Accountability is critical at National AIDS Council, says new civil society leader

Accountability is critical at National AIDS Council, says new civil society leaderSolly Nduku, seen at a workshop held in KZN, is the new chairperson of the SANAC Civil Society Forum. (Photo: SANAC/X)
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23rd October 2024 | Thabo Molelekwa

HIV activist Solly Nduku was recently elected to the top civil society position at SANAC. Thabo Molelekwa asked Nduku and his newly-elected deputies about their plans and priorities for the council.

The South African National AIDS Council (SANAC) is meant to play a co-ordinating role in the country’s response to HIV, bringing government, civil society, and other stakeholders together under one roof.

SANAC is chaired by South Africa’s Deputy President, currently Paul Mashatile.

Solly Nduku was recently elected as the new chair of the SANAC Civil Society Forum (CSF). The CSF represents SANAC’s 18 different civil society sectors, which includes sectors for women, youth, people living with HIV, and sex workers. Since the chair of the CSF automatically becomes deputy chair of SANAC, Nduku is now also Mashatile’s deputy on the council.

Prior to this, Nduku served as deputy chair of the CSF, a position he held since 2017, and was sector leader for Traditional Health Practitioners. Nduku is currently also the General Secretary of the National Unitary Professional Association for African Traditional Health Practitioners of South Africa.

Nduku replaces Steve Letsike, who was chair of the CSF from 2013 until 2024. Letsike is a member of the ANC and now Deputy Minister for Women, Youth and Persons with Disabilities. Prior to Letsike, health activist Mark Heywood was chair of the CSF. The current CEO of SANAC is Thembisile Xulu (Spotlight previously interviewed Xulu here).

‘Our advocacy must not waver’

“I have a commitment to serving communities, something that I’ve been doing for over 35 years,” Nduku told Spotlight.

He described the challenges still facing the country’s HIV response as significant. “These include funding constraints, access to quality healthcare, stigma and discrimination, and treatment fatigue.” These issues, especially among the most vulnerable populations, are compounded by complexities such as the stigmatisation of groups like sex workers, the LGBTIQ+ community, and men who have sex with men, said Nduku.

Thus, he said, SANAC still has a critical role to play in the country’s response to HIV, and must be strengthened, with more accountability added.

“As a civil society leader, my primary duty is to ensure that everyone in the SANAC space is held accountable, including ourselves. Our advocacy must not waver. If necessary, we must stand firm, even when confronting Ministers or the President. We must ensure that SANAC’s voice is heard and respected at the highest levels of government,” Nduku said.

He added that SANAC’s decisions must be enforceable, particularly for those representing the government. “It is essential that government officials and other stakeholders are held accountable for their participation, and including SANAC engagements as part of their key performance areas could ensure this,” he said.

Deputy leadership

Mluleki Zazini and Sheila Mbele, who were elected as Nduku’s deputies, also have backgrounds in the HIV sector.

Zazini, who is openly living with HIV, is National Director of the National Association of People Living with HIV and AIDS. He identified three key challenges facing the HIV sector: funding shortages, lack of political will, and limited involvement of key and vulnerable populations.

Zazini expressed concern about budget cuts affecting the health ministry and particularly the lack of adequate funds for all sectors within the CSF to ensure the effective implementation of the National Strategic Plan for HIV, TB and STIs (NSP).

To address the funding gaps hobbling the CSF from delivering on the NSP, Zazini said all 18 sectors making up the CSF will convene for a summit. “These sector plans will be used for resource mobilisation. We will engage with the donor community, including development partners and the private sector, to fund these sector plans,” he said. “We must revive government sector collaboration to explore areas where our government can commit funding to support the sectors,” he added.

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Touching on political will to ensure the effective implementation of SANAC’s work at provincial and district levels, Zazini is calling for premiers to not only provide leadership and resources, but to also chair provincial AIDS councils, while urging mayors to collaborate with civil society chairpersons.

Mbele, who is practicing as a traditional healer and has recently been travelling internationally, wasn’t able to give Spotlight any substantial response.

As a woman in the CSF leadership, she said she is prioritising, among other issues, human rights-related barriers to healthcare access and advocating for equality and fairness for women and girls. “To achieve these goals, I will focus on building a strong network, conducting evidence-based advocacy, engaging with affected communities, and influencing policy,” said Mbele. “By prioritising these areas and working collaboratively, we can create a more equitable and just response to HIV, TB, and STIs in South Africa,” she added.

A good story to tell by 2030

Through his spokesperson Keith Khoza, Mashatile expressed his support for the new leadership.

“The new SANAC leadership is committed to ensuring that by 2030 [when the NSP’s goals must be met and includes the deadline for countries to meet the 95-95-95 targets], we will have a good story to tell,” Khoza told Spotlight.

He conceded that despite meeting the first target that 95% of people living with HIV should be diagnosed, South Africa face challenges with the second target, that 95% of those that have been diagnosed should be on antiretroviral treatment. “Our efforts are focused on closing that gap”, Khoza said.

Commenting on the role of government, he said: “We expect improved participation from the 22 government departments involved in SANAC’s [Inter-Ministerial Committee] IMC.”

Khoza added: “Our efforts will be further strengthened by the government and civil society partnership approach where each sector of civil society is paired with a corresponding government department for shared accountability and improved collaboration.”

Other efforts the government is pursuing, said Khoza, is bringing onboard the private sector. In this regard, he said work is underway to launch the SANAC Private Sector Forum in provinces. “Collaboration between government, civil society, and the private sector is essential to address the multifaceted challenges of HIV, TB, and STIs,” he said.

‘Grassroots and civil society voices must be heard’

Meanwhile, the Treatment Action Campaign (TAC), emphasised that SANAC’s new leadership must refocus its efforts on grassroots involvement.

“It is critical that we hear from the communities themselves. We need community-led monitoring and real-time reporting on the gaps in service delivery. Only then can SANAC truly claim to be representative of the people it is supposed to serve,” TAC National Chairperson Sibongile Tshabalala told Spotlight.

She urged that more attention be given to improving healthcare access in rural areas and informal settlements, where HIV and TB rates are still much higher than average, as well as protecting civil society’s role within SANAC so that advocacy organisations like TAC have the power to hold government structures accountable.

“We need SANAC to make sure civil society voices are heard, not silenced,” she said.

“There has been a worrying trend of pushing civil society organisations to the margins, but we are the ones working directly with people living with HIV. Our involvement is crucial if we are going to achieve the targets set in the NSP.”

The Positive Women’s Network wants the new SANAC CSF leadership to show more support to address issues facing women living with HIV, including mental health, treatment care, treatment fatigue, human rights violations, discrimination, and gender-based violence, said Executive Director Thandi Maluka.

She also called for backing to fund women-led organisations working with women living with HIV. “We need SANAC to advocate for a dedicated budget for women living with HIV, ensuring that women-led organisations are part of the budget discussions and negotiations. The private sector must also be brought on board to provide a percentage of support for these organizations,” Maluka added.

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