B Hlongwa: Gauteng Provincial AIDS summit

13 October 2006

Programme director
Distinguished guests
Ladies and gentlemen

HIV and AIDS is probably the biggest health challenge that the world has
ever faced. Its importance is magnified by its impact on broader society,
beyond those who are either directly infected or affected by the disease.

In a developing economy such as South Africa we are experiencing this impact
on issues such as job creation, economic growth, loss of productivity and the
allocation of financial resources. It has a draining effect on our budgets for
welfare, for looking after both the very young and the elderly, on education
and even on our ability to combat crime and manage safety and security. On a
daily basis it robs us of some of our best brains, some of our most creative
minds, and some of our potential future leaders.

We are, in fact, dealing with a comprehensive assault on society as we know
it, where not a single person in Gauteng; man, woman, child, young, old, rich,
poor, white, black, healthy, sick can escape the impact. And for this very
reason we need a comprehensive response that includes the contribution and the
co-operation of every single person in our province.

Events such as this Provincial AIDS summit are very important to mobilise
the efforts of the many committed individuals, organisations and volunteers who
have dedicated their lives and careers in the treatment and caring for people
living with HIV and AIDS. Let me, at the outset, pay tribute to you and to your
work to the researchers who are looking for a cure; to the medical
practitioners who are treating patients with an admirable degree of
professionalism; to the nursing staff who look after patients with the utmost
compassion; to the non-governmental organisations (NGOs), and the faith-based
organisation (FBO) who brings to our efforts an element of passion; to
home-based care-givers and families who are tending patients with such love and
dignity.

Ladies and gentlemen,

Quite often we look at the global AIDS statistics and the projections for
the growth of this epidemic in Africa with a sense of apprehension and we run
the danger of becoming overwhelmed by the magnitude of the issue. We are
dazzled by figures, mesmerised by PowerPoint presentations and paralysed by the
ominous statistics coming from global think-tanks and research houses.

Our responses tend to follow the same patterns. We set up committees and
councils, we draft strategies and action plans, and we plot the effectiveness
of our interventions in the finest details. We take heart and courage when we
see a slight drop in figures in one specific target group and are driven to
despair when there is a blip in the graph in another area.

Please do not get me wrong, I am not downplaying the importance of careful
planning or the urgent need to have strong structures and well-equipped
programmes in place to ensure a coherent and cohesive response to the
challenges.

What I am saying, however, is that we should not forget that our human
resources form the frontline of this response. You who are here today, you who
are providing medical assistance, you who are involved in counselling of the
youth, you who are providing home-based care and you who are spreading the
moral messages of prevention and lifestyle changes - you are the most valuable
resources that we have and you are our strongest weapons in the battle.

Ladies and gentlemen,

My call on you is not to get disheartened by the size of the big picture but
to continue focusing on what you are already doing within your own environment
and your own sphere of influence. I am convinced that our ability to turn the
tide against HIV and AIDS will as much depend on the large scale dramatic
interventions that we are implementing from the side of government than by our
ability to reach individuals and to persuade them to change their risky
behaviour.

Ladies and gentlemen,

This summit also gives us the opportunity to evaluate our responses and to
measure the successes we have achieved, perhaps, also to analyse our failures
and to consider alternative responses. In the next two days we will be
inundated with statistics and graphs. It is not my intention to add to this
body of knowledge. I will leave it to the researchers and the statisticians. I
am convinced that we will depart from here with a very thorough understanding
of where we are and what our strengths and weaknesses are but also with a clear
vision of where we want to go.

I would rather want to focus on two areas where every person in Gauteng and,
indeed, in South Africa, can make a contribution in our response to AIDS.

* The first one is: Leadership.
* The second is: Responsibility.

On the issue of leadership, I believe it is time that all of us realise that
the size of the AIDS challenge is infinitely bigger than the egos of the
individuals concerned. We are faced with an AIDS 'tidal wave' but we squabble
among ourselves on who must sit where on the lifeboat, who must be in the back
and who must be in the front, who must steer and who must bail out the
water.

