the local HIV/AIDS Indaba
29 June 2006
SETTING THE LOCAL GOVERNMENT AGENDA ON HIV/AIDS
Programme Director,
MEC Qedani Mahlangu,
Mayors and councillors,
Distinguished guests,
Delegates,
Ladies and gentlemen,
HIV/AIDS is probably the toughest health challenge that the world has ever
faced. But it is also the most urgent one given the impact it is having on
wider society and the demands it is placing on human, physical and financial
resources.
It is safe to say that there is not a single person living in Gauteng who
has not been directly or indirectly affected by HIV/AIDS. We who are present
here today work on a regular basis with communities and individuals whose lives
have been profoundly changed by the direct impact of the epidemic. We are
affected as people living with AIDS, as their families and friends, as health
workers, community workers, counsellors and care givers.
But outside of this direct environment there is a wider world with a society
and an economy where people go about living their daily lives often oblivious
of the way in which HIV/AIDS are affecting their very existence now and in the
future.
And I believe that if we don't sufficiently realise the secondary impact of
HIV/AIDS on the broader economy, on economic growth and job creation, on the
allocation of resources and on the devastating loss of creative and productive
people we will never be able to mobilise the required community support to
tackle the challenges posed by the disease. We are all aware of both the local
and global projections which indicate that the economic tsunami associated with
HIV/AIDS will only start rolling over us in four to five year's time.
Ladies and gentlemen,
I want to thank you for your presence here at this indaba. You have been in
the front line of our collective response to HIV/AIDS for a number of years.
You have been active at provincial hospitals and clinics, in health centres,
involved with local government initiatives or have given of your time and your
souls to work with community organisations, faith-based organisations (FBOs)
and non-governmental organisations (NGOs).
The country and the province of Gauteng owe you a great debt of
gratitude.
As we focus at this indaba on structures, programmes and agendas to empower
local government we should not lose sight of the immense contribution made by
caring individuals who are dedicating their entire lives to care for
others.
Let me assure you that we in the Gauteng department of Health recognise and
acknowledge the excellent work that are being done at the various sphere of
government but also by NGOs and community organisations.
As a Department we are keenly aware of the magnitude of the challenges posed
by HIV/AIDS. In Gauteng this is a priority issue. It is reflected in our
budgets, in our provincial strategic priorities and in our comprehensive
Gauteng AIDS strategy.
Our HIV/AIDS response is a key element of our five-year provincial strategy
which includes the important acknowledgement that the development of
sustainable communities in Gauteng will depend in part on how well we manage
these epidemics.
In my recent budget I announced that the total budget for this programme has
been increased by almost 50 percent for the coming year, to be exact an
increase of 47,8 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 (CCM) and
treatment programme including Anti Retroviral Treatment (ART), 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/AIDS comprehensive care and treatment
programme including anti-retroviral (ARVs) 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 ARV
therapy.
We are getting positive feedback from both health care workers and people
accessing ART with regards to the quality of our service and the responses to
treatment. I believe that this programme also helps to strengthen the
relationships between the Gauteng Department of Health and the various
community organisations working in the field of HIV/AIDS care.
Programme Director,
This indaba will look at local government responses to HIV/AIDS from a wide
variety of angles. 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 don't want to dwell
too much on the details but allow me to draw a broad framework for the
discussions.
The first point is that HIV/AIDS pose a profoundly human challenge to our
health services and our ability to respond.
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 tend to be
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 minutest 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 don't 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/AIDS will as much depend on the large scale dramatic
interventions that we are implementing than by our ability to reach individuals
and to persuade them to change their risky behaviour.
That is the reason why I have so much respect for the work done at local
government level through your door to door campaigns and by the sterling
efforts of civil society and NGOs. We have to make sure that we reach every
single young person in this province every learner at school, every student at
a tertiary institution, every member of a sports club, a youth organisation or
church group.
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 of 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 show 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
So, please don't underestimate the valuable work you are doing within your
own environment and please do not let up on your commitment and your
dedication. The most recent Human Sciences Research Council (HSRC) surveys show
that we are indeed making measurable progress in the areas where we have
focused most of our attention in recent years and that we are seeing evidence
of behavioural change.
It is pleasing to note that in a year where we are commemorating the special
contribution that the youth of South Africa has made to the liberation and
democratization of our country - the youth is again leading on HIV and
AIDS.
At the same time, while the rate of infection in the age group under - 25
appears to be slowing down the rate of growth is escalating among adults older
than 35. This is a worrying trend and indicates that we will have to adapt our
prevention messages to groups who might have considered themselves invulnerable
to the disease.
Programme Director,
This brings me to the second principle. I believe we have to fully
appreciate what it means when we say that the HIV/AIDS is not solely a medical
issue. And that we need a multi disciplinary approach and a multi sectoral
response to address the myriad of issues associated with the epidemic.
This indaba is evidence of our belief in the multi sectoral approach. We
have with us delegates from a wide range of constituencies and the topics on
the agenda include the impact of the disease on housing, on the delivery on
municipal services, on the provision of education and on ordinary households.
