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Press statement issued by the Congress of South African Trade Unions.

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Defeating HIV: Now is the time!

Address by Willy Madisha - President of COSATU - at Sparrow's
Nest Aids Village, Gauteng (14 February 2002)

The Congress of South African Trade Unions (COSATU) has
welcomed President Mbeki's comments in relation to HIV made in
his state of the Nation address recently. COSATU further made an
"appeal to everyone concerned to get out of entrenched positions
and public posturing on this grave national crisis and put the needs
of the our people first."

(Batho Pele is a watchword of our government- and truly we are
trying as a public service to do this). In tackling HIV "we must put
people first" because - the evidence in the hospitals and our
cemeteries confirm that people are dying and that where anti-
retrovirals are applied life is clearly extended, and where they are
denied, as day follows night, so a premature death follows such
denial.

Last year, two separate reports confirmed that large numbers of
people are now dying of AIDS-related illnesses. The first report by
the Medical Research Council (MRC) was contested by the
government, particularly because it drew the conclusion that AIDS
was now the main cause of death amongst adults and would lead
to millions of deaths within the next few years.

The second report produced by Statistics South Africa (SSA), the
government's "official" analysts, repeated that there have been
dramatic changes in
(a) the numbers of people dying, which has increased greatly and
(b) The patterns of death in South Africa - with large numbers of
people now dying...in their 20's and 30's. This report resisted
drawing the conclusion that AIDS was the major factor behind this.
We on the ground know that there can be no other explanation.

What both reports confirm is being felt on the ground and is being
reported anecdotally by doctors, nurses, church leaders,
community activists and trade unionists. This pattern of increasing
sickness and death among young and poor people in SA will
continue for many years to come unless there is a deliberate and
united intervention to prevent it.

When our President talks about a holistic approach, it cannot be
faulted; however, two key points need to be stressed.

First of all, new HIV infections can be prevented by more effective
communication strategies but also by targeting the social
conditions that put people at a greater risk of infection. Here we are
talking about the urban and rural poor who are the systematic
victims of capitalism's ruthless pursuit of profits over all other social
and moral considerations.

We in COSATU believe that targets must be set - to both reduce
the number of infections - currently 1500 per day - as well as
having it as a measuring tool to test effectiveness of our strategies.

The second point is that there is absolutely no doubt, in my mind,
that anti-retroviral medicines lead to a reversal of many of the
consequences of HIV infection and, in most instances,
dramatically improve and prolong lives.

There is ample evidence that anti retroviral therapy is highly effective
in reducing a person's level of infection with HIV. That leads to a
substantial improvement in the immune system and a longer life.
Since the most effective treatment, which combines three of the
anti-retrovirals (so called coctails or combination therapy) was only
introduced in 1996, it is not known for how long treatment can be
used.

A seminal study by Palella and others have shown a decrease of
deaths in the USA by more than 70% since the combination
therapy was used. A study in a Chilean public hospital between
1997 and 2000 demonstrated an equally remarkable success.

Patients getting anti-retrovirals experienced a 60 to 73% fall in Aids
- related deaths, whilst Aids related illnesses dropped 65 to 76%.
Oesophageal candidiasis dropped 84%, TB75%; cryptococcosis
and toxoplasmosis, 66 %, PCP 55%; and bacterial pneumonia,
46%. Overall, hospitalisations were 73% lower for patients getting
anti-retrovirals than for patients who did not.

Brazil has been cited by UNAIDS as a best practice for its
response to HIV - Aids epidemic. The country has about 500 000
people with HIV, substantially less than South Africa. Its
government introduced an anti-retroviral programme in the early
1990's. It now ensures universal access to the therapy, including
mother-to-child prevention programmes. As a result, mortality rates
for people with HIV dropped by 50%.

The above facts is the reason for all our focus on Anti Retroviral's
(ARVs), but it should not be read as excluding or denying the
importance of other interventions. However, the bottom line is that
for ± 200 000 people a year access to these medicines is their only
hope.

The key priorities then for 2002 are:

A) Now is the Time / Sekunjalo! The issue of mother-to-child
transmission (MTCT) needs to be put to bed and put beyond further
controversy, and we - as nation - cannot wait. Despite its
opposition to the court case, in 2001, senior government figures
viz (Zweli Mkhize, KZN Minister of Health, Eddie Mahlanga,
Director of Maternal and Child Health, Ayanda Ntsaluba - Director
General of Health), have repeatedly accepted that Nevirapine works
and that it is safe and that the sole challenges are around
implementation.