We simply cannot continue with internal squabbles, personality differences,
conflicting egos, private agendas and cheap publicity stunts if we want to make
a dent in this campaign. Let us stop shouting at each other and talk to each
other. Let us stop dragging each other to court and wasting time and money and
rather meet each other around the table.

If we do so we will find that there is much more that we share than what
divides us. Let us agree that between government, the medical profession, NGOs
and activist organisations we share a common concern about the magnitude of the
problem. We share a common understanding about the impact HIV and AIDS is
having on our society. We share a common compassion for people living with the
disease. We share a common aspiration that the growth of the disease will be
halted and, eventually, turned around.

In my humble opinion we share common ground on at least 90% of the issues.
Yet, we continue to squabble, to fight and to shout at each other on the
remaining ten percent where we might encounter differences of approach and
opinions.

We need leaders and not publicity seekers. We need negotiators and not
grandstand artists. I think the time has come that all of us involved in this
pandemic demand of our leaders to demonstrate maturity and responsibility. Let
us forget what has been said in the past, let us leave our egos at the door and
let us start talking with warm hearts and cool minds.

From my perspective, I can assure you that it is simply untrue to allege
that the government does not take the HIV and AIDS pandemic seriously or that
there is any ambivalence on policy or programmes. At Gauteng Health, we spent
an extraordinary amount of our time, our efforts and our money on HIV and
AIDS.

This year alone, the total budget for this programme has been increased by
almost 50 percent to bring it to R514 million.

The Premier of our province is providing leadership not only through his
active participation in the Gauteng AIDS Council, but also through the moral
content of the messages he is conveying on prevention, on abstinence and on the
need for profound changes to lifestyles and sexual behaviour.

I believe that our efforts in Gauteng are already making a measurable
difference. Since the inception of the Comprehensive Care Management and
Treatment Programme including anti-retroviral treatment, more than 350,000
patients have been assessed and over 41 000, of which 6 000 are children have
commenced treatment.

In this financial year, the HIV and AIDS comprehensive care and treatment
programme including antiretrovirals will be expanded to hospitals, community
health centres and all sub-districts. By the end of this year, there will be 54
operational sites with an estimated 60 000 patients receiving antiretroviral
therapy.

Ladies and gentlemen,

The point I am making is that we can differ on the allocation of this
budget; we can differ on whether we have the right priorities; we can differ on
the effectiveness of our programmes or whether we are reaching the right
audiences with the right messages. But we should do so through a mature debate
and without demonising those who might have different views to our own.

I am quite optimistic about the prospects of a more constructive
relationship between all participants in the AIDS debate in future. I think
Cabinet has demonstrated its commitment to the issue with the appointment of
the Deputy President to lead and co-ordinate the campaign and I am convinced
that she will provide strong and decisive leadership in this regard.

However, ladies and gentlemen, leadership should extend beyond politicians
and the high-profiled activists that dominate the media headlines. Each and
every one of us is a leader in our own right and each and every one of us has a
responsibility to provide direction within our own sphere of influence.

* I have high regard for the very positive contribution made by South
African Business Coalition on HIV and AIDS (SABCOHA) and organised business but
the time has come that every business in this province steps up its efforts to
yet another level to inform their workers and to advise them on prevention, on
treatment, on counselling and on personal responsibilities. We need chairmen of
the boards, managing directors and chief executive officers to show visible
leadership and not to leave it to human resources or internal
communications.
* We need church leaders and moral leaders to make HIV and AIDS a central theme
of their messages in churches, synagogues and mosques. We simply cannot afford
to be coy or shy about the issue. Let us call it by the name.
* We need to talk openly about gender inequality and its impact on the
prevalence of HIV and AIDS. We must address these social norms and deep rooted
attitudes that women are the possessions of men and that they must be available
for sex at the beck and call of males. The current estimates are that at least
30% of girls and women do not have control of the conditions under which they
have sex. If we do not change these attitudes we are not going to make a dent
in the AIDS figures.
* We have to redouble our national efforts to reduce poverty, create jobs and
improve the quality of life of all our people. This is not a political slogan
thought out by the ruling party; it is a prerequisite for a stable, prosperous
and peaceful South Africa. If we do not reduce poverty and create economic
opportunities we will not address some of the root causes of HIV and
AIDS.
* Our educators and our teachers should step up the contribution they are
making in providing accurate information about behaviour and lifestyle. We have
to introduce these programmes at a much earlier stage into our educational
system and we have to make the messages clear, simple and easy to
understand.
* Our youth's role models should take greater responsibility in conveying
correct messages, but also to set the examples in their own lifestyles and
social behaviour. Musicians, actors, sportsmen and women should not only be
seen performing at big rallies or appear in advertisement but then often send
conflicting messages through their own public behaviour.

