[Marxism] SA government ends Aids denial

Patrick Bond pbond at mail.ngo.za
Sun Nov 5 03:21:55 MST 2006

glparramatta wrote:
> ... the ANC government has been forced to back down, if indeed that is 
> what has happened (the ANC has failed to keep its promises in regards 
> to AIDS treatment many times), by the mass movement...

For the authors of this article covering the 27-28 October congress,
'Important indicators would be the restructuring of the SA National AIDS
Council - SANAC - and concrete commitments to dealing with violence
against women. The civil society congress ended on a confident note as
years of critical engagement with the state, largely led by the TAC,
showed results.' More results are available in today's report, below.

Certainly the rhetoric from Pretoria is finally consistent with the
pro-treatment position. But what about the reality; what would be more
substantive indicators?
* Showing a plan for rapidly doubling or tripling the number of people
on treatment?
* Firing health minister Manto Tshabalala-Msimang, as TAC has long
* Deporting Matthias Rust and ending his vitamin reign of t/error, and
reversing current state encouragement for other AIDS denialists, e.g.
Antony Brink, David Rasnick, Khayelitsha Sanco?
* Providing subsistence packages to those recieving ARVs, to include
additional nutritious food, clean water, electricity and transport
* Immediately ending the policy of terminating disability grants to
those whose CD4 counts rise above 200?
* Shifting from decentralised, unpaid community care of HIV people to a
much stronger and well-funded AIDS treatment system in hospitals,
clinics and homes?
* Requiring insurance companies to be more generous to those with HIV+
status? Requiring companies to implement ARV coverage for workers and
extend options to partners?
* And, to deal with the kind of stigma Peris Jones identified in his
article below, replacing LoveLife psycho-babble with very clear, strong
* Others that activists have been making demands around that I haven't

The past eight days have shown none of these kinds of indicators, and
'restructuring SANAC' doesn't seem a particularly strong demand given
how seriously the society takes the advice of a prior SANAC chair whose
AIDS prevention technique is a hot shower after-the-fact.



A Victory for Civil Society Activism

Sipho Mathathi, Secretary General of the Treatment Action Campaign
(TAC), victoriously holds up her fist at the National Civil Society HIV
and AIDS Prevention and Treatment Congress, a watershed event marking a
dramatic change in government’s outlook in dealing with the treatment of
HIV and AIDS, after sustained civil society lobbying and advocacy.

The Congress, which took place from 27-28 October 2006 in Randburg, was
a high level event which boasted a list of luminary speakers, including,
but not limited to, South Africa’s Deputy President, Pumzile
Mlambo-Nguka, Deputy Minister of Health, Nosizwe Madlala-Routledge,
President of the Congress of South African Trade Unions (COSATU), Willie
Madisha, as well as its General Secretary Zwelinzima Vavi.

The civil society coalition responsible for organising the event,
comprised of the TAC, the South African Council of Churches, the South
African NGO Coalition and COSATU. A total of 350 delegates representing
the various civil society partners attended the event.

The congress had multiple objectives related to reaching consensus about
the prevention, treatment and support of HIV/AIDS. This included
offering concrete civil society recommendations relating to the
restructuring of the South African National AIDS Council (SANAC), an
agency that has to date been criticised for being ineffective and
unrepresentative. The congress was timed to influence the outcomes of
the National AIDS strategy, which is currently being reviewed by the state.

Under the broad banner of solidarity, the congress engaged with the
above objectives in relation to the rights of marginalised groups such
as women and children. Violence against women was an important area for
consideration. Also highlighted, were the rights of prisoners.

South Africa’s Deputy Minister of Health surprised all with her candid
acknowledgement that government had failed to develop an effective
HIV/AIDS strategy. She expressed government’s willingness to strengthen
its partnership with civil society to increase access to AIDS drugs and
urged civil society to demand “truthful and honest answers” from the
state. She also recognized the need to have more accredited sites closer
to communities to deal with the increasing number of HIV/AIDS patients
who need antiretrovirals.

