P Mlambo-Ngcuka: Congress of South African Trade Unions 9th National
Congress

19 September 2006

President of COSATU, Willy Madisha,
General Secretary of COSATU, Zwelinzima Vavi,
The entire leadership of COSATU and its affiliates,
South African Communist Party (SACP) Secretary General, Dr Blade Nzimande and
the entire leadership of the SACP,
African National Congress (ANC) National Executive Committee (NEC) members here
present,
Distinguished guests,
Comrades, delegates,

We meet here today at the 9th COSATU Congress, at a congress which also
coincides with the celebration of COSATU's 21st anniversary. We salute members
and leaders of COSATU for the outstanding contribution and sacrifices that have
been made over the past 21 years and over the years of struggle.

Our ANC led government has been in the trenches with the working class,
rural people, women, traders, Non-Governmental Organisations (NGOs), Community
Based Organisations (CBOs) and will continue to draw its strength primarily
from these constituencies, even though the ruling party is a broad based
organisation that also draws membership from all of society.

Government policy and the people who represent us in parliament are there to
safeguard the interests of the poor in the first instance. As lawmakers we
continue to need and appreciate consultations with our allies at different
levels of policy making and formulation, when it has gone through the party and
the alliance phase.

Let me highlight some of the key challenges that we need to address
together:

* universal access to basic services
* intensifying a growth path that ensures that the benefits of growth are
shared
* rolling out interventions in public education and scarce urgently needed
skills, such that we realise growth with a better life for all
* target better those who are worst affected by poverty and joblessness that
include urban and rural poor, women and youth. For all of these we need to
build on the partnerships
* we also know that HIV/AIDS prevalence is linked to poverty and socio-economic
status so as we address prevention, care and treatment, we need to do all we
can to improve the overall quality of life of our people.

While your congress will be dealing with a number of critical issues in
relation to the vision and strategic direction of COSATU, building and
strengthening your federation reflecting on the state of the tripartite
alliance and its future, one of the most vexing issue that this congress must
address itself to is that of HIV/AIDS. The role that COSATU and all its
affiliates can play in ensuring that the people of South Africa emerge as
victors in the struggle to combat the HIV/AIDS pandemic.

It has been established that young women, in the age-group 25 to 39 are the
worst affected by this disease. There are inter-provincial and intra-provincial
variations but the most common underlying factors are poverty, underdevelopment
and gender power imbalances. People living in urban informal settlements are
the most affected with the phenomenon of economic migration.

The national response to HIV/AIDS is contained in the National
Multi-Sectoral Strategy 2000/05 that is currently under review. The approach to
the review of this plan was adopted by South African National AIDS Council
(SANAC) in May 2006, where it was agreed that its fundamentals are still
relevant and there is therefore no need for any new approach. The two main
goals of the strategy are the prevention of new HIV infections and the
reduction of the impact of HIV/AIDS on individuals, families and
communities.

These are to be attained to addressing four key priority areas of
prevention, treatment care and support, legal and human rights as well as the
area of research and monitoring.

We agreed at SANAC that all sectors will give reports on progress with the
implementation of this strategy and make recommendations on how best to enhance
the national multi-sectoral response going forward. This process is underway;
reports from all sectors that are represented at SANAC are now being
consolidated into a national report.

The plan is to develop the five-year plan before the end of December 2006.
This process is led by the Department of Health.

We need to work together as partners to rebuild the partnership for AIDS and
send one message that will assist our people to fight and manage the disease
better. We owe our people that unity of purpose! SANAC working alongside the
Department of Health and not replacing it and mobilising all of government,
will work to build the partnership.

The partnership that is needed to deal with HIV/AIDS is at a critical
point:

We welcome the opportunity to address COSATU as a key partner in the
national effort against HIV/AIDS. When SANAC was launched and the partnership
against AIDS was established in 1998 the message was clear and we are here to
repeat that message, that:

"HIV/AIDS is amongst us; it is real; it is spreading, we can only win
against HIV/AIDS if we join hands to save our nation". Two years later, the
year in which the five-year national strategic plan was adopted SANAC was
established to create and strengthen partnerships with government for an
expanded national response amongst all sectors of society in the battle against
the spread of HIV/AIDS.

