WAD 2014 Speech by Deputy President
This speech was the keynote address at World Aids Day 2014 in the Free State by the Deputy President, Cyril Ramaphosa
National NSP Stakeholder Consultation – Speech by Dr Gwen Ramokgopa
The Minister of Health, Dr Aaron Motsoaledi
The Deputy Chair of SANAC and Chairperson of the Civil Society Forum
Fellow Trustees of the SANAC Trust
Ladies and gentlemen
The development of the National Strategic Plan for HIV, TB and STIs for the period 2017 to 2022 is one of the most important tasks of the SANAC Trust and it needs to be done in a way that ensures all stakeholders agree with the goals and objectives stated in the Plan and develop a sense of ownership for this Plan for the next five years.
It is important to reflect on the history of the HIV response in this country as in doing so it becomes abundantly clear how important it is to have a National Plan that is owned and supported by all stakeholders.
The miraculous turnaround of the AIDS response that we have seen over the last decade is undoubtedly linked to the last two national strategic plans. The breathtaking rollout of antiretroviral treatment can be traced back to the second NSP that covered the period 2007 – 2011. This NSP called for the national scale up of antiretroviral treatment as it main goal. The Plan would not have succeeded if it were not for the extensive consultation and negotiation that took place within the SANAC structures during 2006. If the Plan was supported only by government and not by civil society then it would not have made as much progress as it did over those five years.
The NSP 2007 – 2011 also saw the massive HCT campaign during which more than 15 million South Africans tested for HIV. This led to a massive surge in the number of PLHIV initiating treatment. A clear articulation of the goals of the NSP led to all partners, including the massive PEPFAR programme, supporting government’s rollout of antiretroviral treatment.
The same can be said for the 3rd NSP covering the period 2012 – 2016 which set ambitious goals for treatment and PMTCT but also set goals for prevention of HIV and a fifty percent reduction in TB incidence and mortality. Both these plans led to a substantial increase in domestic funding for HIV and TB responses.
In development the next five-year plan it is important to build on the successes of the past and to improve upon those areas where progress was slow.
The Enhanced Progress Report published by the M&E Unit of the SANAC Secretariat in May this year provides a clear analysis of what has worked and where we need to do more over the next five years. The report shows that we have more than 3 million people of antiretroviral treatment and the MTCT rate is well below the 2% target set in the NSP. The government and especially the Department of Health must be congratulated for that. So must all the NGOs who have been supporting the rollout at clinic and hospital level.
The report points out that we did not reach the target to reduce new infections by 50%. This is extremely concerning for all of us and it is widely recognised that much more needs to be done to reduce the number of new infections especially in young women where incidence is higher than 3% in most high burden communities. I would like to emphasise that whilst we focus on young women and certain key populations, new HIV infections are high across the board and no target group can be considered to be low risk. Therefore, prevention must be across the board.
Although we did not meet the very ambitious targets set for TB there are definite signs of progress and there has been a complete revolution with the use of geneXpert in the diagnosis of drug resistant TB.
One of the most neglected areas of the NSP has been the diagnosis and treatment of STIs. The SANAC Trust has discussed this and identified the need to invest greater resources in the management of STIs. The zero draft of the NSP that is under discussion at this stakeholder consultation has clearly identified the need to address all aspects of HIV prevention and treatment as well as TB and STIs. The challenge will be in the selection of priorities for programmes across the three epidemics. There is only a limited amount of resources available and whilst the plan needs to be aspirational it also needs to be realistic and implementable. It is important that we draw on the tools that we have such as the Investment Case to guide the choices we make and that we should make together.
Consensus building is a difficult goal to achieve but it is essential that we invest the time and resources to create the opportunity for all voices to be heard in a meaningful way. The Secretariat has been systematic in putting together the consultation process and the evidence of this consultation.
One of the major roles of SANAC is to build consensus as I have stated before and the consultation about the development of the NSP is one of the most important processes on the SANAC calendar. It happens every five years and the Trust is committed to raising the resources needed for this consultation process. The Trust has raised R8.9 million for the consultation process so far and has received support from the WHO, Gates Foundation, UNFPA and GIZ. As Chairperson of the Trust I would like to thank these partners for their support.
