ANCs ledelse om AIDS 2002

LEND A CARING HAND OF HOPE - STATEMENT OF THE NATIONAL EXECUTIVE COMMITTEE OF THE ANC

Issued by the African National Congress

20 March 2002

1. During its meeting of 15 to 17 March 2002, the National Executive
Committee of the ANC held a wide - ranging discussion on the issue of HIV
and AIDS. The discussion was preceded by extensive briefings on the
evolution of policies and programmes of government against the epidemic.

2. The meeting noted the comprehensive nature of the programme of government
and the ANC, including the Youth and Women's Leagues, to work together with
other sectors of society to combat this scourge. While reaffirming the
correctness of the strategies currently being implemented, the meeting
underlined the commitment of the ANC to a continuing search for better and
more effective ways of fighting the spread of HIV infection and the
management of AIDS.

3. The ANC wishes to reassert three critical components of the basic premise
from which we move in dealing with this matter.

4. The first one is the assumption that HIV causes AIDS.

5. The second one is that, though the Syndrome can be managed in a variety
of ways, there is no cure for AIDS.

6. The third is that socio-economic conditions, particularly poverty, play a
critical role in both the transmission and progression of the disease.

THERE IS HOPE

7. The AIDS epidemic is one of the greatest challenges that our society has
ever faced. The difficult and complex questions it raises and the pressure
it exerts on families require unity of purpose and action among all of us.

8. We are confident that, inspired by this joint commitment to action, South
Africans can succeed in managing and ultimately defeating AIDS. Our primary
call, therefore, is for all of us to lend a caring hand in building hope.

9. There is hope because South Africans have the internal strength to ensure
their self-preservation as individuals, as communities and as a nation.

10. There is hope because the message of awareness that we have all promoted
has reached the overwhelming majority of South Africans.

11. There is hope because the partnerships that we built over the years,
are an important resource and would continually be strengthened.

12. There is hope because the programmes of treatment and home-based care we
have initiated in the past are helping the nation to manage the epidemic.

13. There is hope because we are continually improving our legal instruments
and cultural practices to protect the rights of those living with AIDS.

14. Above all, there is hope because, through our comprehensive programme to
build a better life for all, we are eradicating the conditions of poverty
that are critical in the propagation of HIV and progression of AIDS.

CONTINUITY AND CHANGE

15. The NEC meeting put all elements of our policies and strategy under
scrutiny, and also examined the environment within which these matters have
to be articulated. The overriding conclusion the meeting came to, is that
these policies and strategies are, under current circumstances, amongst the
best and most relevant approaches required to manage the epidemic.

16. However, we wish to assert, now, more than ever before, that many areas
require improvement. Indeed, there would never be a time, as long as HIV and
AIDS exists, that we could be satisfied with the work we are doing.

17. In this regard, the NEC concluded that our work in the current period
should be characterised by an approach of "continuity and change":
continuity in broad strategy and policy, and change in intensity and
coherence of implementation and articulation.

18. The NEC reaffirmed the comprehensive strategy of government to address
all aspects of the disease. In particular, the following issues were
isolated for emphasis:

19. The programme of prevention epitomised by the ABC Strategy is the key
pillar of our awareness campaign.

* Abstain, Be faithful, Condomise is a message that has reached a wide
cross - section of the South African population. In this context, it is crit
ical for all of us to take personal responsibility for our lifestyles.
Emphasised also is changing lifestyles; management of sexually-transmitted
infections [STIs] and the vaccine initiative: In this regard, two matters
came under scrutiny:

a. On prevention of mother-to-child-transmission, the NEC stressed that
PMTCT entails more than just the administration of anti-retrovirals; but
includes complex procedures to manage delivery of new-borns ,the health
status and well - being of their mothers.

b. With regard to the matter of Nevirapine, it was emphasised that the
current programme is one of research to establish both the long-term
efficacy of the drug, resistance to the drug and other operational
challenges.

c. The key questions to be answered by the research sites are:

* What is the impact of using Nevirapine in reducing
mother-to-child-transmission of HIV in a South African setting [rural and
urban];

* What are the safe feeding options that are available for the babies born
to HIV positive mothers and how should government support these mother and
child pairs to strengthen the health and survival of the mother and child.

* Because some concerns have been raised regarding the safety and resistance
due to the drug Nevirapine, how serious are these concerns and what
action(s), if any, should government take in this regard.

* What are the operational challenges of implementing a MTCT programme in
the light of our health care infrastructure and capacity;

* What is the cost and sustainability of implementing a MTCT programme
within the South African context;

d. The current task, therefore, is to consolidate this research. Any
extension of these research sites will be determined by the demands of this
programme and such a decision will be taken collectively by the Minister and
MECs, based on national guidelines, norms and standards.

e. It will be possible to determine whether the administration of the drug
could be universally rolled out or not when the first group of babies in
this programme would be between 12 -18 months This process will start in
December 2002.

f. In the meantime, we will intensify the training of lay counsellors and
the implementation of other procedures to manage the delivery of babies born
to HIV positive mothers.

20. On preventing transmission following sexual assault or needle-stick
injury, the meeting noted that the efficacy of the use of anti-retrovirals
in this regard was unproven. The NEC therefore reaffirmed that these could
not be provided in public health institutions for this purpose. However, it
instructed the Health Ministry to do further work on this subject by
consulting with medical practitioners and other health workers.

21. On treatment, care and support, the NEC reaffirmed its support for the
government's programme and called for the intensification of the programme
to treat all opportunistic infections and care for the affected and
infected.