When the operational plan for comprehensive HIV/AIDS treatment and care was
adopted in 2003, again the message was clear: progress in implementing the plan
would depend to a significant degree on mobilisation and a co-operative
relationship among all sectors of society. Today, when significant progress has
been made in implementing the comprehensive strategy and its operational plan
and when there is still much more to do to expand access and turn the tide, the
need for partnership is as great as ever.

We cannot afford the luxury of not working together to make this plan work
to continue our ABC message. The ABC strategy remains the key strategy for
behaviour change. It needs to be supported by an enabling environment where
cultural practices support implementation.

When we fail to work together as partners the disease wins. When we adopt
the narrow approach and neglect to deal with all aspects of the disease - be it
care, treatment or prevention and improving the quality of life, we risk
limiting our impact. So I am calling for a holistic approach that government
has always called for.

At this critical point, both SANAC itself and the sectors represented in it,
as well as the government are sharply aware of the need to strengthen the
council so that it can better play its key role of strengthening the national
partnership.

HIV/AIDS campaigns need to move beyond just concentrating on international
campaigns, some of which work against us. Our programmes are thin mainly
concentrating on awareness raising activities, which in some cases only come
during the big-day events like World AIDS Day.

There are difficulties and misunderstandings that we need to deal with to
improve the climate for practical joint action and all of us owe it to our
nation to do so. I believe that COSATU as the biggest component of South
Africa's organised labour movement should play a larger role in this regard and
I invite you to do this within SANAC at the workplace and in communities at
large.

Government's comprehensive approach is clear and in line with international
best practice:

On all sides there is appreciation of the correctness of our approach. At
its last meeting in May, SANAC agreed that the major approaches of the
five-year strategic plan for 2000/05 were correct and should inform the
framework for the next five years, and a detailed plan to be discussed by SANAC
before finalisation. We all emphasise the need to overcome the problems that
are drawing us down.

The major approaches and their dependence on partnership can be briefly
stated.

(i) HIV is a major cause of death and illness in our society:

Whatever the precise figures, the sharp increase over the past eight years
in the number of deaths from non-violent causes among young adults 25 - 34
years, confirmed again in the latest report by Statistics SA on mortality
statistics, is plausibly explained only by an increase in AIDS-related deaths.
The impact of the pandemic is showing itself on both mortality and morbidity.
The number of child-headed and granny-headed households is a big challenge that
we cannot ignore.

(ii) Since there is no cure for AIDS we must act together to stop new
infection by the HIV which causes AIDS:

We need to understand and tackle the factors that are helping make the
impact of HIV/AIDS so severe in Southern Africa. Socio-economic factors;
unequal gender relations that put women at risk; unprotected and unsafe sex;
lifestyle and stigma - these and others play a part in the extent and severity
of HIV infection across our society and region and the progression of its
impact.

From a public health perspective and as a nation it is imperative that we
address these drivers of HIV infection. Comprehensive behaviour change
programmes that recognise and respond to the structural, social and individual
drivers of HIV infection must therefore be the cornerstone of our prevention
efforts. We are implementing these in line with international best practice and
in recognition of the need to scale up rapidly. Notwithstanding all the bad
publicity South Africa gets!

It is agreed that South Africa has one of the most comprehensive plans to
deal with HIV/AIDS and the shortcomings we have are part of the challenges of
implementing such a complex plan. We have to make this plan work together!

As you know our plan is supported by other elements of prevention;
'prevention of mother to child transmission' of the HIV; post exposure
prophylaxis and positive prevention amongst those who are HIV-positive. We have
challenges of human resources in that regard, hence the departments aggressive
human resource development.

(iii) The management of HIV and AIDS requires both personal and public
responsibility:

Though there is no known cure for AIDS, we can slow down the effects of HIV
infection. The comprehensive programme includes treatment, care and support but
these will only help if individuals and communities play their part.

Good nutrition, regular exercise, safe sexual practice, non-smoking and use
of alcohol in moderation all help to keep people healthy and to protect the
immune system. People who adopt this healthy lifestyle are more likely to stay
fit and well for longer than those who do not.

A healthy and responsible lifestyle is necessary and complements the
treatment which is part of the programme - both treatment of opportunistic
infections and anti-retroviral treatment for those who need it.

