Civil Society helps in KZN ARV Roll-out

About 90 NGOs in South Africa's KwaZulu-Natal province have teamed up to work with the government in rolling out anti-retroviral (ARV) drugs, in the first structured civil society response of its kind in South Africa, and possibly even on the continent. When the government announced a national rollout plan for free ARVs in September 2003, Cati Vawda, Director of the Durban-based Children's Rights Centre, and a number of her NGO colleagues, quickly realised that "government alone cannot do it".

Making ARVs available does not end with handing out the drugs, said Vawda, who has been co-ordinating the NGO initiative known as the KwaZulu-Natal HIV/AIDS Civil Society Network. Once the pills have reached the HIV-positive patient, a large number of additional requirements come into play - from AIDS education and treatment support, to legal and social issues.

With that knowledge, Vawda and her colleagues started to contact NGOs in the province and have now built up a network of about 90 organisations in the fields of health, human rights, HIV/AIDS, children and social security, among others. Participants range from one-person home-based carers, faith-based organisations, legal support networks and academic researchers, to large funding bodies.

"A successful ARV rollout requires long-term co-ordination of services between civil society and government, and good monitoring of the process has very high organisational demands," Vawda explained. It would be impossible for the government's health department on its own to individually appoint home-based carers, counsellors and community mobilisation groups, to systematically support the rollout.

KwaZulu-Natal, on South Africa's east coast, has an HIV prevalence rate of 33 percent compared to the national average of 25 percent.

A task team of 18 representatives currently co-ordinates the civil society network. They have managed to pull together a variety of organisations and initiatives that were operating on the ground, but were in many cases unaware of each other.

As soon as the network was established, the task team contacted the KwaZulu-Natal Department of Health and met with provincial health minister Dr Zweli Mkhize. According to Vawda, he proclaimed his interest in co-operating with the NGOs, but official recognition of collaboration is still outstanding.

"The Minister is very committed to including civil society in the fight against HIV/AIDS," the department's spokesman, Dumisani Shange, told PlusNews, without elaborating on the details of co-operation with the NGO network.

The KZN network plans to make available a team of experts from different NGOs for each hospital in the province selected as a rollout site. The team would function as a resource and support network for hospital personnel and patients, giving them access to professionals in the fields of counselling, home-based care, AIDS education, advocacy, nutrition, social services, children's rights, legal services and much more. "No one organisation or institution has the capacity to offer all of these services, but together we do," said Vawda.

The success of the civil society network will depend on how seriously the department of health takes cooperation, and the quality of information on the ARV rollout it provides. Apart from tight teamwork with the hospitals, the network would need to be constantly updated about policies, regulations, budget allocations and other issues if it is to function efficiently.

The health department "has not developed an ethos of sharing specific information with civil society as yet,?” Vawda commented.
"It is not enough to know that there will be 32 ARV rollout sites by the end of August in the province. Civil society needs to know which hospitals have been selected for the programme, how sites have been assessed and accredited, the procedures and work plans for the drug roll-out, points of access for patients, and so on," she noted.

The network aims to work closely with the South African government, yet wants to maintain its independence. It therefore plans to seek funding from non-governmental and international donors. "We want to be an effective, constructive and strong critical voice," said Vawda. "Funding can either limit or enable this."

This item is delivered to the English Service of the UN's IRIN Humanitarian Information Unit, but may not necessarily reflect the views of the United Nations.