The Aids plan that never saw light of day

Published Oct 10, 2004

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The ANC government's prejudice against anything that involved the apartheid state denied South Africans a comprehensive national plan to deal with HIV and Aids.

The plan to tackle the disease was formulated with the help of high-ranking ANC officials, including Health Minister Manto Tshabalala-Msimang and her predecessor Nkosazana Dlamini-Zuma, but was shelved, apparently because of its ties with the former government.

The Aids plan was hard hitting and comprehensive and tackled a multitude of issues linked to the Aids pandemic. The almost 300-page document divided issues into several categories, with specific priorities.

Education and prevention was top of the list and the priorities included increasing awareness; creating a social climate for behaviour change; a separate document on life skills education; development of a comprehensive sex education; expansion of sexually transmitted disease clinics; development of a women's health programme and a central infection policy.

Tshabalala-Msimang was one of the convenors for the education and training strategy.

Other priorities were counselling - ensuring that people received pre- and post-test counselling; care for people with Aids, as well as an essential drug list.

Research was also a top priority, with the monitoring of tuberculosis patients and the efficacy of TB management identified for special attention. Tuberculosis has been one of the major causes of death as a complication arising from Aids.

In a nutshell, the national Aids plan proposed practical strategies to prevent Aids (promote safer sex); reduce the impact of Aids; mobilise and unify Aids bodies and budget for the impact of Aids.

This week Tshabalala-Msimang slammed a report by former president FW de Klerk which stated that the government wasted 10 years by not implementing the Aids plan.

Tshabalala-Msimang accused the apartheid government of failing to take meaningful action and said that the ANC and other organisations had to lead efforts in the early 1990s.

At the centre of the controversy is former minister of health and population development, Rina Venter.

Venter retired from politics after the 1994 elections, but kept copies of the documents and Aids strategies her department was involved with. These included the national Aids plan formulated by the National Aids Co-ordinating committee of South Africa, which was headed by Dlamini-Zuma.

When Venter was appointed in 1989, she became the first woman minister in South Africa. During her term in office, she had come under fire from various quarters. Despite this, many of the changes she implemented were continued by her successors, including the drive towards primary health care.

She desegregated hospitals and placed a moratorium on the building of new ones. She also slashed government spending on academic hospitals. "The 12 academic hospitals used 47 percent of the health budget and because of the lack of clinics, people with minor ailments went to tertiary hospitals," said Venter.

In 1991 the government built 152 primary health care clinics as part of its Aids prevention campaign.

When Venter took office the world was beginning to understand Aids. The first test to diagnose Aids was developed in 1983 and the Medical Research Council confirmed two cases in South Africa.

"It was seen as a gay disease and not a problem affecting black people," said Venter.

However, when it was established that people could pick up the infection through blood transfusion, steps were taken to safeguard the bloodbank. According to Venter, the first cases involving Africans were noted in 1985 when truck drivers from other parts of the continent were diagnosed with the virus.

While alarm bells were ringing around the rest of the world, South Africans realised that they too would have to deal with the spread of the disease.

In the early 1990s, Aids information packages were introduced at schools.

Venter said that against the backdrop of the Convention of a Democratic South Africa (Codesa), the ANC insisted on forums to address issues. However, Venter insisted on informal talks with the ANC to avoid turning it into a political discussion.

In 1991 the ANC's health department head, Dr Ralph Mgijima, indicated that they were willing to hold a discussion to formulate a HIV/Aids strategy to care for people affected and infected by the disease. Meanwhile, the Health Department's Aids Unit launched an information programme.

What followed was the discussion of the formulation of the National Aids Co-ordinating Committee of South Africa. A steering committee was set up and its objectives included the drafting of a national Aids plan. The members included Zuma (who chaired the steering committee), Tshabalala-Msimang, Alan Whiteside (an expert on Aids), Quarraisha Karim, Zachie Achmat, Mary Metcalfe, Cheryl Carolus and several other leaders in Aids and related fields.

In October 1992, what was dubbed in the media as the Codesa for Aids, was attended by 442 delegates, including representatives from the ANC, education, health, welfare, research, law reform and labour organisations.

At the time the ANC was reported as saying that Aids could not wait for the outcome of (Codesa) negotiations. At that stage 450 people had already died from Aids.

According to Venter, a decision was taken to go ahead with the implementation of a national Aids plan.

"We had a great deal of support and a clear strategy, but needed the support of the government of national unity for the National Aids Co-ordinating Committee of South Africa to carry out the strategy," said Venter.

Task team members were responsible for expanding the programme and finding solutions for issues including determining how the welfare services would accommodate people with HIV and Aids and preventing the spread of the disease.

"It was a step by step manual on how to implement the plan," said Venter. But the ANC appeared to have ditched the plan despite its own contribution.

Venter said she was not wanting to score points and after 1994 decided to quit politics. She felt disappointed that the ANC did implement the strategy they had helped draft.

"The ANC and Tshabalala-Msimang must stop blaming apartheid for the Aids crisis and acknowledge some of the positive aspects of FW's government.

"Did they forget or are they denying that they were involved," asked Venter.

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