Ladies and gentlemen,

I am concerned that we have been spending millions of rands on awareness
programmes over the past decade or more. We have all the messages on billboards
and posters; we have produced soap operas and youth programmes; we hold massive
rallies and music festivals; we spend weekends in seminars, workshops and
lekgotlas.

Yet, we are not able to stem to growth in new HIV infections.

Please, do not misunderstand me. I have the highest regard for the efforts
we are making to combat the disease. And we have made tremendous progress
through the years to raise awareness and inform people about the lurking
dangers.

But, we simply have to ask ourselves how do we move beyond awareness into
behavioural change? Despite all our efforts and all our resources why can't we
stop new infections? It should now be quite clear to us that a high degree of
information and an increased level of knowledge do not automatically translate
into safe behaviour and a reduction in new infections.

Programme director,

I am encouraged to see that these are exactly the issues that will be on the
agenda of this two day summit. I have no doubt that we have assembled here the
best brains and the most competent expertise in the fields of medicine,
behavioural science, education and communication.

I want to encourage you to speak freely and openly. If you have concerns or
reservations about what the department is doing, this is the forum to raise
them. We are in this together and we want to jointly find the right approach to
this massive challenge facing our country.

Ladies and gentlemen,

I earlier referred to the two issues that I believe are keys to the HIV and
AIDS debate. The one is leadership. The other one is personal
responsibility.

I have no doubt in my mind that we will not make progress in our efforts to
stem the tide of HIV and AIDS if we are not able to persuade each and every
individual to take responsibility for his or her individual lifestyle.

Life is made up of choices. And every individual - especially our young
people - is presented every day with a vast array of different choices and
options. They are being bombarded by messages from the media, from advertising,
from role models and from their peer groups.

Quite often we make the wrong choices. And we see that on a daily basis in
the growth in alcohol and substance abuse, the growth in the drug trade, the
steady erosion of family values, the carnage on our roads, family and gender
violence, the abuse of children, the low status of women in our society. We can
go on and on - but suffice to emphasise that this destruction of societal and
moral values is a major contributing factor to the continuing growth of HIV
infections and the prevalence of AIDS.

Within this wild cacophony of enticing messages and lurid options you as
health professionals and moral leaders have to bring the 'boring messages' of
abstinence, faithfulness in relationships and the use of condoms during sexual
activities. I don't think anybody envies your task and we want to commend you
for your enduring efforts.

Ladies and gentlemen,

We have to ensure that we throw a blanket of credible information and
correct messages across the entire Gauteng. We have to use every single medium
at our disposal and use every opportunity available to hammer home the same
messages: prevention, lifestyle change, respect for your own life and those of
your partners.

We should never forget that the prevention of new HIV infections must remain
our top priority in order to reduce the future impact of AIDS. And although our
research shows that the knowledge of HIV prevention, especially among the youth
is growing, we must redouble our efforts to ensure that knowledge is turned
into action.

I am pleased to say that there are today in Gauteng very few sectors of
society that do not form an integral and valued part of our response to AIDS.
Together with our partners from government, business and civil society we are
taking the key messages to the suburbs and the informal settlements; to the
media, to schools, to places of entertainment and to sports fields, to the
workplace and to schools.

I believe that we are indeed making a difference in the lives of the people
of Gauteng. Our objective is to develop healthy, skilled and productive people
that can take our province into the future and ensure a better life for our
people. I trust that this provincial AIDS summit will help to accelerate this
process.

I thank you.

Issued by: Department of Health, Gauteng Provincial Government
13 October 2006
Source: Gauteng Provincial Government (http://www.gautengonline.gov.za)