So far there have been major consultations with civil society, government, the private sector, development partners and public health specialists. We understand that civil society sectors and the government sector have requested further consultations. The Trust is working with the Secretariat to raise the additional funds required for these further consultations. I would like to thank Steve Letsike, Dr Nono Simelela and Dr Yogan Pillay for their assistance in raising additional funds. I also met with the Deputy President who has assured me of his support for raising additional resources.
I look forward to consultation that will take place over the next two days. It is important that the discussion is robust and open and that all stakeholder views are expressed in a constructive manner and in a way that is objective. It is important to choose priorities and to ensure that our inputs are grounded in the evidence and that recommendations are practical and realistic.
We have made great progress to date and what we decide to include in the next NSP will give us the results we need to be able to control the three epidemics in the next five years.
Address by SANAC Chairperson, Deputy President Cyril Ramaphosa at the funeral of Prudence Mabele
Members of the Mabele Family,
Health Minister, Dr Aaron Motsoaledi,
Director-General of Health, Dr Precious Matsotso,
Members of the South African National AIDS Council,
Leaders and members of civil society groupings,
Friends and comrades,
Today we are gathered in sadness.
We are here to bid farewell to a beloved friend, colleague and comrade. We are here to bid farewell to a remarkable South African, a tireless campaigner and a person of great beauty and purpose.
Our thoughts and prayers are with the Mabele family.
We hope that in your bereavement, you can draw comfort and strength from the many people, in this country and beyond, who offer you their gratitude for producing such an extraordinary human being.
As we struggle to come to terms with the deep pain of her passing, we celebrate a life that made such a profound difference in the lives of so many.
We celebrate the life of a person who – through her activism, her passion, her commitment, her compassion, her defiance – has left an indelible mark on all of us.
Prudence’s courageous life journey, the campaigns she fought, the causes she championed, echoed the historic march by 20,000 women to the Union Buildings in 1956.
Prudence was a modern-day iteration of the fearlessness, steadfast conviction and selfless activism that drove Sophie de Bruyn, Lilian Ngoyi, Helen Joseph, Rahima Moosa and so many other notable women to the very bastion of the apartheid regime.
Like those who marched on the Union Buildings, she did not see the struggle that she had to fight in one dimension.
It was not a fight simply for the rights of people living with HIV.
It was a fight to affirm the rights, dignity and well-being of every person who suffered discrimination, oppression, stigmatisation and exploitation.
Her very being reflected the many dimensions of human endeavour.
She was a humanist, a comrade, an activist, a leader, a manager and a sangoma.
None of these trumped the other.
She was a multi-faceted individual who shouted and marched and challenged authority and later went home to the silent sacred space of the ancestors where she meditated and connected with the spirits.
It is fair to say that when HIV struck the 18-year-old Prudence Mabele, it struck a rock.
Prudence decided not to hide her status, becoming one of the very first South African women to publicly acknowledge her HIV status.
In doing so, she felt the full force of stigma.
She had to change her course of study from medical technology because the institution, Peninsula Technikon, feared that she may infect other students in the laboratory.
Her hospital file was stamped with a big red X and nurses who treated her asked her if she was a sex worker.
Yet, despite the daily attacks on her dignity, despite the bouts of despair and disillusionment, she had the resilience and the fortitude to form the Positive Women’s Network at Garankuwa Hospital.
Two years later, Prudence helped to set up the Treatment Action Campaign to fight for antiretroviral treatment.
In those early years of our democracy, as many activists pursued a quieter life after the exertions of our liberation struggle, Prudence bravely opened new frontiers of struggle.
Prudence was among those AIDS activists who were essentially fighting a struggle to be human, to be remembered into the human race, as worthy normal individuals with a manageable condition.
Prudence gave voice to thousands whose stories and experiences, fears and dreams, often went unheard.
She brought comfort to those she knew were pained by physical discomfort, social stigma and the violation of their fundamental human rights.
