Solidarité internationale et luttes sociales en Afrique subsaharienne
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Afrique du Sud
Challenges of HIV prevention and treatment in South Africa
Joint Cosatu, SACC, TAC, statement
23 November 2005
COSATU - http://www.cosatu.org.za/
Treatment Action Campaign - TAC - http://www.tac.org.za/
On 22 November 2005 a historic meeting of the executive structures of COSATU, TAC and the South African Council of Churches took place. The meeting assessed the challenges of HIV prevention and treatment in South Africa. We resolved to build a better response within our organisations and in society generally.
Stepping up Civil Society Action to Prevent and Treat HIV
Whilst we will continue to put pressure on our government to take a lead on the matter, we have decided to do what we must do to provide leadership to our own members and society on the matter. Leadership responsibility dictates that we act on behalf of our organisations as well as in our personal capacity.
The HIV epidemic has been permitted to go too far. We all believe that HIV is a disaster that is killing people in terrible numbers, and, as frightening, an epidemic where the numbers of people newly infected with HIV continues to grow. This can and must be changed.
COSATU, the SACC and TAC agree that the two critical pillars of a scaled up response are:
Devising an effective national HIV prevention plan, that will break the stigma around HIV, encourage massive take up of voluntary HIV testing, and personal behaviour change to reduce the risk of HIV infection.
Increasing the numbers of people who are accessing life-saving ARV treatment, with a target of at least 200,000 people receiving treatment by mid 2006 and an aim of universal access to treatment.
COSATU, the SACC and TAC have agreed on a unique programme of action, which will commence immediately. Among the decisions reflected in the programme of action are:
Joint activity on World AIDS Day 2005 to launch the campaign. This will take place in Durban and be linked to COSATU’s 20th anniversary celebrations.
A joint campaign to stop the unlawful activities of Matthias Rath and similar charlatans and to make our communities aware of the dangers to them posed by false promises and information about HIV.
Organising a National Civil Society conference to agree a People’s Charter and Plan to prevent HIV in March 2006.
Using May Day 2006 to put pressure on employers to ensure all employees have access to prevention information, counselling and treatment.
Finalising the 2003 NEDLAC Agreement on HIV Prevention and Treatment to ensure that all sections of our society (business, communities, labour and government) are working in synergy, with common responsibilities, targets and determination.
We urge every other organisation committed to these aims to join us.
Finally, all three of our organisations understand the complexity of HIV and the way in which the spread of the epidemic presents numerous developmental and social challenges. In view of this we have also resolved to set up a high-level commission on HIV and Development to continually develop and improve strategies around HIV prevention, care and treatment.
We can defeat HIV and we will.
Joint COSATU, SACC and TAC Programme of Action
1. Background and aims
The HIV/AIDS epidemic is a national disaster for South Africa. Over 5 million people are infected and official statistics indicate a huge rise in the number of deaths, particularly of people between the age of 20 and 40. Infection with HIV and death due to AIDS is undermining millions of people’s hopes and livelihoods. It is entrenching and deepening poverty, but also robbing many people of the means to lift themselves out of poverty. The impact of HIV is particularly severe on working class women and girls who, in addition to being more at risk of infection than boys and men, also carry much of the burden of care for people sick with HIV.
Our organisations accept that there are many good interventions in our country that aim to prevent and treat HIV. We salute health care workers, prevention and treatment activists and those Provincial governments (North West, Gauteng, Western Cape) that are genuinely struggling to provide treatment and care to people living with HIV/AIDS.
However, we lament the continued refusal of our national government to declare the seriousness of the HIV epidemic and to mobilise a response on the scale that is needed. Evidence of this is
the continued impotence and ineffectiveness of SANAC,
In addition there is the confusion about treatment being fuelled by the Minister of Health and her department’s refusal to act against pharmaceutical merchant Matthias Rath and stop unlawful clinical trials and clinics that have already led to a number of deaths.
In respect of this crisis we recommit to our call for:
at least 200,000 people to be on ARV treatment by the end of 2006;
But, whilst we continue to demand Ministerial and Presidential leadership, our organisations accept that to date, we have done too little to ensure every member of our society understands HIV and is active in efforts to prevent new infections and promote access to treatment. Specifically, COSATU, the SACC and TAC must now work together to mobilise our members and communities:
1. To show solidarity with people infected and affected by HIV, ending stigma, discrimination and harassment.
2. To work to prevent new infections with HIV through both educational work and by ensuring that everyone, particularly women, can practice safer sex without threat and with access to information and male and female condoms.
3. To ensure that everyone who needs anti-retroviral (ARV) treatment, as well as treatment for TB and other opportunistic infections, can get it from a clinic or hospital within a reasonable distance.
4. To support orphans, vulnerable children and the ill, recognising however that the best form of support is to contain the epidemic, including through effective treatment, so that fewer people die.
5. To build a Peoples Health Service with adequate human resources, decent conditions of employment for health workers and health facilities that meet the health needs of the population and respect people’s dignity. We reject the privatisation of the public health system as foreseen in current proposals on Social Health Insurance.
