By Nomatter Ndebele
Ten years ago, the International AIDS Conference was held in Durban in KwaZulu-Natal. Nkosi Johnson, who died a year later at the age of 12 – the longest-surviving HIV-positive born child at the time – addressed the plenary and made a plea to the government to make antiretroviral treatment available to pregnant women with HIV.
At the time, former President Thabo Mbeki pressed on with a campaign of denialism, claiming that there was so such things as AIDS. Thousands of people lost their lives because they were not given life-saving medication.
In July this year, the International AIDS Conference heads back to Durban. Thankfully it is a different time.
Today, KwaZulu-Natal has the biggest antiretroviral programme in the country. Of the 1.8 million people diagnosed to HIV, 1.1 million have access to life-saving drugs. Once one of the worst provinces of South Africa in terms of its response to HIV, KZN has now become the model for a functional HIV-response system. The province has become the poster child for tireless work to bring about change.
Despite this, poor administrative processes and human resource shortages continue to undermine efforts to bring the HIV/AIDS epidemic to an end. Like the rest of the country, the crisis in the public health care system cannot be ignored.
The Treatment Action Campaign has worked tirelessly, particularly in the province, to try to ensure that the most vulnerable people’s needs are put at the forefront of the HIV/AIDS fight. Despite the great strides they have made, the TAC is still wary of the difficult terrain in which they have to work.
Patrick Mdletshe, deputy chair of the TAC said: “KZN Cannot afford complacency, the war on HIV is far from being over. KZN is not immune to problems that are seen and experienced by other provinces like the shortage of essential medicine, high numbers of patients lost to follow up processes exasperating the steady growth of defaulters. Therefore we cannot pretend that its business as usual.”
Mark Heywood, executive director of SECTION27, a public interest law centre, says: “There are many tangible manifestations of the crisis that we see every day: HR shortages, drug shortages, dirt, disease, corruption and so on. But my concern is the overall inertia, paralysis, decay, demoralisation and lack of will. It’s on a downward slide in many areas. We see best practices and possibility, we have the resources and knowledge to turn it round, but we lack the conviction to do so.”
Human resources are a major concern for Mdletshe as well, “We understand that without community health care workers (CCG’s) health care system won’t able to keep up with the number of people on treatment as we move to test and treat. we will see more number of people that will default on treatment, next thing people may die while on treatment. It one thing to be on treatment but also is another to adhere on treatment. right now we want people to adhere on treatment and be viral suppress which that is an ultimate goal, otherwise having so many people on treatment will be just meaningless,” he said.
Furthermore, political squabbles within the province also impact negatively on the work done by Civil society.
“All these political issues could potentially undo all the work we have done as civil society,” said Mdletshe.
Although KZN has progressed far down the road in its HIV mission, there is still a lot of work to be done and complacency is a real danger.
This upcoming conference needs to be more than just a formality. It needs, says Heywood, to be “an earthquake that shakes up the complacency and rhetoric around the HIV response”. It needs to find consensus on the priority areas for sustaining and expanding the AIDS response, and to create a new momentum and belief in the possibility of truly overcoming AIDS.
“In other words,” says Heywood, “a repeat of the 2000 conference, but in a very different context.”
Nomatter Ndebele is a Spotlight Journalist