22. With regard to antiretroviral drugs, the meeting noted the fact that a
number of these drugs have been registered for use in the country. However,
they could not be provided in the public health system
because of prohibitive costs and the complexity of management with
disastrous consequences in instances of non-compliance, which is quite
common in managing such diseases as TB.

23. Again, on the above issue, (anti-retrovirals), the meeting emphasised
that, while these drugs could not be provided in public health institutions
currently, the Ministry was again instructed to do further work in this
regard by consulting with medical practitioners and other health workers.

24. The meeting welcomed the briefing on support structures and resources
that were being provided to help the infected and affected, including foster
care grants and food parcels.

25. The NEC strongly emphasised that the ANC has a critical responsibility
to mobilise communities to assist in this regard. This will be part of the
ongoing Letsima programme during the Health Month in April.

26. The NEC examined the place and role of continuing scientific enquiry in
the struggle against HIV and AIDS. The meeting resolved as follows:

a. Government is duty-bound to pose scientific questions on this and any
other matter that affects public policy. In this regard, the NEC welcomes
the continuing work of the Presidential Advisory Panel on AIDS, and urges
that these matters under investigation should be handled with the urgency
they deserve.

b. We wish to emphasise however, that neither the ANC nor government are
protagonists in the intense debates surrounding this matter. Rather, what we
seek to achieve is the establishment of knowledge that will help us and the
nation to fight the epidemic even more effectively. At the same time, we
shall not be stampeded into precipitate action by pseudo-science, an
uncaring drive for profits or an opportunistic clamour for cheap popularity.

BUILDING PRINCIPLED PARTNERSHIPS

27. The NEC examined the need to strengthen partnerships across all sectors
of society for us collectively to make maximum impact in the fight against
HIV and AIDS. The meeting welcomed the current discussions in the SA
National AIDS Council aimed at strengthening this body, which brings
together various sectors of society, including those living with the HI -
virus.

28. The strength of these partnerships depends critically on the strength of
structures in government to co-ordinate and integrate this campaign and
strengthen the HIV and AIDS Directorate in the Department of Health to meet
these challenges, including the Core Team of Ministers in SANAC. Further,
the Core Team of Ministers in SANAC will be constituted into a Presidential
Task Team on HIV and AIDS.

29. The NEC emphasised that the ANC, the Youth and the Women's Leagues had a
central role to play in mobilising communities to realise the objectives of
all aspects of the comprehensive strategy. The same applies to the
Tripartite Alliance and the mass democratic movement.

30. In contributing to building these partnerships, the ANC proceeds from th
e understanding that many NGO's and CBO's are driven by the desire to pursue
the people's interests on the matter of HIV and AIDS. These form part of the
people, and without prejudice, do recognise that the ANC and the government
pursue the same interests.

31. There are those who express concern and impatience faced with an
epidemic that creates a terrible toll on individuals and families. Others,
in various professions, have to deal with difficult challenges on a daily
basis. These and many others do experience a sense of frustration; and their
pronouncements and actions are then portrayed by agents of doom as being
antagonistic to the objectives we pursue.

32. The ANC rejects such insinuations. We shall continue to seek
co-operation with all who are genuinely interested in joining the fight
against the epidemic. At the same time, we shall combat populism and
opportunism that derives from cheap politicking or from benefits lavished by
the lobby of powerful local and international interests.

33. From practical experience, we are also convinced that, when we are
united about our objectives, there are many areas of co-operation that we
can find with many pharmaceutical companies. We shall further continue with
the co-operation we started with pharmaceutical companies.

DEALING WITH THE COURT JUDGEMENT

34. The NEC approved the decision of government to appeal the court
judgement on universal access to Nevirapine, at the Constitutional Court.
The appeal is driven by the desire to clarify the critical matter of the
role of the judiciary in relation to detailed matters of public policy. We
are convinced that it is incorrect for anyone to prescribe a specific drug
from the Bench, let alone one whose efficacy is still under investigation.

35. Further, it is our view that the order to implement the court judgement
pending the Constitutional Court appeal defies logic. What this means in
actual practice is that medicine still subject to research should be
delivered to health institutions for universal access, with the possibility
of withdrawing it if the Constitutional Court rules against the judgement.

CONCLUSION

36. These then are the views of the ANC on the campaign against HIV and
AIDS. We hold these views out of a deep sense of conviction and concern for
the people of our country, particularly those infected and affected. Our
positions and actions are inspired by hope in the strength of South Africans
to lend a caring hand to defeat the pandemic.

37. Where there is prophesising for doom, we stand for hope. Where there is
mobilisation for despair, we call for measured, effective and sustainable
programmes. Where there is focus on one issue, we draw attention to the
whole gamut of actions required to fight HIV and AIDS.

38. We are not populist. And we shall always strive to act with honesty.

39. Not once in its history has the ANC been corrupted into acting as an
agent for any force, no matter how powerful.

40. Not once in its history has the ANC sought short-cuts when faced with
difficult problems. Nor shall we mislead our people in search of an
adulatory news headline.

41. We are confident that the overwhelming majority of South Africans will
work with us, in lending a caring hand of hope!

42. The NEC calls upon its leadership in its entirety to explain the policy
of the ANC on AIDS to its constitutional structures, including its branches
and regional general councils, in a coherent and simplified manner. To take
this profound message to all levels of our society should be the
responsibility of all caring South Africans.

43. Finally, the NEC emphasised that at the centre of this programme should
be caring for the people who are infected and affected, by lending a caring
hand of hope.

For more information, contact Smuts Ngonyama at 082 569 2061