/ 3 November 2006

Is this the sea of change?

The Treatment Action Campaign (TAC) may suspend its call for Manto Tshabalala-Msimang to quit as health minister — if the government “shows the leadership on HIV/Aids we have been asking for over the past five years”.

TAC general secretary Sipho Mthathi made this declaration after a remarkable week in which Deputy President Phumzile Mlambo-Ngcuka and Deputy Health Minister Nozizwe Madlala-Routledge pledged to work with Aids organisations to fight HIV.

“What we are calling for is leadership in the department of health on HIV/Aids,” said Mthathi. “While it will be difficult for us to have confidence in the health minister, what will enable us to live with her is if she and government start to seriously address the problems of HIV and tuberculosis.

“We have raised the problem of the minister’s failure to lead on HIV/Aids with the Presidency. They need to deal with this problem, and if they do we will call off the campaign for the minister’s resignation.”

At a University of Cape Town panel this week Madlala-Routledge also paid tribute to the government’s old enemy, TAC leader Zackie Achmat. She said government had changed course after being embarrassed at the Toronto International Aids Conference earlier this year. She had recently lost two cousins to Aids, she added.

Madlalala-Routledge, backed by Mlambo-Ngcuka, is rapidly assuming a leadership role in government. City Press reported that Social Development Minister Zola Skweyiya had severely criticised Tshabalala-Msimang’s mishandling of the Toronto conference.

Mlambo-Ngcuka has effectively staked her reputation on improving the government’s approach to HIV/Aids, and the health ministry is going to come under immense pressure to shape up.

“The vibe we are getting is that the Presidency is taking control of the situation and will ensure that the health department operates differently,” said Mthathi.

After a three-week absence because of ill-defined illness, Tshabalala-Msimang found on her return to work this week that the Presidency and civil society had forged a new partnership to address the virus.

Mlambo-Ngcuka and Madlala-Routledge both addressed a two-day civil society meeting convened last weekend by the TAC, Tshabalala-Msimang’s nemesis. The minister was not invited.

This week, the structure of the revamped South African National Aids Council (Sanac), chaired by the deputy president, was revealed.

Stakeholders envisage that health officials will have to be far more accountable to Sanac on progress being made in fighting the virus.

In the past three months Sanac stakeholders have assumed control over the process of developing a new strategic plan for HIV/Aids for 2007 to 2011. This was after the health department failed to do so when the old plan came to an end last year.

Sanac’s draft plan stresses the need for proper monitoring and evaluation of government’s Aids response — which was absent from the 2000 to 2005 plan.

The new strategic plan is due to be launched in a few weeks’ time on Aids Day, and is also expected to pin the health department to meeting specific targets in the treatment, care and prevention of HIV.

While Mthati said there had been “a significant change in government’s language and tone” she cautioned that “in the end we will have to see how this translates into action”.

“We have to believe that this is a real change because it would be unimaginable for government to want us to go back to the conflict and division on an issue that should have united all of us,” she said.

Government’s commitment to redressing its mistakes could be assessed immediately by the speed with which it reached patients on the waiting list for antiretrovirals, she added.

“Government says there are 31 000 people on the waiting list. It could sort this out by the end of this year and that would be an immediate measure of its new commitment.” The TAC believes the immediate priorities are the need to scale up South Africans’ access to treatment, embark on mass prevention campaigns and send out the message that gender-based violence is unacceptable, said Mthathi.

The TAC and its allies have also called for an operational plan outlining definite steps government will take in health districts countrywide to address treatment, care and prevention, and for ARV treatment to be decentralised from hospitals to primary healthcare clinics.

“Everybody in government is tired of this conflict. It has become a moral issue for the ANC government. It can never justify what it has done in the past, but it now has an opportunity to atone,” Mthati said. — Health-e News Service.