3 May 2006
There have been a number of disputes between the Department of Health and the Treatment Action Campaign over the past few years the last being the dispute over the organisation's participation at the United Nations General Assembly Special Session (UNGASS) on HIV and AIDS.
As the Department of Health management team, we have been engaging with TAC on number of health issues and our effort have been to find a working relationship with the organisation as we do with many other non-governmental organisations in the health sector.
The experience over the past five years including negotiations over the UN issue, have taught me to accept that the success or failure of these engagements is dependant on the balance of power amongst three broad groupings that seems to constitute this organisation.
The first group is made up of more rational TAC members who try and systematically argue various health issues from the perspective of their organisation. This group includes the likes of TAC Treasurer, Mark Heywood and his colleague in the AIDS Law Project, Fatima Hassan.
They push their point as far as they can. But they also acknowledge that some concessions have to be made in return for gains in other areas - the basic principle of give and take which is critical for success of any discussion. We have engaged with them on such issues as the development of the Charter for the Health Sector and the Human Resources Plan for Health without much furore.
This is the initial group that we engaged with when we sought to resolve the dispute over the participation of the TAC at the UNGASS. There was a feeling from both sides that progress could be made if a few issues were resolved.
The possibility of an amicable solution was there until the second group of what may be termed "extremists" took over the matter. For this group, embodied in the figure of Zackie Achmat, government bashing is an end to itself.
This is the same group that led what was called the Civil Disobedience Campaign, accusing Health Minister, Dr MantoTshabalala-Msimang and former Minister of Trade and Industry, Alec Erwin of genocide. It has rallied various local and foreign partners in its campaign to falsely label South African government as "HIV and AIDS denialists".
For this group, nothing good can come out of engagement with the Department of Health until government accepts the narrow view that antiretroviral drugs are the only tool for saving South Africa from the destruction of HIV and AIDS. The comprehensive approach based on prevention and the provision of a variety of care and treatment interventions (including ARVs) as promoted by government is nothing but a denialist approach to the problem. Therefore, a positive response to an invitation by government is, in principle, a bad thing.
The last group is mainly township youth who are now and again called upon to the streets of Cape Town, dressed in HIV Positive t-shirts and chanting slogans. The last of these marches was to demand that the world's most proponent of HIV prevention, the South African government, must stop" undermining HIV prevention."
This first prevention march to be organised by TAC was as a result of the decision by the African Ministers of Health (including MinisterTshabalala-Msimang) to declare 2006 as the year of HIV prevention.
Represented in the likes of the TAC general secretary, Sipho Mthathi, the last group is made up of young men and women driven by passion to deal with the challenge of HIV infection and willingness to assist in reducing the impact of AIDS. This energy and passion can be positively used to assist the many communities affected by HIV and AIDS to access prevention, care and treatment services that government provides.
But it can also be misdirected into the streets, supporting protest actions whose objectives do not necessarily represent the passion of the marchers to help their fellow South Africans to deal with problems of poverty, unemployment, diseases, etc.
At the end, the organisation has to act as one unit with one of these three groupings determining the course of action. The "extremist" group seems to have gained upper hand over the rational group and mainly township-based youth concerned about HIV and AIDS.
Mthathi has not been able to defend the integrity of her office (general secretary) whose status has been questioned by at least two national newspapers (Sunday Independent and City Press) as some kind of a window-dressing.
Mthathi led TAC delegation in the discussions with the Department of Health to resolve the dispute over the participation of organisation at the UNGASS and was later invited by the Department to the country delegation as a TAC office bearer.
Heywood's concession on a Safm interview last week that the TAC might need to reconsider the decision to reject government invitation to UNGASS was hastily overruled. Heywood has since not made any public statement about the matter.
After being out of public activity for many months, Achmat came back to lead the press conference that rejected the government invitation.
During the closing session of the international conference on microbicide held in Cape Town last week, Achmat went on to revive his old populist grand standing style, criticising almost everything that government has done to address the challenge of HIV and AIDS in the country.
The first opportunity to have a TAC representative in the country delegation to an international forum has been squandered. Zackie Achmat and his government-bashing lobby are back in action.
Sibani Mngadi: Spokesperson for the Minister of Health @ 0827720161