At the same time, Mlambo Nguka, who also heads SANAC invited civil
society organisations to play a key role in the restructuring of SANAC
to ensure that sectors that are directly affected are represented at
this high-level body. She acknowledged the need to have health
professionals, representatives of the infected and particularly women,
represented at SANAC. Mlambo-Nguka also stressed the need to develop and
strengthen partnerships against HIV/AIDS and for government to improve
access to antiretrovirals.

TAC's Mthathi made a rousing input calling for an immediate end to
opportunistic nationalism aimed at self interest and personal power.
However, she welcomed the Deputy President’s new proposals on SANAC as
well as the Department of Health’s partnership invitation.

In general, civil society leaders showed genuine appreciation for
government’s new stance, but cautiously pointed out that the weeks in
the run up to World AIDS Day on 1 December, when the revised National
AIDS strategy will be unveiled, would test government’s dedication to a
new vision. Important indicators would be the restructuring of SANAC and
concrete commitments to dealing with violence against women.

The civil society congress ended on a confident note as years of
critical engagement with the state, largely led by the TAC, showed
results. It highlighted an important point made at an earlier event
hosted by SANGONeT, which is that partnership within a framework of
contestation is important for democratic engagement and that civil
society has a critical role to play in sustained debate, substantial
advocacy and continued grassroots work.

- Butjwana Seokoma and Fazila Farouk, SANGONeT.



Manto muscled out in palace coup


There has been a palace coup in the Health ministry while Minister Manto 
Tshabalala-Msimang has been in hospital. Over the past three weeks, 
Tshabalala-Msimang’s deputy, Nozizwe Madlala-Routledge, and Deputy 
President Phumzile Mlambo-Ngcuka have seized control of the country’s 
HIV/Aids programme.

Mlambo-Ngcuka has been quietly consulting the Treatment Action Campaign 
and other civil society organisations over the past three months, in her 
role as chairman of the South African National Aids Council (Sanac), 
which is driving the development of a new HIV/Aids strategic plan for 
2007 to 2011.

The plan, to be released on World Aids Day on December 1, identifies a 
range of targets to be achieved by 2011, including:

# Treating 650000 people with antiretroviral drugs;

# Distributing 500 million male condoms a year;

# Promoting “mutual faithfulness” among sexually active people; and

# Reducing by 10% the number of children under 14 engaging in sex.

The plan also describes the lack of monitoring, evaluation and clear 
targets as “major weaknesses” of the previous plan, which was overseen 
by Tshabalala-Msimang. The old strategic plan expired last year but the 
Department of Health failed to draw up a new one.

Mlambo-Ngcuka and Madlala-Routledge have engaged with a range of Aids 
organisations and praised Treatment Action Campaign president Zackie 
Achmat, Tshabalala-Msimang’s arch enemy. Mlambo-Ngcuka has also 
committed the government to halving the rate of new HIV infections by 2011.

While Madlala-Routledge said that she had not officially been given a 
new role, she said: “I think I have been given the space to support the 
improvement of relationships.”

For almost three years, Madlala-Routledge was sidelined by 
Tshabalala-Msimang and excluded from HIV/Aids issues, according to 
department officials.

Yet in the past week, Madlala-Routledge stunned even her inner circle by 
speaking out bluntly about the government’s shortcomings on HIV/Aids.

She described South Africa’s stall at Toronto’s Aids conference — at 
which beetroot, garlic and lemon were promoted as Aids treatments — as 
“an embarrassment” to the government.

“Toronto was a catalyst and a turning point. It galvanised government to 
be on a new footing and to recognise that the atmosphere of perpetual 
conflict with civil society is not helping the fight against HIV,” she said.

TAC general-secretary Sipho Mthati described Tshabalala-Msimang as 
“tainted”, saying it would be difficult for Aids organisations to trust her.

Meanwhile, Tshabalala-Msimang is convalescing at her home in Tshwane 
where few people have been allowed to visit her. — Health-e News Service



Still not free to take ARVs
Peris Jones
27 October 2006 09:30

A small cross marks the grave of a man who died in KwaZulu-Natal as a
result of HIV/Aids. Stigma and uncertainty still surround antiretroviral
treatment among many communities. (Photograph: Paul Botes)
The hope that years of strife and stand-off may be giving way to a more
inclusive and participatory Aids policy cannot come a moment too soon.

