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Africa: AIDS Inaction Critiqued
Africa: AIDS Inaction Critiqued
Date distributed (ymd): 010930
Document reposted by APIC
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africapolicy.org
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+ +health+
SUMMARY CONTENTS:
This posting contains a joint statement from the Treatment Action
Campaign, COSATU, the Anglican Church and the Southern African
Catholic Bishops Conference calling for stronger national action on
AIDS. It also includes summaries from the Kaiser Family Foundation
of news reports on recent critiques of both South African and
international failures of leadership, and a September 19 statement
from South Africa's Medical Research Council, promising release of
their new report on AIDS mortality as soon as consultations and
briefings with other agencies have been completed.
+++++++++++++++++end profile++++++++++++++++++++++++++++++
We Must Take Strong Action to Stop AIDS
Congress of South African Trade Unions (Johannesburg)
DOCUMENT
September 21, 2001
Johannesburg
Joint Statement of the Anglican Church, Southern African Catholic
Bishops Conference (SACBC), COSATU and the Treatment Action
Campaign (TAC), Bishopscourt, Cape Town, September 20, 2001
In an historic meeting on September 17, 2001, representatives of
the Anglican Church, the Southern African Catholic Bishops
Conference, COSATU and the Treatment Action Campaign met, out of a
common commitment to life and dignity, to join forces against the
AIDS epidemic.
It can no longer be denied that AIDS is by far the leading cause of
death for adult South Africans, especially those between 20 and 50.
The report by the Medical Research Council (MRC) says that, unless
we can ensure that all HIV-positive people get treatment, between
four and seven million South Africans will die over the coming
decade.
The MRC report only confirms the experience of our organisations.
Our clergy report that every week, they are burying people who die
of AIDS. Young workers are disappearing and dying from "natural
causes" in the prime of life, leaving their families behind with no
income or support. Educators and learners are buried alongside each
other. Mothers watch their babies die prematurely and unnecessarily
from AIDS. We could continue this list indefinitely.
No one in our country can afford to deny the terrible extent of
this epidemic. The meeting expressed concerns over the attempts of
some in government to downplay its impact. The data are clear, and
must not be obscured by wishful thinking. No organisation or
individual should try to suppress the facts - that way lies
disaster.
Faith-based organisations, trade unions and TAC are committed to
building an effective alliance of civil society to prevent new HIV
infections and ensure that people with HIV/AIDS get life-prolonging
and effective treatment. This includes the development of a
national treatment plan that includes anti-retroviral therapy. We
have agreed:
- To set up a working group that will develop shared campaigns to
overcome the denial syndrome that has emerged in some official and
unofficial circles; and
- To work with representatives of civil society in the South
African National AIDS Council (SANAC) to guide and challenge our
national leaders to take more positive action on AIDS, to replace
the cycle of controversy and denial with co-operation, common
purpose and courage in the national interest.
Government must ensure that its policies face up to the national
emergency caused by AIDS, or it will fail our people in both human
and economic terms. We call on it:
- To declare that the AIDS epidemic constitutes a National
Emergency.
- To take into account the extent and impact of AIDS in all its
policies and public statements, providing the moral and political
leadership our country so desperately needs.
- To increase the health budget and ensure cheaper anti-retrovirals
and other medications, in order to provide adequate care for
HIV-positive people, and to expand prevention and educational
campaigns.
Even one death from AIDS is a death too many. We need to use every
tool at our disposal, from education and prevention to treatment,
to address this national emergency. We call on all faith-based
organisations, every trade union, and all civil society
organisations to join us. We are making HIV/AIDS a top priority. We
call on our government to do the same.
Njonkulu Ndungane, Archbishop of Cape Town,
Chairperson of the AIDS Commission
of the Council of Anglican Provinces in Africa.
Willie Madisha, President of COSATU
Zackie Achmat, Chairperson of TAC
The Rev Father Richard Menatsi, General Secretary of the SACBC
Patrick Craven and Moloto Mothapo, Acting COSATU Spokespersons.
Kaiser Family Foundation
http://www.kff.org
Daily HIV/AIDS Report
Friday, September 21, 2001
Contact Daily Reports Staff
http://www.kaisernetwork.org/contact/contact.cfm
Editorial phone: 202-672-5952 FAX: 202-672-5767
Editorial e-mail: dailyreports@kaisernetwork.org
E-mail registration: http://www.kaisernetwork.org/email
South African Health Ministry Report 'Challenges' Government's
AIDS Policy
[Sep 21, 2001]
A confidential document issued by the South African Ministry of
Health "directly challenges many of" South African President Thabo
Mbeki's HIV/AIDS policies, stating that they are "increasingly
politically dangerous" and encourage the country's health system
to provide "inadequate" care for people with HIV, the London
Guardian reports. The report, which was obtained by the Guardian,
was drafted in July, before Mbeki wrote a "controversial" letter
to South African Health Minister Dr. Manto Tshabalala-Msimang
instructing her to "consider a cut" in the country's HIV/AIDS
budget. The report states that it is government policy to "'not
provide any meaningful care' for large numbers of South Africans"
with HIV/AIDS.
