sahr2001 - Health Systems Trust

9 • Mainstreaming HIV/AIDS
Remembering the positive developments
The problems of leadership have been partially counter-balanced by a reemergence
of health activism and social action to combat the epidemic.
Organisations such as the Treatment Action Campaign (TAC), the SA Council
of Churches, the AIDS Law Project and trade unions have been mobilising
communities and the media to take up the fight against HIV/AIDS in a more
urgent and pro-active manner, especially around issues of treatment. They
have played an invaluable role in raising the profile of HIV/AIDS and helping
to provide a more open and caring society for those afflicted by the disease.
Significantly, this HIV activism has had positive spin-offs on other spheres of
health and social development. For example the crucial role played by health
activists in supporting the government when multi-national drug companies
took it to court, helped to educate the public about the politics of AIDS
‘profiteering’ and the greed of pharmaceutical companies.
Equally important, though less commented on, are the thousands of managers
and frontline service providers working in government departments, NGOs,
CBOs and the private sector who are battling to provide a decent service for
the communities they serve in the face of the mounting human tragedy of
premature death, human suffering and loss of dignity, poverty, psychological
despair, the break-up of families and the cruel loss of parental care.
Conclusion
Evaluations of countries with successful HIV campaigns have shown that
the axis of any effective response is a prevention and treatment programme
that draws on the explicit and strong commitment of leaders at all levels and
that is built on a community and multisectoral response that mainstreams
HIV/AIDS. This commitment is vital to effect the necessary mind shift in all
sectors of South African society. This chapter has illustrated numerous
problem areas where such a mind shift is necessary:
◆ Leadership: The lack of clear and unambiguous messages about the
link between HIV and AIDS and the resistance to planning for the roll
out of PMTCT services reflects a problem with leadership which needs
to be addressed.
◆ Gender relations: Nearly 2 out of 5 (39%) sexually experienced
teenaged girls report having been forced to have sex. Only 25% of
men use condoms with irregular partners. Many of our schools provide
an environment that is not conducive to a life skills programme.
◆ Health worker training and attitudes: Basic STI and HIV/AIDS care
remains sub-optimal. Many health workers are unwilling to offer clients
VCT. Health workers have received very little training and guidance
around HIV care.
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