It is particularly important to ask how the mixed messages of the
government and its conflicts with civil society exacerbate fears and
beliefs about antiretroviral (ARV) treatment. And, how does this
confusion manifest itself in communities and among people living with Aids?

A necessary starting point to reverse confusion is to provide
accessible, unambiguous and consistent information on treatment, as well
as involving the broader community in treatment issues.

In one semi-rural community outside Tshwane, it is easy to gauge the
palpable level of uncertainty surrounding ARVs. “Eh! Some of the people
are scared of treatment because if you spoke to someone and say let us
go and get some treatment they will pretend as if they take it and
stop,” said one woman living with Aids.

Some throw ARVs away because of pressure from relatives or gossip that
says ARVs kill. A woman who recently buried her neighbour told how she
discovered a cupboard full of ARV tablets, still sealed. ARVs have
themselves now become a signifier of Aids, marking someone as infected.
Some people are deterred from approaching the public sector ARV clinic
because “they were scared that some would look at them and say their
lives are over”.

The result is that many only approach the clinic when they are already
in an advanced stage of Aids. This is often the first time they receive
unambiguous information on ARVs. There are also fears about side effects
and lifelong treatment, as well as being encouraged to disclose their
status and generally having “to do a lot of things [preparation]” prior
to receiving treatment from the clinic.

Stigma is also present in the home: “Sometimes at home they see the
tablets you are taking … they start to comment, ‘Why are you taking so
many pills? What is wrong with you?’ and all the things like that and
there is nothing you can do.”

Taking medication is especially difficult where people have not
disclosed. Many spoke of taking ARVs in secret or devising strategies,
such as removing ARVs from the original packaging and concealing them in

Those who had disclosed to friends, family or colleagues reported a more
supportive environment was more likely, but not guaranteed. One person
living with Aids described commencing ARV treatment: “It was a gamble.
Actually, I put my life at stake. Because I didn’t know exactly the ARVs
was gonna help me or is going to make my condition worse.

“I said it is better I put my life at stake as I have put my life at
stake before. They took blood [at a hospital four years ago] then they
told me that [I should] ‘go and die’. You see. So I risk again going for

One obvious source of information on ARVs should be the local community
radio station. But a radio presenter, with a weekly slot on Aids-related
issues, told me that it was currently addressing “alternative
medications” as the local hospital had not given permission for the
previous head of the clinic to promote ARVs on the radio. Instead air
time was being bought through sponsorship and advertisements for herbal
remedies and immune boosters.

Respondents were split on the desirability of mixing traditional and ARV
medication, but many openly expressed support for and personal use of
traditional herbs with ARVs: “I think that most of the times many of us
take ARVs and mix them with other treatment. How about we find someone
to come and clarify to us? I was told that you are not supposed to mix,
[but] some mix.”

These beliefs may be exacerbated by mixed government messages on
traditional remedies and the nutrition versus ARVs debate, but they
would certainly exist regardless. The dangers of this practice were
recognised by people living with Aids, one of whom mentioned 10
acquaintances that mixed ARVs and herbs: “I can tell you and assure
[you] that all those people are no longer existing. They are dead, they
passed away.”

Since June this year six people at one local community Aids hospice
died, apparently as a result of mixing medication and/or interrupting
ARV use. These deaths reinforce negative perceptions concerning ARVs.

It is a shocking indictment of the state of official stewardship of the
epidemic that such levels of confusion and apprehension exist in this
community. If ever there was a fitting testament to all the years lost
while waiting for a concerted and unified response, then surely it lies
in this community’s lack of freedom to take ARVs. As one person living
with Aids so tellingly put it: “They are not free, they are not free.”

Peris Jones is a visiting research fellow at the Centre for the Study of
Aids, University of Pretoria. This article is based on a research
project on perceptions of and access to ARVs

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