Working for access to quality public healthcare in South Africa since 1998
6 April 2016

The Road to Durban 2016

– TAC statement following the meeting of the National Council, March 30th – 31st 2016

On March 30th and 31st 2016 the Treatment Action Campaign’s (TAC) National Council met in Booysens, Johannesburg. The National Council is made up of TAC’s national and provincial leadership. It is TAC’s highest decision-making body between congresses.

The National Council noted with concern the current political situation in South Africa, the state of the AIDS response and of the failing public healthcare system. The National Council agreed that the political situation in the country and the capture of parts of the state for material ends and self enrichment is having a detrimental impact on the quality of healthcare services delivered through the public healthcare system. The clearest example of this is in the Free State, where Dr Benny Malakoane remains as MEC of Health, despite multiple serious charges of fraud and corruption and evidence that TAC has presented to the government of the continued collapse of the province’s public healthcare system.

The National Council further discussed the following:

  • Shortage of healthcare workers: The Rural Health Advocacy Project presented on the freezing of posts and the reduction in budgets for provincial healthcare systems. The National Council is alarmed at the impact that staff reductions are having on our public healthcare system. We consider the underfunding of provinces and the freezing of posts in the healthcare system to constitute a crisis. We note that whilst government denies that it is officially freezing posts, TAC and partners have indisputable evidence that this is what is happening.
  • Quality treatment for all: The council also engaged in extensive discussion regarding recent scientific advances in our understanding of HIV such as the findings of the landmark START trial. The START trial showed that HIV treatment has important benefits for your health, even if your CD4 count is still high. The evidence now clearly shows that we must offer antiretroviral therapy to all people living with HIV. However, the council is deeply concerned that while we now know how to dramatically curb the spread of HIV and save lives, and while most policy-makers are saying the right things, the funding and political will to make this a reality is severely lacking. TAC is calling for the next National Strategic Plan to provide a roadmap to universal access to antiretroviral medicines including measures for vital health system strengthening.
  • Increased solidarity: The council recognised the important work being done by many of our partner organisations. TAC is part of the Fix the Patent Laws campaign – which is presently a coalition of 18 organisations. We intend to work much more closely with these organisations in other areas relating to healthcare. Through a process of branch, district, provincial and finally a national People’s Health Assembly, we will strengthen our links with partner organisations and refresh our mandate based on the realities faced by communities.

International AIDS Conference – a new beginning for AIDS activism?

In July 2016 the International AIDS Conference returns to Durban for the first time since the historic 2000 conference. The National Council recognised that the conference presents a unique opportunity for activists to once again change the course of the global AIDS response – a response that has been waning in recent years. Significant build-up work is being planned for all seven provinces where TAC has a presence – with special attention being given to mobilising and awareness building in KwaZulu-Natal, the province where the conference will take place.

After extensive debate the National Council agreed on the following three advocacy priorities for the conference and the period leading up to the conference:

  • A new era in access to medicines: Whilst we have had some victories in fighting for access to AIDS medicines, those victories were limited to specific ARVs. New AIDS medicines, TB medicines, and a number of cancer, hepatitis C, and mental health medicines are simply priced out of reach for people who need them. We cannot allow this inhumane state of affairs to continue. We have great expectations that the United Nations Secretary General’s High-Level Panel on Access to Medicines will in June publish an ambitious and paradigm-changing set of recommendations that will bring sense and humanity to the way society pays for medical research and for medicines. If the High Level Panel’s report is ambitious enough, we will place campaigns for the implementation of its recommendations at the centre of our advocacy at the AIDS conference.
  • No more hollow promises about “ending AIDS”: We now know that all people living with HIV should be offered antiretroviral therapy. We also have compelling epidemiological models suggesting that with an aggressive scale-up of treatment and care it is possible to dramatically curb the spread of AIDS. We agree with the recommendations made in the UNAIDS and Lancet Commission report on “Defeating AIDS – Advancing Global Health”. But whilst there is wide agreement on the direction we must take, the rhetoric is generally not being matched by political and financial commitments from governments or the private sector. What is required is a second wave of political will and commitment to the AIDS response. This is what we will demand from world leaders and donors in Durban.
  • No healthcare without healthcare workers and a functional public healthcare system: As with Ebola, the AIDS response is being undermined by dysfunctional healthcare systems and shortages of healthcare workers. In South Africa the HIV treatment programme is expanding at a much faster rate than capacity in the healthcare system. Whilst the need for healthcare workers is growing, budget cuts are effectively leading to a freezing of posts. One of the worst examples from South Africa is the Free State province – which lost a quarter of its public sector doctors from 2014 to 2015, in our view largely due to mismanagement by the provincial MEC for Health, Dr Benny Malakoane. Whilst the problem of mismanagement and dysfunctional healthcare systems is much wider than Malakoane, we will nevertheless centre much of our advocacy work on the Free State given how emblematic it is of the problems we face.
  • TAC has begun discussions with activists globally to set the agenda for AIDS2016. South Africa is in the midst of a political and economic crisis. Millions of people go to bed daily hungry. 60% of our young people are unemployed. Gender based violence is epidemic. These social realities are all drivers of the AIDS and TB epidemics. TAC calls upon all those attending the conference to recognise this and to make a pledge to support local and global activism to make a change to the AIDS response. AIDS2016 must not be another chapter in the AIDS gravy train. We will not allow it to be so.  

The National Council also made a number of additional resolutions. They include the following:

  • TAC must take a lead in the formation of a National Health Movement through working with its various partner organisations – both generally and specifically through the People’s Health Assemblies which will take place between April and June in all provinces.
  • TAC will use the Eastern Cape and the Free State provinces as focal points in our campaigning to improve the quality of services provided in the public healthcare system.
  • TAC will send a team to gather new evidence of the situation in the Free State public healthcare system.
  • TAC will organise a march in May 2016 to the Free State office of the National Prosecuting Authority and provincial police commissioner to call for all charges against Free State MEC Benny Malakoane not to be delayed any further.
  • TAC will continue to monitor healthcare service delivery at facility level. In addition to adopting at least one healthcare facility, each of our 236 branches will also adopt a school. We will ask the National Department of Health for a letter that will facilitate the monitoring of healthcare facilities by TAC members.
  • TAC will ensure that our advocacy and activism work is initiated and led by local TAC structures at the branch or community level.
  • TAC’s People Living with HIV sector and Women’s sector must ensure TAC’s visibility on AIDS Councils from ward, local, district, and provincial level and ensure the mandate of the organisation is carried forward in these structures.
  • TAC’s international advocacy work must focus on access to affordable and quality medicines and universal health coverage.
  • All vacant positions in TAC’s provincial leadership structures must be filled by April 29th 2016.
  • The National Council thanked Helen Chorlton for her committed service to TAC over the last 18 months. As acting Chief Operating Officer, Helen helped steer the organisation through a very difficult change process. We are pleased to announce that Helen has been replaced by Ms. Lungile Zakwe.

For media comment contact Lotti Rutter at lotti.rutter@tac.org.za or 081 818 8493.