A spirit of greater openness and unity between government and civil society has emerged from a two-day AIDS congress, signalling a possible end to damaging divisions in South Africa’s HIV/AIDS response.

Reinforcing a number of moves by the South African government in recent months aimed at improving its strained relationship with AIDS activists, Deputy President Phumzile Mlambo-Ngcuka urged delegates to partner with government in the fight against AIDS.

“Our people want and need to hear us speaking in one voice,” said Mlambo-Ngcuka, who was recently appointed chair of a new inter-ministerial committee on HIV/AIDS.

Health Minister Manto Tshabalala-Msimang, who has been the focal point of past conflict between the government and anti-AIDS campaigners, was not invited to the meeting, held in Johannesburg last week. Deputy Health Minister Nozizwe Madlala-Routledge, however, acknowledged shortcomings in her department’s HIV/AIDS response.

“Our country is in pain. We are all in pain,” she said. “Tremendous efforts and resources are being invested in combating HIV and AIDS by government and civil society, but we continue to see unacceptably high levels of new infections and deaths from AIDS-defining illnesses.”

Madlala-Routledge identified a long list of weaknesses in the national response that included uneven access to antiretroviral treatment and nutritional support, inadequate patient monitoring systems and the failure of prevention strategies to change behaviours and stop an estimated 500,000 new infections in South Africa each year.

“We need to speak honestly about the challenges we face as we begin to experience the strain resulting from the growing burden of the disease and staff shortages,” she told delegates. “It is right that you use this platform to engage government and to show us our blindspots.”

The event was organised jointly by a coalition of civil society organisations that included AIDS lobby group, the Treatment Action Campaign (TAC), the Congress of South African Trade Unions (COSATU) and the South African Council of Churches.

The 350 delegates representing more than 80 organisations broke into groups on Friday to tackle issues including prevention, treatment access, social support and governance. Their resulting recommendations will be submitted to government ahead of a meeting this week to discuss the restructuring of South Africa’s ineffective National AIDS Council (SANAC) and a draft national strategic plan for 2007 to 2011.

Delegates agreed with the deputy president’s endorsement of a more representative and inclusive SANAC but strongly opposed her suggestion to create a separate body for the administration of grants from the Geneva-based Global Fund to Fight AIDS, Tuberculosis and Malaria. Delegates feared that a separate body could duplicate efforts and waste scarce resources.

Coalition leaders emphasised that the real test of the new spirit of unity between civil society and government would be the degree to which commitments and recommendations could be turned into actions.

“I think one mustn’t expect miracles,” said prominent AIDS activist, Zachie Achmat, of TAC. “The only thing we can be measured by is how much we cut infection rates and how many lives we save.”


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