put pressure on government if it is unwilling to include civil society in the process,” said Mthathi.
The consensus document will urge officials to strengthen the South African National Aids Council (Sanac).
Established in 2000 by government to enable greater cooperation with civil society, Sanac has been repeatedly criticised in recent years for not managing funds properly, ineffectiveness and excluding members of civil society. NGOs also complain that Sanac’s structure is dominated by the national Department of Health and its policies.
Yet, the council remains a key link between civil society and the Department of Health. — IPS