HIV positive parents must do all they can to live healthy as long as they
can as their children need them. We know today more and more people are living
longer, healthier and as productive members of society. When two parents die
and children are left alone that creates a big social problem in the future and
for generations - that is what makes HIV/AIDS such a drastic disease and our
collective responsibility - that is why we in the public sector see the need
for partnerships.

The importance of the establishment of service accredited sites for access
to the comprehensive sites of services and the steadily growing number of
people provided with voluntary counselling and testing; with nutritional
supplements; and enrolled for antiretroviral treatment are a matter of
record.

So is the number of condoms distributed; the number facilities providing
prevention of mother-to-child transmission drugs; the fact that almost all
hospitals provide post exposure prophylaxis; the number of laboratories and
pharmacovigilance centres; the expansion of public funds dedicated to combating
HIV/AIDS. All of these are matters we are busy with.

When this progress is noted and celebrated it is not to say that enough has
been done. But each step forward in the implementation of a comprehensive and
sustainable response is reason for confidence that we can make further progress
in ensuring access to those who do not yet have it. It should be stressed that
a healthy lifestyle and good nutrition are not alternatives to treatment.

Equally antiretroviral treatment is not a cure � it can prolong life and
keep people fitter and healthy for longer but will not remove the virus from
the body.

(iv) The state provides some resources to tide people over the worst of
infection but care and support are also a community and social
responsibility

The temporary disability grant helps tide people over the worst of the
infection, but the aim of public health interventions is to restore people
living with AIDS to health so they can take up rights and responsibilities like
any other citizen.

Communities have a crucial role to play identifying children at risk,
referring them to social services and keeping them at school, protecting
child-headed households and others who are vulnerable.

Many NGOs and CBOs are playing a vital role as are many families and
individuals; they are part of the national partnership and their efforts should
be recognised and supported. I feel as the nation we should give greater
support. It is not only government's role to support civil society.

The business sector could also play a greater role by extending its mainly
workplace-based wellness programmes in helping prevent new infections in
communities they draw their workforce from. We commend the work that is already
being done.

The private sector needs to accept greater responsibilities. This means not
only taking into account the treatment of their own employees, but extending
this to spouses and dependents as far as this is feasible. I feel they can go
further than where we are now.

They should ensure that once treatment for a worker is begun there should be
some continuity of treatment in prospect. For instance, when a worker leaves a
job this person should not be summarily cut adrift and left to his/her own
devices or to try for available public-sector options, but rather offered
further treatment as part of the departure package, at least until some other
employer or agency can take over this responsibility. Again in our work on
local economic development and poverty alleviation we need to work together to
target the families for Vuk'uzenzele so as to improve their socio-economic
status.

This has a cost implication. But indeed, this is no normal situation as it
involves life and death decisions. If treatment is not kept up and aligned with
other support, the person can be worse off than when the treatment was extended
or introduced by the employer. This means entering into a commitment that has
implications for the future. We can and should integrate closer partnership
also for that reason.

Trade union organisations are well-placed to play a part in supporting
people living with AIDS. In the workplace they can ensure that the rights of
workers living with AIDS are protected against discrimination; that employee
assistance programmes are in place and that active and effective prevention and
awareness campaigns are conducted. Union members can take this work into their
communities, strengthening the efforts of community based organisations.

(v) Now is the time to strengthen the national partnership against HIV/AIDS,
the epidemic is reaching its peak � we must act to rapidly reverse its
course

The epidemic has stabilised - slight increases in prevalence from year to
year are because the most heavily infected group is getting older with new
infection in this group keeping it high. That also needs us to adapt our
strategy and responses.

Prevalence has stabilised amongst young people though not yet amongst
school-leaving girls and we need to focus on achieving success with this group,
clearly much ignorance here is a problem. But this situation provides an
opportunity to begin to reverse the course of the epidemic.

And yet we must acknowledge that at this critical moment the climate is not
as it should be if we are as a nation to seize this opportunity. So we as
government seek to normalise the situation. People who want to work with us as
partners need to come forward and hold hands.

I must add that we will not accept preconditions by individual stakeholders
who seek to predetermine the agenda for engagement; we want to engage without
prejudice in SANAC and not in a fragmented manner.