Prudence never stood back from speaking truth to power.
She never stopped questioning and confronting those whom she believed were neglecting their own duty to society.
She spoke her mind to shape other minds and build networks of activism and support that changed thousands, if not millions, of lives.
While many marvelled at our achievements in putting millions of people on antiretroviral treatment, as many declared the battle nearly won, Prudence did not give up the struggle.
She kept fighting because she saw the many lives that still needed to be saved, the many wounds that still needed to be healed, the many injustices that still needed to be righted, and the many indignities that still needed to be confronted.
Just two months ago, we were honoured to have Prudence join us in the public gallery of the National Assembly for the presentation of the Budget Vote of The Presidency.
It was an opportunity to present Prudence and a group of remarkable young women to Parliament to illustrate the depth of talent and commitment that underlies social transformation in our country.
It is our hope that many young women – and indeed young men – will follow Prudence’s example.
We need young people who are passionate, committed and deeply care about the welfare of others.
We need young people who will stand up for the rights and dignity for the most vulnerable and marginalised.
We need young people with the courage to challenge complacency, incompetence, arrogance and corruption.
Importantly, we need young people who will organise, mobilise, conscientise and build.
South Africa has lost a true fighter, an activist, fearless and passionate.
She believed in resolving issues through dialogue and continued to bring all sectors of civil society together in all her efforts.
She was not intimidated by science because she experienced many of the things scientists write about and was therefore the best advocate.
She lived her life unapologetically and had strong views about the actual experience of living with HIV.
In the end, Prudence outlived AIDS.
She epitomised hope and life at a time of death and despair.
Today, we bid Prudence farewell and allow her to take leave of every banner, every poster, every march, every argument, every home visit, every podium and every loss of a comrade that marked her own life.
Your time to rest has finally come, Prudence.
Leave the struggle to us.
Let us learn from your life how to shape a better future in your absence.
You have earned your place in history.
But most importantly, you have made your home in our hearts.
I thank you.
Address by SANAC Chairperson, Deputy President Cyril Ramaphosa at the commemoration of World AIDS Day 2017, Walter Sisulu University, uMthatha, EC
Our Host, the Premier of the Eastern Cape, Mr Phumulo Masualle,
Your Majesties and all traditional leaders present,
The Minister of Health, Dr Aaron Motsoaledi,
Ministers and senior government officials,
Board and Management of SANAC,
Vice President of the Chamber of Mines, Mr Andile Sangqu,
Social and Development Partners,
The community of OR Tambo region,
Manene nani manenekazi,
For nearly three decades – beginning on the 1st of December 1988 – people across the globe have been commemorating World AIDS Day.
Every 1st of December, we take time to affirm our collective solidarity with people living with, and affected by, HIV.
This is a day dedicated to the memory of friends and loved ones who are no longer with us because of AIDS.
Siyabakhumbula bonke abantu bakuthi abangasekhoyo ngenxa yesifo sengculaza.
It is a day on which local and global social partners dedicate their energy to raise awareness about the HIV epidemic and share plans to end it.
On a day like this one, we also pay tribute to the organisations and activists who have devoted their lives fighting for the recognition of the rights of people living with HIV.
It is a day that reminds us of the bravery of late activists like Gugu Dlamini, Nkosi Johnson and Prudence Mabele.
Nakhona apha kulomhlaba we nkosi zomthonyama nezindlovukazi, maninzi amaqhawe esiwaziyo asebenze kanzima ukuze uhhulumeni wethu wakhe izinhlelo zokulwa nesifo sengculaza.
It brings to mind the founding President of our democracy, Nelson Mandela, uYem Yem, who fought against discrimination against people infected with HIV and TB and rallied behind the campaign for expanding ARV treatment.
It is a day where we must also pay tribute to the scientists whose work is continually improving our response to the epidemic.
Today we also pay tribute to the many health care workers, social workers and educators in hospitals, clinics, schools, orphanages and in our communities who have devoted their lives to increasing awareness about HIV transmission, prevention and treatment.