The health ministry states that it has prevented public hospitals
from "disintegrating under the demand for HIV treatment" through
a policy of "providing 'inadequate quality of care' for some, and
'not providing any meaningful care for a proportion of those with
HIV/AIDS, especially in areas with generally poor access to health
care.'" However, the report states that these policies are
"'increasingly unstable' from a political, moral and legal
perspective" as HIV infection rates rise, especially among the
poor. "Failing to provide care for population sub-groups
(primarily the rural poor with poor access to health care) will
become increasingly politically dangerous as the absolute number
of people sick with AIDS rises among poor and vulnerable groups,"
the ministry writes. Mbeki has "consistently rejected" offering
antiretroviral drugs in public hospitals, stating that the
medicines are toxic. However, the report refutes his statements
and calls for the creation of trial distribution programs of
antiretrovirals.
Refuting Mbeki's Other Claims
In the report, the ministry also challenges a number of Mbeki's
other positions on HIV/AIDS, including his questioning of the
causal link between HIV and AIDS and his declaration that
AIDS-related causes are responsible for only a "tiny proportion"
of annual deaths in South Africa. The report "concede[s]" that HIV
causes AIDS, that antiretroviral drugs "extend lives" and that 3.5
to 4.5 million South Africans will have died of AIDS-related
causes by 2010, a figure much higher than Mbeki's claim, based on
1995 WHO data, that AIDS-related causes lead to approximately
5,000 deaths each year in the country. The health ministry
document "confirms" what the WHO has said: that AIDS is "the
single largest killer" in South Africa. Health ministry officials
urge the government to allocate "much greater funding" toward AIDS
treatment and broaden access to antiretroviral drugs. The authors
of the report include health ministry officials "known to be
unhappy" with the South African government's AIDS policies, but it
is unclear whether the report has the backing of
Tshabalala-Msimang (McGreal, London Guardian, 9/21).
[From Daily HIV/AIDS Report, Sept. 27, 2001
Tshabalala-Msimang Responds
In her letter to the Guardian, Tshabalala-Msimang states that the
report was only a first draft and had not yet reached her desk or
"been discussed or edited at any level." Tshabalala-Msimang refutes
many of the report's statements, including its claim that the
government does not provide adequate HIV treatment. She writes that
the government "is not opposed" to antiretrovirals, but that the
cost of the drugs puts them "beyond our reach." Tshabalala-Msimang
states that although areas of South African AIDS policy "require
further improvement," she adds that "to twist this statement into
the suggestion that South Africa has a deliberate policy of
providing inadequate care or even withholding care is a disgraceful
distortion" and "an insult to all those who struggle daily to fight
the challenges posed by poverty and underdevelopment, including
HIV/AIDS in our country." She added that the latest version of the
report calls for additional funding to fight HIV/AIDS and
"contradict[s] Mbeki's 'assertions' on HIV/AIDS by conceding that
HIV is the cause of AIDS." She concludes, "All our HIV/AIDS
strategies are based on the premise that HIV causes AIDS"
(Guardian, 9/26).]
Groups Call for Swift Release of MRC Report
A number of religious, labor and AIDS groups gathered in South
Africa this week to "challeng[e]" the South African government to
"overcome the denial syndrome" of HIV/AIDS and release a Medical
Research Council report that supposedly points to AIDS as the
country's leading cause of death, Reuters reports. The Anglican
and Catholic churches, the Congress of South African Trade Unions
and the AIDS group Treatment Action Campaign met on Monday to
draft a statement asking the government to "acknowledge the scale
of the HIV/AIDS epidemic" in South Africa. The coalition said that
it has created a program to help government officials and others
overcome their "denial" of HIV/AIDS. However, the delegates
declined to say whether Mbeki numbered among those "in denial."
COSATU delegate Derrick Cele said, "We don't want to separate the
president from the government. We are making a call on the
government, led by the president."
The group has also called for the "immediate release" of the MRC
report, which, according to media reports, states that
AIDS-related causes accounted for 40% of deaths of South Africans
ages 15 to 49 in 2000 and names AIDS "the country's biggest
killer" (Boyle, Reuters, 9/20). The MRC report compiles the
official South African mortality figures for 1997 through 2000 and
is scheduled to be released by the end of the year (Kaiser Daily
HIV/AIDS Report, 9/20). Catholic Bishop Reginald Cawcutt said,
"[The government] cannot withhold that report. It is our report.
