In South Africa, governance structures in the form of clinic committees and hospital boards are intended to ensure community participation in the healthcare system at facility-level. They are provided for in South African law and are key to ensuring accountability and a successful HIV/AIDS and TB response. They are the forums through which public healthcare users are meant to engage and take ownership over the health system, raise concerns and ensure accountability at local, district, and provincial levels. The committees should be made up of a combination of community representatives and health professionals and allow community concerns to be heard and addressed. However, it cannot be claimed that clinic committees or hospital boards function effectively in any province. Too many lack a clear understanding of their role and responsibility and no financial resources are allocated to improve this situation. TAC is working to capacitate certain clinic committees however the government needs to do much more to improve their functionality in areas where TAC doesn’t have a presence.