We pay tribute to all leaders in our communities, business and labour who are leading in the struggle against HIV and TB.
The South African National AIDS Council recognises traditional leaders as key players in the country’s strategic plan to end new HIV, TB and sexually transmitted infections.
As respected custodians of our culture, traditional leaders have a significant influence on social attitude and behaviour.
We salute Izinkum’kani zethu for standing up with our people to build socially cohesive communities, for promoting progressive cultural practices and for taking a stand against harmful and destructive practices like ukuthwala.
Ukuthwala robs our girls of an opportunity to complete school.
They end up becoming young mothers and sometimes they are abandoned and left destitute.
Culture is supposed to build.
It is not meant to limit developmental opportunities for our children.
Our traditional leaders are standing up to say it was never part of African culture to deny our children full opportunities and freedoms to make reproductive health choices.
Amakhosi wethu are rejecting the notion that it is part of African culture to abuse women and to forcefully circumcise young boys without the knowledge and involvement of their parents.
They are calling on everyone to return to the core value of Ubuntu, which recognises and affirms the humanity and inherent dignity of all.
Today they are with us because they want their actions to count in stopping new HIV infections.
They are determined to take the lead in encouraging individuals and communities to go for HIV testing and counselling.
They have responded to the call we made last year for a national prevention revolution.
The call for a prevention revolution is a call for a fundamental change in the way we relate to each other.
It is a call that envisions a new society based on equality, non-sexism and human dignity as called for in the Freedom Charter.
It is a society where women are economically free and culturally empowered to refuse to have intercourse with men who refuse to use a condom.
It is about building a new, caring and empowering world civilisation where culture and religion does not associate the use of condoms with immoral and sinful behaviour.
It is a society in which the LGBTI community is free from stigmatisation.
Such a revolution must produce a new woman and a new man who seek empathy, compassion and understanding – not indifference, prejudice and ignorance.
This is a call to end patriarchy, sexism, poverty, unemployment and inequality, all of which increase the vulnerability of women to contracting HIV and AIDS and other sexually transmitted infections.
It is a call for us to create a new language that will allow our young people to talk about the wisdom of safe sex and the use of condoms.
It is a call to writers, poets, painters, sculptors and musicians to find the words, melodies and imagery that will make the use of condoms a part of our new identity, new culture and desired future.
Ladies and Gentlemen,
Thanks to the efforts of government and all social partners, our country has the biggest HIV treatment programme in the world.
We have 4.2 million people who are in treatment.
But there is still some way to go because we have about 7.1 million people who are HIV positive.
We intend testing and treating at least 6.2 million people with HIV by 2020.
We will be introducing a new treatment combination from April next year.
It is known as Dolutegrevir and is good for patients.
The new treatment will save us money, which in turn will allow us to put more patients on treatment.
New infections are coming down, but too slowly.
We had an estimated 270,000 new infections in 2016 and the target is to reduce these to no more than 88,000 by 2020.
In a year, we distribute more than 900 million male and 40 million female condoms.
But we need people to consistently use them as it is the most effective way of preventing HIV and unplanned pregnancies.
We are happy to report that the She Conquers Campaign which we launched on 24 June last year has taken off in 22 sub-districts.
We wish to appeal to every sector of society to take this campaign seriously to build the capacity of our girls to make responsible decisions about their lives and careers.
We call on our traditional leaders, religious leaders, civil society formations, government departments and the private sector to learn more about the campaign and to support it.
Without this campaign, they may never have known their status and be on treatment.
Critically, however, we as a society have to work harder to prevent these new infections.
Kumele sisebenze ngokubambisana ukuvikela izingane zethu kwigciwane le ngculaza.
The number of people who die from HIV and TB – although still unacceptably high – is decreasing.
Part of the reason for this decline is that we have large numbers of people on treatment.
Abantu abathatha imishanguzo yabo yesifo sikagawulawo baphila isikhathi eside.
Sikhumbuza bonke labo abathatha imithi yokuthoba i-TB ukuba bayiphuze baze bayiqede njengoba befundiswa onompilo.