6. To build a broad civil society alliance against HIV in South Africa and to work with allied organisations such as SATUCC to develop common campaigns on HIV and AIDS across southern Africa.
Our organisations agree to do more to empower our members to take both individual and collective action in these areas. That means we will do more to support both direct action and to continue to struggle for a more active and progressive role from state institutions and leaders.
2. Key elements of the Programme of Action
The proposed Programme of Action (POA) for the coming 12 months combines major joint events, campaigns, programmes and joint policy engagements. To take the POA forward requires a joint technical team plus provincial structures. The POA will be reviewed and extended in October 2006.
2.1 Joint events
We propose the following national joint events in coming 12 months.
2.1.1 World AIDS Day 2005
On December 1, World AIDS Day, we will focus national events on Durban, linked to COSATU’s 20th Anniversary commemoration. Specifically, on December 1 we will hold a joint vigil and rally, with high-level speakers. The theme of the rally will be Every good COSATU/TAC/SACC member knows his/her HIV status! Get tested for HIV! Treat at least 200,000 people by 2006! Campaign to stop all new HIV infections!
2.1.2 Civil Society Conference on HIV/AIDS
We will convene a joint conference for civil society in March 2006. The conference will:
The technical team proposed below will develop the draft charter and Plan with an emphasis on:
Our common expectations of the state in the struggle against HIV.
2.1.3 May Day
May Day 2006 will have the theme: AIDS - The New Struggle. It will emphasise breaking the silence and solidarity, with the slogan: Each one teach one! Test, Treat and Fight for Life!
We will raise demands with employers before May Day on HIV/AIDS and demand policies in the workplace and on treatment. Where possible, we will convene sectoral summits on HIV with employers and other stakeholders during 2006.
In addition, we demand that the mining companies, through the Chamber of Mines, create a fund to assist with the scaling up of access to care and treatment of HIV and AIDS in Lesotho and Mozambique, where the HIV pandemic has been directly fuelled by migrant labour to the mines and retrenchment of thousands of former mine workers.
On May Day, we will hold demonstrations to identify recalcitrant employers and to the Chamber of Mines in Johannesburg to back up our demands. May Day actions will also include community marches led by COSATU, the SACC and TAC to local hospitals and clinics to raise awareness in communities about health care services and appropriate treatment.
COSATU in particular will have to ensure adequate consultation and work with SACC and TAC to incorporate the HIV/AIDS theme in preparations for May Day.
2.1.4 COSATU Congress
COSATU’s Ninth Congress takes place around September 2006. We propose that the Congress events include:
The POA seeks to extend current action to promote effective HIV prevention, access to treatment and combating Matthias Rath and similar sources of misinformation, and to strengthen joint action against stigma and discrimination.
2.2.1 Treatment action
Between now and World AIDS Day, every province should have at least one joint action to support stronger roll out of anti-retroviral treatment and, where relevant, to protest Rath’s activities. The action could take the form of a visit to a hospital or clinic, or a protest demonstration at a Rath site to warn the community.
COSATU will meet with SANCO to discuss a common strategy on treatment and on Rath’s activities.
At the national level, we will develop and support demands to employers and the Chamber of Mines, as noted above.
No later than January 2006, COSATU, TAC and SACC should meet at provincial level to identify campaigns that are needed to improve access to treatment and meet the target of at least 200,000 people on treatment by 2006. Provinces that are doing particularly poorly on roll out - notably Limpopo, Mpumalanga and Eastern Cape - will develop programmes of action to ensure more is done to meet people’s needs for treatment and care.
2.2.2 Building solidarity
The March conference will launch a campaign to build solidarity with people with AIDS, with a special focus on fighting stigma and discrimination. This campaign will be linked to education on prevention of HIV infections as well as actions to support people affected by the epidemic.
The campaign will highlight the impact of gender and class oppression on the transmission and treatment of HIV and AIDS. It will seek to identify and reach vulnerable groups, such as migrant workers and prisoners.
The campaign will include:
By 2009 COSATU will train 5000 COSATU shopstewards to provide basic counselling and treatment education. The SACC and TAC will develop similarly ambitious programmes. These programmes should lay a sound basis for fighting stigma and building solidarity in our communities and workplaces.
At the local level, our organisations will collect material support, such as food, blankets and clothing, for distribution to families affected by AIDS and to orphans.
2.3 Policy engagements
Joint policy engagement will focus on:
Developing a civil society caucus for SANAC, with common strategies and positions, that will include all civil society representatives.
Ensuring finalisation of the agreement on HIV/AIDS at NEDLAC in time for May Day.
To drive the POA requires both national and provincial structures are necessary.
2.4.1 National structures
At the national level, we will set up a commission of high-level leaders to ensure intensified efforts and co-ordination to drive our POA. It will also act as a caucus for SANAC and to propose responses to important developments.
The commission will be backed by a technical taskteam to plan and drive joint events and campaigns. It will report to the highest constitutional structures of our organisations.
2.4.2 Provincial structures
At provincial level, we will set up formal teams that bring together our provincial leadership to plan and drive provincial and local events. These teams must develop a provincial POA to implement national actions and campaigns.
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