Only last week there were reports about an important study by the centre for
urban and built environment studies at Wits University pointing to the impact
of HIV/AIDS on population growth leading up to 2020 and its implications for
housing and infrastructure planning.
At this indaba we will also talk about how all sectors that can influence
our response to HIV/AIDS can be most effective within their own environment
whether that be the medical profession, traditional healers, traditional
surgeons, community workers or leaders of faith.
I am personally encouraged by the progress we are making in broadening the
alliance in Gauteng. Every year we are bringing in an ever growing number of
organisations into our efforts to communicate the AIDS messages and every new
group enrich us with their own experiences and special skills.
Because we are dealing with issues of morality and behaviour it is
encouraging to note that we have significantly expanded our representation from
FBOs to now include the traditional western churches, as well as a broad range
from evangelical churches, the African Independent Churches (AIC) as well as
the Muslim, Hindu and Jewish faiths.
We believe that the influence of FBOs together with the great support that
we are receiving from traditional healers and traditional surgeons will enable
us to bring our key messages across in a more effective manner.
The international experience has shown that we can not separate the
prevalence of HIV/AIDS from the issue of morality and moral standards in
society. That is also why there is such a high correlation between HIV/AIDS and
other societal ills such as alcohol abuse, drug and substance abuse and teenage
prostitution.
Our responses to the epidemic should take this into account and that is why
we are relying so heavily on organisations and institutions who are working in
related fields.
Programme Director,
The Gauteng AIDS programme will continue to base its prevention strategy on
social mobilisation. We must continue to draw in community leadership and
organisations that are able to influence lifestyle choices and behaviour
changes.
We are closely aware of the linkages between HIV/AIDS and poverty and that
is why the Gauteng government is constantly looking at the packages of social
services that we provide to affected households. This includes a range of
social grants and ensuring that affected children can access education
opportunities. Underlying this is our belief that we require stable families
and households as an important building block for effective responses to
HIV/AIDS.
The Bana Pele programme places a special focus on children in need and we
have been able to mobilise a strong coalition in support of our
initiatives.
But again we need to sharpen our focus to ensure that we identify all
children in need and enable them to access the available services.
Through the Gauteng AIDS Council we maintain a very productive working
relationship with business through South African Business Coalition on HIV/AIDS
(SABCOHA) as well as with the major labour federations.
Within the provincial government we have workplace programmes in place in
all 11 departments. Moreover the province is responsible for joint strategy and
policy development, programme planning and high level co-ordination across 20
government departments and 15 civil society sectors in Gauteng.
The implementation of these programmes needs to be coordinated locally by
municipalities and incorporated into Integrated Development Plans (IDPs).
I do, however, want to call on senior management in departments as well as
in the municipalities and local government structures in Gauteng to provide
greater leadership in workplace and awareness programmes in their respective
environments. Perhaps leadership on HIV/AIDS should be incorporated in the
scorecards of senior management.
It is encouraging to note that so many state, civil organisations and are
increasing number of businesses are elevating the importance of the HIV/AIDS
challenge as part of their core activities.
Ladies and gentlemen,
I want to briefly refer to the specific role of local government structures
in the response to HIV/AIDS. I am of the opinion that municipalities will in
future play an increasingly important role primarily because of their abilities
to mobilise local communities and develop the capacity for education and
training.
I am aware of the problems that you have with regards to capacity and
finance and these are some of the issues that needs to be raised and discussed
with frankness over the next two days. However, I also believe that we can find
innovative approaches to the issues within the confines of existing financial
restraints. The recent survey of the South African Cities Network (SACN) speaks
of âoutstanding examples of pioneering approaches towards building capacity and
extending the reach of HIV/AIDS service delivery organisations.â Again, the
answer lies in creative partnerships between government structures and civil
society while business should also explore opportunities in this regard.
The door to door campaigns that annually reach a peak around World Aids Day
is a prime example of how municipalities can reach a significant number of
people that do not fall within the spheres of influence of community
organisations. The Jozi Ihlomile initiative in informal settlements around
Johannesburg is an example of such an effective operation.
Programme Director,
I believe that the local government structures in Gauteng can strengthen
their response to HIV/AIDS through a number of interventions.
* There must be clear strategies to bring HIV/AIDS into the mainstream of
government activities through the IDPs. In this way municipal departments and
agencies can identify activities that are directly related to their core
functions.
* We must integrate HIV/AIDS strategies into all other developmental issues
including poverty alleviation, social grants, substance abuse counselling and
other social interventions.
* We must strengthen the existing inter-governmental relationships between
national, provincial and local government structures.
* We can not afford to duplicate services and programmes or to work in
competition with each other. One of the primary objectives of local government
in the next few months should be to do a thorough audit of the work done by
civil society and NGOs within their environments, to identify areas of
co-operation and to strengthen the mutual relationships. In this way we will
ensure that money and human resources are allocated more productively.
Ladies and gentlemen,
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 work
place and to schools. This conference is of great importance to the future of
our responses to HIV/AIDS in Gauteng. We value your contribution and are
looking forward to the constructive inputs that you will make to the
discussions during the next two days.
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 indaba will help to accelerate this process.
I thank you!
Issued by: Department of Health, Gauteng Provincial Government
29 June 2006