It was paid for with taxpayer's funds and it belongs to the
people." TAC Chair Zackie Achmat said that his group has written
to Tshabalala-Msimang, giving her one week to publish the report.
After that, he said, TAC will take the issue to court (Reuters,
9/20).
Industrialized Nations 'Fail' to Show Leadership in AIDS Fight,
UNICEF's 'State of the World's Children 2002' Report Says
[Sep 21, 2001]
HIV/AIDS is one of the "cruellest political and social problems in
the world," particularly for children, UNICEF reports in its
"State of the World's Children 2002," released Sept. 13 in
preparation for the U.N. General Assembly Special Session on
Children. The assembly, originally scheduled for Sept. 19-21, has
been postponed because of the recent terrorist attacks on New York
City and the Pentagon. HIV/AIDS is "destroying families,
communities and nations," causing life expectancy to "plumme[t]"
while AIDS orphans "overwhelm family networks, social services and
health care institutions," the report states. One of the goals set
forth at the 1990 World Summit for Children was to "improve
protection of children in especially difficult circumstances,"
including children affected by HIV/AIDS. According to the report,
the impact of the disease is "crushing the attempts of countries
all over the world to put human development and the rights of
women and children first," especially in Southern and Eastern
Africa. The poverty of the regions has exacerbated the epidemic,
illustrating that AIDS is the "most savage index of the inequality
of our world," the report states. Projected child mortality rates
for 2000-2005 in Botswana, Zimbabwe and South Africa are equal to
or greater than 50%, and the southern and eastern regions of the
continent had 6,400,000 AIDS orphans as of last year.
Leadership Needed
Industrialized nations have "markedly failed to show the requisite
global leadership" on HIV/AIDS-related issues, responding with
complacency once the epidemic had been contained within their own
nations, the report states. However, HIV/AIDS has begun to receive
global attention, first with the U.N. Security Council recognizing
in January 2000 that the disease poses a threat to worldwide
security and then with the U.N. General Assembly Special Session
on HIV/AIDS in June, which produced targets for worldwide HIV
prevention and established the Global AIDS and Health Fund to
fight the disease. Leadership in the most affected nations has
also been "markedly varied," the report states. Successful
initiatives in Uganda have lowered the HIV infection rate from 30%
of adults in 1990 to 10% today, and in Botswana, officials have
begun to implement a national program to reduce vertical
transmission. Thailand, Venezuela and Brazil have also
successfully implemented programs to reduce HIV transmission.
However, other nations have "pursue[d] an ostrich-like approach,
taking no account of the rising tide of infection" until the
numbers were overwhelming, the report states. Corporations have
also begun to take initiative, according to the report. The
Coca-Cola Co. recently said it will use its distribution network
to distribute condoms, HIV testing kits and educational materials
to remote areas. The company is part of the Global Business
Council on HIV and AIDS, to which companies like AOL Time Warner,
MAC Cosmetics and Unilever also belong. Drug companies have also
begun to offer steep discounts to developing nations, the report
notes, citing Bristol-Myers Squibb's offer to sell its medicines
didanosine and stavudine for $1 a day to African nations and
Pfizer's donation of fluconazole to the least developed nations.
Pfizer is also spending $11 million on a medical training center
for doctors treating HIV/AIDS patients in Uganda.
Medical Research Council of South Africa
PO Box 19070, 7505 Tygerberg, South Africa
Tel +27 (0)21 9380911 / Fax +27 (0)21 9380200
http://www.mrc.ac.za
19 September 2001
Impact of HIV/AIDS on adult mortality in South Africa
The MRC has conducted rigorous research on the pattern of
mortality in South Africa over the last fifteen years. This
research has been commented upon and reviewed by a panel of
leading world authorities on demography, epidemiology and medical
statistics. As an institution the MRC is proud of this work and
stands by the findings of this report. We recognise that the
findings are of major public interest with enormous and serious
policy and public implications for our country in the future,
particularly in relation to the HIV/AIDS pandemic. We also
consider this work will contribute significantly to the global
understanding of the HIV/AIDS pandemic.
Given the significance of the findings, the MRC decided to pursue
the process of informing the policy-makers of our country through
several briefing and discussion processes. These processes are
currently underway during which the MRC has received useful and
constructive feedback from the other government agencies who are
using different methodologies and approaches to analyse the same
problem. When these processes are completed the MRC will release
the report. We have every confidence that our country's
policy-makers will expedite this process in the interest of
informing the public.
This material is being reposted for wider distribution by
Africa Action (incorporating the Africa Policy Information
Center, The Africa Fund, and the American Committee on Africa).
Africa Action's information services provide accessible
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of human
rights.
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