(vi) SANAC needs to rise to this challenge

SANAC, which was established in order to embody and strengthen the national
partnership has a crucial role to play. In 2003, SANAC restructured itself in
order to better play its role. Now three years later it is again reviewing its
performance in order to enhance it. We agree upfront it has under
performed.

The Cabinet two weeks ago before last, recognising the need to strengthen
partnership and address the current tensions, mandated the Deputy President as
Chairperson of SANAC to take concrete steps to strengthen SANAC. We have inputs
from stakeholders on how to strengthen SANAC that we are reviewing.

This was further discussed at the first meeting, last week, of the
reconstituted Inter Ministerial Committee (IMC) on HIV/AIDS. It discussed how
SANAC could be strengthened to play the key role of strengthening the national
partnership against HIV/AIDS. That discussion will inform government's input
into the SANAC review and we will take the inputs of stakeholders on board.

To begin with the secretariat of SANAC will be strengthened to ensure that
operations of SANAC are better managed and co-ordinated. I as the chairperson
of SANAC, will convene SANAC over the next six weeks to take these matters
forward. The IMC also agreed that there is a need for sectors generally to
ensure that they are represented on SANAC by senior members; for its part,
government will ensure it is represented at the level of Ministers and
Directors-General (DG). That will be important, while allowing multi-sectoral
meetings to happen in between the leaders' meetings.

Institutionalised in SANAC is the broader national partnership made up of a
host of organisations, communities, sectors, families and individuals. The IMC
also resolved to improve government's interaction with these stakeholders.

In addition to convening SANAC, my office will take steps to ensure that
there is interaction with all other players in the country who have a
meaningful contribution to make in the fight against HIV/AIDS.

Meetings will take place in the first instance, with senior government
officials at the level of Directors-General, prior to meetings with the Deputy
President and members of the IMC.

These meetings will help create a conducive environment for constructive
interaction between government and the various players, and will go a long way
towards clearing the misunderstandings that have existed in the sector. I want
to commend National Association of People Living with AIDS (NAPWA) and thank
them for calling off the hunger strike and for agreeing to work with our team,
headed by the DG in the Department of Health, to find ways of responding to
their needs.

A time of opportunity, a time for a partnership of hope even though modest;
the stabilisation of the epidemic and the progress made in strengthening the
health system and in implementing the operational plan creates an opportunity
for the nation to reverse the course of the disease, to deal with weaknesses
and unevenness in implementation, and to accelerate the implementation of the
plan in a shared effort of government and society.

Our collective response has for too long been undermined by finger-pointing
and despair, I appeal to you that we change that.

Partnership is a two-way process with a shared responsibility to the nation
to treat problems and challenges as matters for joint solution and not sticks
to beat one another with or as a means for scoring points; because in that
scenario there are no winners.

We are concerned about the new and challenging development as far as
tuberculosis (TB) is concerned - the emergence of extreme drug resistance (XDR)
TB must not cause panic or lead to the victimisation of the affected people.
All the provinces are working very hard and we urge members of the community to
make contact with the medical services if they have symptoms or they know
people who are affected.

* In summary we are calling for a strong partnership and for COSATU in
particular, to be a partner.
* We are calling for all of us to strengthen SANAC and to work constructively
with the Department of Health, to work together in solving the problems
encountered in implementing the comprehensive plan.
* We restate government's position which has got treatment and care including
nutrition.
* We must not stop the ABC campaign because it is still relevant.
* We call on employers as partners to extend their support to the families of
their workers.
* By the end of 2006 we will emerge with a restructured SANAC which will draw
inputs from all stakeholders.
* We urge all of us to streamline our messages so that members of the public
are clear about what we are saying and they get the same message from all of
us.

As a country we owe it to ourselves to unite first and to support our people
even before we expand our energy on international campaigns. We must devise a
plan to support children in all our communities who have lost a parent, because
every child is my child.

Comrades let me conclude by once more thanking the organiser for inviting me
to speak on behalf of SANAC. I have given a brief outline of where the country
is with the implementation of a multi-sectoral strategy, the strengthening of
SANAC, as well as the comprehensive plan. I wish you well as you deliberate on
this and other critical matters affecting the working class in the country.

Let us join hands in a partnership of hope!

Amandla!! Awethu!!

Viva COSATU Viva!!

Issued by: The Presidency
19 September 2006