Unanswered questions surround the National Aids Council

Once again the battle against the South African AIDS epidemic has been dealt a blow with controversy and politicking surrounding the long awaited announcement of the National AIDS Council.

Now the danger, according to AIDS activists, is that as in the past with Sarafina 2 and Virodene, good intentions on the side of government, will do more harm than good.

Chaired by deputy president Jacob Zuma, the Council consists of 13 government ministers, two government officials and 16 members representing sectors as diverse as the hospitality industry and traditional healers.

Attempts to get answers from the department of health on how the council members were chosen have been fruitless.

The AIDS directorate indicated that they had no mandate from the Minister’€™s office to speak on the Council.

An official said a second meeting was planned whereafter question from the media would be answered.

The council held its first meeting last week and cancelled a press conference after changing the times and venue on several occasions.

This only fuelled the controversy surrounding the body.

These actions have also fuelled the dissent among the non-governmental organisations, activists and other AIDS specialists. The voice of the Treatment Action Campaign (TAC), a lobby group committed to cheaper access to anti-AIDS drugs, has been the loudest so far.

Spokesperson Zackie Achmat was cautious in welcoming the government’€™s political commitment to the Council by nominating some of its most senior ministers, but expressed regret that the council members from civil society did not represent the same seniority.

“For example, the senior executive of the South African Non-Government Organisation Coalition (Sangoco) is not on the Council.

“Neither is there anyone from the Rural Women’€™s Movement, the National Land Committee or the Association for Rural Advancement. These are all organisations that deal with poor women in rural areas, women who are particularly vulnerable to HIV and AIDS,” he said

Achmat said none of the AIDS council members would disagree with the minister and they didn’€™t speak the language of the people who were in the poor, rural areas.

He was also critical of their ability to speak to urban youth and questioned how credible they would be speaking to young people.

Achmat said the TAC would have liked to see serious religious representation on the National AIDS Council. “We don’€™t think it’€™s adequate to have someone from the ANC’€™s Religious Desk. We would have like someone such as Bishop Lekhanyane of the ZCC or Archbishop Njongonkulu Ndugane on the Council.

“What surprises us most is, if the AIDS Council is meant to be an executive body and must carry out decisions, then its membership knows too little about HIV and AIDS. If it is a body that is symbolic, then the problems we’€™ve outlined above of not including or speaking to constituencies who are at risk is seriously problematic.”

Achmat said the Treatment Action Campaign was angry that at its first meeting, the National AIDS Council made no announcement about the pressing question of mother to child HIV transmission.

“This shows the weakness of the civil society members on the Council to address issues that are controversial. The only civil society member on the Council who speaks for his constituency is Zwelinzima Vavi of Cosatu,” said Achmat.

No details have been released on what the council discussed at its first meeting. A press release indicated that the members were given copies of the council’€™s terms of reference and the HIV/AIDS and sexually transmitted diseases Strategic Plan for South Africa 2000-2005.

“Council discussed the documents broadly and will study them in detail and make their written submissions,” the statement said.

A source told Health-e that government gave no indication at the meeting that it was prepared to discuss the contents of the AIDS plan.

“They were told to make submissions on how to take the plan forward, not whether it was feasible,” the source said.

Dr Clive Evian, a former consultant to government’€™s AIDS directorate, said the council seemed to be too loaded with government officials and had too few people with real expertise and experience

But he said there was concern that those who ‘€˜bashed’€™ government did not always understand the difficulties that government faced as well as government’€™s relative inexperience in management and delivery.

“It is always easier to shout advice from the sideline. However, there is clearly a lack of legitimate expertise and some important role players and others have been left off.

“But let’€™s see what happens and give them a chance. I do think they must know they will be watched and there is an expectation of action.”

Evian said South Africa did not need “rocket science”, but simply – basic primary care services, good information and education, better utilisation of the mass media, the schooling system and workplace, mother to child prevention, more levels of care from community to tertiary level and more support services for People living with HIV/AIDS.

Mary Crewe, director at the Centre for the Study of AIDS (University of Pretoria), said one of the interesting things was that the Council brought new people to the AIDS world, which consisted of a small pool.

“So, there is a possibility for new energy and new insights and new sectors to get involved and new creative ways to deal with the epidemic.

“Having said this, some obvious sectors were overlooked. You need a balance of new people and the older, experienced people. They have failed to strike a balance,” Crewe said.

Crewe said a wealth of experience and expertise was overlooked in what appeared to be a selection procedure that was flawed and not transparent.

“Nobody really knows what the role and function of this council is going to be.”

Crewe said the teachers’€™ unions should have been there

“It can’€™t be an advisory group as all those people with expertise have been left out. If it is a lobby group, then it might work,” she said.

Mark Heywood, head of the Aids Law Project, said his initial response was that there had been a deliberate exclusion of certain communities.

“It is ludicrous that there are two traditional healers and no ‘€˜modern’€™ healers (medical doctors).

“But we can’€™t afford to pronounce this council a failure until we have given it a chance. The challenge lies with the members to engage effectively with their sectors,” Heywood said.


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