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

(Deputy President Cyril Ramaphosa delivering eulogy). Deputy President Cyril Ramaphosa during a funeral service of Prudence Nobantu Mabele at Rhema Bible Church in Randburg, Johannesburg. South Africa. 19/07/2017. Siyabulela Duda

Image: Siyabulela Duda

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.