Ama-community health workers ethu ahamba engena amakhaya namakhaya esikhumbuza ukuthi sidle imishanguzo yethu ngayona ndlela efanelekile.
As SANAC, we call on our development partners, like PEPFAR, to continue to support our prevention and treatment programmes as we pursue the goal of zero new HIV infections, zero discrimination, and zero AIDS-related deaths.
We know that stigma and discrimination against people living with HIV makes it a challenge for people to test for HIV and for those infected to seek treatment.
We know that the marginalisation, discrimination and persecution of vulnerable groups like sex workers and men who have sex with men only create conditions for the spread, not prevention of HIV.
We know too well that HIV thrives where women are disempowered and excluded from education, employment and economic opportunities.
The health and growth of our economy depends on the wellbeing and capabilities of our people.
To develop the economy of the country, we need people who are healthy and living productive lives.
The epidemics of HIV, TB and non-communicable disease drain the economy of its most talented people in their most productive years.
This means that all sectors of society must contribute to improvements in the health outcomes of our nation.
In this regard, we are pleased that the Chamber of Mines, which is represented here today, has pledged nearly R2 million towards the HIV and TB screening of the people of OR Tambo.
We applaud the Chamber of Mines for recognising that this district, which for many decades served as a reservoir for cheap labour for the mines, needs the investment of the private sector to advance reconstruction, development and prosperity.
We applaud the recent launch in Tshwane of the Phila Taxi Industry Campaign by the Ministers of Health and Transport and the leadership of SANTACO.
This campaign will focus on tackling HIV, TB, non-communicable disease and violence and trauma among the 15 million passengers that use taxis each day.
We call on the construction industry to take care of its workers as well as the people who service this industry, including the hawkers at construction sites.
Research shows that when we have many workers who are new to an area, they attract sex workers.
Waterberg, with its increasing mining activity, is a good example of this phenomenon.
We call on schools to start implementing the Cabinet-approved HIV and TB policy to educate both learners and educators about health, in particular HIV and the hazards of early sexual debut and unprotected sex.
To our young girls, remember the slogan: “Books before boys because boys bring babies!”
Please love education, a lifelong partner that will never cheat on you; it will never abuse you; it will never risk infecting you with any disease.
We plan to launch a national HIV, TB and non-communicable disease screening and testing campaign in February next year – to reach the most vulnerable people – people who have HIV but don’t know this and are not on treatment.
We want to reach people who have diabetes and hypertension but don’t know this and are not on treatment.
This campaign will focus on the importance of prevention.
It is also aimed at destigmatising HIV and TB.
It is informed by the overwhelming evidence that stigma is still a barrier to treatment.
This is not the time for falsehoods and myths.
Prevention works. Let us all do the right things.
Let us use condoms – and use them correctly and consistently.
Let us circumcise, test for HIV, and stop the abuse of women and members of the LGBTI community.
Visit your nearest clinic as soon as you feel unwell.
Let us encourage our boys to circumcise because research has proven beyond doubt that circumcision significantly reduces the risk of HIV infection.
The Minister of Health has a campaign called double-up, which recognises that circumcision alone does not prevent HIV.
It becomes more powerful when used with a condom.
In this regard, I would like to commend the government of KwaZulu-Natal and especially King Zwelithini for leading the biggest medical male circumcision programme in the country.
This is expected to significantly reduce the scourge of HIV in that province.
We acknowledge that here in the Eastern Cape and in Mpumalanga medical male circumcision is being carefully rolled-out.
We are encouraged that traditional leaders are looking into this matter, providing guidance so that the introduction of medical male circumcision does not undermine our cultures and traditions.
In this regard government would like to strengthen our partnership with traditional leaders to ensure that no boy or young man gets injured or dies from circumcision.
Once more, we wish to extend our profound sense of appreciation to all the individuals and organisations who are daily contributing to ensure that we can eliminate HIV and TB as public health threats by 2030.
And we pay tribute to our Kings, Queens and other traditional leaders for taking up the challenge to deepen and accelerate the prevention revolution.
Let our actions count!