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The State has an AIDS plan
Dr Manto Tshabalala-Msimang. Minister of Health. Right to Reply. Mail and Guardian. 28 February 2003
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The following article was written to and published in the Mail & Guardian newspaper as a "Right to Reply", by Health Minister Dr Manto Tshabalala-Msimang:
Normally I do not respond to journalistic fiction about me. But I cannot allow last week?’s article in the Mail and Guardian (?“What?’s so special about AIDS??”) to pass without challenge. This is because the article poses a threat on at least three fronts.
Firstly, it totally misrepresents my approach to HIV/AIDS and undermines the government?’s intensive efforts against this major challenge. Secondly, it exploits the emotions of those living with HIV/AIDS by suggesting that their own government does not care or share the urgency the urgency and desperate nature of their situation. Lastly, it falsely suggests some kind of contradiction within the government and particularly between myself and the Department of Health?’s Director General, Dr Ayanda Ntsabula.
I have been on record as saying HIV/AIDS is a major challenge facing the country. It is not just a health problem that can be contained by adopting a few medical or health-centred interventaions. My view is that it affects almost all sectors of our society and therefore requires a much more comprehensive and concerted response.
This is exactly what informs our HIV, AIDS and STI Strategic Plan for 2002-2005. The plan emphasises a multi-sectoral approach, pulling together resources of all sectors in fighting this developmental challenge. The South African National AIDS Council (SANAC)leads and co-ordinates this very important partnership and advises the government on further policy direction on HIV/AIDS.
The magnitude of financial and other resources that the government puts into curbing the spread of HIV infection and reducing the impact of HIV/AIDS cannot be compared to a response to any other disease.
Our standpoint is that any policy development on AIDS, or any other field for that matter, cannot be dictated by agreements we enter into with our social partners. Actually it should be the other way around. We should enter into partnerships based on the government?’s own policy decisions. This, among other things, will ensure that we honour our commitments within those initiatives.
This approach has applied in the case of the National Economic Development and Labour Council (Nedlac) discussions on HIV and AIDS. Most matters referred to in the Nedlac discussion document on HIV and AIDS cover programmes that are already being implemented by the government. The government was happy to discuss these issues at Nedlac as we believe that their success is dependent on the mobilisation of all social partners.
On AIDS-related treatment, the government indicated that there was a task team made up of the Health Department and the Treasury, which is currently looking at resource implications for various treatment options including anti-retroviral treatment. This exercise will not only cover the cost or procurement and the dispensing of the anti-retrovirals, but will also look at factors such as the health infrastructural base required for the safe and effective administration of anti-retroviral drugs.
I want to state quite plainly that we are concerned about the challenges that HIV and AIDS treatment poses. We are not trying to dodge the issues but come to terms with their complexities. We want to offer the best this country can ?– and to do so in a sustainable manner that overcomes many of the weaknesses in our delivery systems.
The government representatives in the Nedlac dialogue consistently took the position that the section of the discussion paper dealing with the anti-retroviral drug treatment be bracketed for further discussion. The government?’s position in such a discussion will be informed by the policy adopted on treatment in response to the findings of the Health/Treasury task team. These findings are expected to almost certainly by April. The government wanted to ensure that we discussed these issues from an informed position in terms of their financial and infrastructural consequences.
There is no agreement that the government is refusing to sign. There is work in progress based on the discussion document presented by the Treatment Action Campaign. We are committed to continuing the dialogue aimed at reaching consensus among Nedlac partners subject to the policy-making processes outlined above.
As chairperson of the Cabinet?’s social cluster, I have made it clear that our priorities this year include the expansion of the Mother-to-Child Transmission of HIV programme and increased funding for post-exposure prophylaxis (PEP) for survivors of sexual assault.
The spread of HIV infection and impact of AIDS are major challenges facing our country. We need to recognise that the challenges are compounded by conditions of poverty and underdevelopment that undermine the overall health status of our population.
High levels of illiteracy and lack of access to means of communication continue to limit the impact of our HIV prevention and health messages in general. Hunger still discourages people from completing their six-months' treatment for tuberculosis ?– a disease that remains the biggest killer of people with HIV/AIDS, despite being curable, even in the presence of HIV.
The fact that this government places the challenge of poverty squarely on the AIDS agenda is not an indication that we are reluctant to tackle the issues of treatment. Quite the opposite: poverty eradication and medical interventions are mutually reinforcing and we would be selling our people short if we did not attend to both. |
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