Most recently, our President Thabo Mbeki said that provinces with
capacity should be allowed to use this capacity whilst focus should
be on improving capacity of the poorest provinces, particularly the
Northern province. The essential and yet-not-in-place ingredients of
patient counseling have often been raised in the media and public
debate. This must be urgently addressed by us all especially those
in the service unions (health, education etc) and community
organisations.

When President Mbeki quoted the case of the teacher from
Inkonjane Senior Secondary School in Soweto I was doubly
pleased. The teacher, Bathabile Serei, is a member of SADTU and
together with the Sunday Times did really good work in supporting
learners in the KZN area who are less privileged and suffering from
HIV. The other reason for being pleased is that the president
underscored the importance of solidarity and the need to rebuild
community spirit.

Research has it that KZN is at the epicentre of the virus in our
country. The impact of the epidemic on students, teachers and
institutions is extremely severe as University of Natal's researcher
Peter Badcock-Walters argue, that SA is witnessing a decline in
the quality of education which negatively impacts on the potential
and the productivity. His study estimates that:
* 275,000 school-age children in KwaZulu-Natal Province are not
attending school.
* First grade enrolment has dropped 60 percent since 1998.

My union, SADTU has shown that teachers in the province are
dying very young - presumably from AIDS.

With this in mind, I am calling on COSATU leaders - shop-
stewards and activist members - as well as the Labour Movement
at large, together with all civil society organisations, to join in the
spirit of Matsema / Letsema and volunteer their time to become
counselors. A number of NGOs are willing to do this training and I
am going to take up the course myself. I know there are many who
are able and willing to do likewise. Every workplace and community
must have at least one counselor.

B) One giant step towards a holistic health strategy will be to put
into place a National Treatment Plan for tackling HIV. This will deal
in a comprehensive manner on prevention of HIV. We are fully
aware that other illnesses and diseases such as Malaria and TB
are widespread.

But, by preventing HIV we will go a long way towards freeing the
public health system - so that it can deal with other illnesses as
well as providing meaningful treatment to those people who are
already infected. For this to happen means proper and adequate
funding for the public health system, must be forthcoming.

C) For the plan to succeed, the political will as well as the
resources must be put in. We have all along called for HIV to be
declared a national emergency, since it is not one equal health
issue amongst many, but the determinant of many other epidemics
as well as the general ability of health workers and health services
to promote and improve health in South Africa.

Since the COSATU / TAC /MSF "operation" to bring ARVs back
from Brazil and challenge the patent holders, the TAC and
COSATU have again been directly approached by the local
pharmaceutical industry with proposals for local production of these
medicines.

This would create jobs, create investment and the possibility of
sustaining access to these essential medicines. However, the
generic companies cannot produce unless there is political
support and political pressure to issue compulsory licenses for local
production.

Finally, I have spoken above about solidarity and rebuilding
community spirit and organisation but it will require a massive
injection of urgent treatment to ensure that the hope and resilience
of our people is nourished and sustained. This calls for
governments - our public sector - to be centrally involved in rolling
out the treatment since only it has the leverage and capacity to
reach all our people.

When I voted for this government I did so with the express
understanding that as a government - like all governments it has an
obligation to look after the most vulnerable of its people. The case
of people living with HIV has become the litmus test of our
revolution, since it touches on illnesses, and the impact poverty
and other factors has on it. Whilst a rich or relatively well off person
living with HIV may truly live, because they can afford to buy all the
anti retroviral cocktails, poor people, cannot afford these.

Here I am reminded of my good comrade Judge Edwin Cameron,
who has been living with the virus for years, and has been eating
healthily, going to gym and keeps on taking his cocktail. A poor
person, on the other hand, living in an informal settlement without a
job and without access to treatment will surely die.

Our government will surely, and I sincerely believe, rise to this
challenge. Then we as a people -united- civil society, unions and
our government will shoulder to shoulder, do what we did to
Apartheid: relegate it to the dustbin of history.

Our presence here - at the Sparrow Rainbow Village, which we
believe will not only be a place to die, but to resist the virus and
win. COSATU commits itself to working with all people in our
country working to overcome the devastation caused by the virus
and poverty. We shall overcome! Venceremos - Victory is certain!

Patrick Craven and Moloto Mothapo
Acting COSATU Spokespersons

[email protected]
082-821-7456
339-4911

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Contact 082-821-7456 Patrick Craven or Moloto Mothapo for further comment.

Visit the COSATU web site at http://www.cosatu.org.za/press/latest.html for
copies of our most recent press statements. For the full archive go to:
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up now! It's free!

COSATU takes steps to ensure that any attachments are free from viruses.
You should, however, carry out your own virus check before opening any
attachment. COSATU accepts no liability for loss or damage caused by
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