Colonialism and apartheid is a complex phenomenon rooted in dispossession, economic impoverishment, and exclusion of blacks. The apartheid system shaped the South African racialised HIV prevalence at 0.3% among whites and 15.0% among blacks (HSRC Survey, 2014). Although the face of HIV and TB is black, this is not reflected in peak non-profit organisations that have the greatest resourced capacity to address HIV and TB. This is demonstrated in the arrangement of civil society organisations in South Africa, where black founded, owned and managed organisations have overwhelming predominance at ‘grass-roots’ level characterised by poor infrastructure, restricted information systems, shoe-string budgets, deficient qualified human resource, weakened governance and financial management systems associated with lack of resources, in stark contrast with a peculiar South African phenomenon of an unjust state of elite civil society organisations founded, owned and managed by whites as well-resourced grossly funded peak organisations, which though numerically few, have a significant influence and impact to shaping the outcomes of the most affected by HIV and TB, who are almost exclusively blacks in South Africa.
In their statement, the Treatment Action Campaign (TAC) completes misses the point and that social justice and inclusion is directly linked to better health outcomes https://tac.org.za/news/reckless-calls-for-suspension-of-hiv-money-threatens-aids-response/.
TAC is a constituent member of SANAC Civil Society Forum, and they have their own organisational independence to advocate their views. However, their views are not the views of the collective of the Civil Society Forum 18 sectors. We have decided to respond to TAC and in the process educate them so that as a collective, we ensure the attainment of social justice. HIV and TB in South Africa is black and funding is white.
It is within this context that the South African National AIDS Council (SANAC) Civil Society Forum (CSF) confronts the highly racialised model of funding for the HIV and TB response that continue to sustain an apartheid modus operandi that deepens inequalities along racial lines through patterns of development that restrict the lives of black South Africans. Communities must rise and confront Afro-pessimism agents, particularly those who have strategically placed themselves at the ‘centre’ of the HIV and TB response when in fact they are opponents of the values of the Constitution of South Africa and Agenda for Sustainable Development Goals, a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity. Communities most affected by HIV and TB must be at the front, center and back of the AIDS response. SANAC CSF calls for funding directed at HIV and TB to shift towards social inclusion and justice, translate efforts towards a community response to realise the elusive ‘bottom-up approach,’ through community capacity enhancement and genuine community ownership of the HIV and TB response.
The suggestions by TAC that “calls to suspend and redirect AIDS financing without proper public evidence, reflection and planning could destabilise and reverse the gains made in the HIV response to date,” require the AIDS Inquiry to provide on record the historic evidence of with whom, where and when was “proper public evidence, reflection and planning” previously conducted to direct AIDS financing in a constitutional democratic South Africa that has resulted in the current racialised model of funding in responding to HIV and TB.
The SANAC CSF calls for the redirection of AIDS financing and accountability to address community systems strengthening. This goes beyond the challenges confronted by the narrow bio-medical centred definition of health pursuing “absence of disease and infirmity” that is offered by current health systems through the administration of drugs, to the broader community capacity enhancement based definition of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
The AIDS Inquiry must investigate the systematic deliberate agenda to weaken the psycho-social, technical and institutional capacity of communities to respond to the dual epidemic of HIV and TB that have redirected funds, which has continued to subject black communities to remain underfunded while experiencing high incidence and prevalence rates of HIV and TB. This is further exacerbated by elevating commodity based programmes, including procurement of drugs and related laboratory services, as well as commodity based prevention programmes at the expense of strengthening sustainable development, prevention and comprehensive care, treatment and support programmes necessary for the realisation of our vision of A South Africa free from the burden of HIV, TB and STIs.
The insinuations by TAC that transformation will “dramatically weaken accountability mechanisms and could potentially open the door to the looting of funds meant for HIV and TB” are conclusive proof of the prevailing Afro-pessimism that seek to suggest that black communities although devastated by HIV and TB lack the moral consciousness and conceit to an extend that blacks cannot be entrusted with resources to respond to the morbidity and mortality affecting their own communities. TAC implies that black communities are such delinquent, self-loathing societies that the capacity to seek a prosperous, long and healthy life is non-existent and there is a necessity for white led organisations to provide oversight and management, as blacks are inherently predisposed to incompetence and corruption.
The SANAC CSF is also concerned that these organisations, while having positioned themselves as champions of ‘good governance’ and ‘legitimacy,’ have created parallel structures that have systematically ensured that they remain unaccountable to the people of South Africa. These organisations’ fundamental difference from the ‘State Capture’ occurrence that we are grappling with is that unlike the efforts of the ‘Saxonwold Shebeen’ patrons to operate under the cover of darkness, they have the audacity to state on record that they do not operate or cooperate in SANAC, a constitutional body formed by the Cabinet of South Africa, that represents Civil Society, Private Sector and the Government, which is chaired by the highest offices at National by the Deputy President (National AIDS Council), at Provincial level by the Premier (Provincial Council on AIDS), at District level by the District Executive Mayor (District AIDS Council), at Local level by the Local Executive Mayor (Local AIDS Council) and co-chaired by democratically elected Civil Society leadership at all levels.
The AIDS Inquiry through the Parliament of the Republic of South Africa must among many inquests, investigate these ‘many organisations that play a part in the national HIV and TB response [and] are not members of SANAC’: Who are they? What are they members of? Where do they ultimately account? Who’s mandate do they advance and how do they receive it? With whom do they meet? Where do they meet? How do they make decisions? How much funding have these organisations received? Who funds them? How are they funded? Why are they funded?
Resources from all partners supporting the South African government to respond to the HIV, TB and STIs epidemics is appreciated and should be increased, however, these funds should ensure empowerment of communities directly, for communities to be at the center of the response. Exploitation of the condition of black people cannot be used as a platform to revive apartheid.
The SANAC CSF calls on communities to continue supporting the National Strategic Plan on HIV, TB and STIs mission to ensure a South Africa on track to eliminate HIV, TB and STIs as public health threats by 2030. South African will be free of the burden of HIV, TB and STIs if we ensure that we leave no one behind, especially the most affected communities.
Issued by SANAC Civil Society Forum
For more information contact:
Steve Letsike | SANAC CSF Chairperson and SANAC Co-Chair | 073 435 6501
Mabalane Mfundisi | SANAC Resource Mobilization Committee Co-chair | 078 683 9535
Denise Zambezi | SANAC CSF Media Liaison | email@example.com | 072 151 2971