This is the first of HIV-911’s monthly update series tracking media coverage of South Africa’s HIV Counselling and Testing campaign. Compiled by Judith King of King Commissions.

 

 

How are people reacting to the principles, policy and potential of the HCT roll-out?

 

 

Join the conversation by sharing relevant news, views and solutions from where you are.
Discuss it here.

 

 

“A great deal will depend on what ordinary people think and do.” - Jonny Steinberg

 

 

Selected local and global commentary on the government’s re-energised response to our national AIDS crisis reflects two opposing features: celebration and cynicism.

 

 

Hailed as a “new revolution”, the impressive HCT plan has generated immense public turn-outs at provincial launches, and all sectors are committing practical support.

 

 

But the core questions voiced by reporters, analysts and citizens are:
Can our health system deliver on implementation?
Can we muster resources and overcome stigma?

 

 

Discuss it here.

 

 

Concern has been expressed about the demands that this model of comprehensive health checks, as a by-product of its authenticity and energy, will make on a national health system already buckled by numerous problems – many of which emanate from the magnitude of the country’s HIV infection levels. Launch events featuring public testing by the nation’s leaders and celebrities have attracted audiences in their thousands coming to be tested for HIV, and this highlights the potential for logistical response problems, such as under-staffing, drug and test-kit shortages, laboratories in collapse and administrative logjams.

 

 

Specific points for caution raised by callers during SAfm’s After-8 Debate of the 29th April 2010 included the need for ensuring quality counselling, finalising policy on community health workers’ access to testing, the question of sustainability and the affordability of treatment and care as the campaign unfolds to expose a clearer scale of the national AIDS burden.

 

 

“South Africans must do it, together.” - Akanyang Merementsi

 

 

While officials and experts admit to the systemic challenges of a failing national health system and diminishing donor aid for ARV programmes, calling on civil society to expose problems, hold government responsible, and activate change – and a communitarian energy is rising.

 

 

Discuss it here.

 

 

UNAIDS Executive Director Michael Sidibe praises government leadership for the drive and urges communities to rally around it - at work, in neighbourhoods, from places of worship and entertainment. KZN Premier Zweli Mkhize sees HCT as moving HIV from a private issue to one of community responsibility. Finance Minister Pravin Gordhan is proud to be part of this social movement. “Spread the message to other districts”, say mayors and Health MECs.

 

 

Journalist Faranaaz Parker describes the HCT push for expanded testing and earlier treatment as “finally, the right HIV tactic” that can unite the country behind prevention rather than cure. Summoned by radio broadcasts, encouraged by mothers and girlfriends, and following advice from traditional leaders, young men in KZN are queuing for medical circumcision to prevent HIV infection, which forms part of the campaign.

 

 

Business is reported to be mobilising: the board of Volkswagen SA and senior NUMSA officials are taking public tests, encouraging staff and members to get counselling and tests, and challenging other chief executives and unions to follow suit. COSATU has declared its aim to encourage at least half of their members to test during the HCT timeframe, and has developed comprehensive implementation frameworks to support this. Brad Mears, head of SA’s Business Coalition on HIV/AIDS, oversees SABCOHA’s provincial structures that partner with Provincial AIDS Councils in empowering businesses to set up workplace wellness programmes, and to measure the impact of private sector investment in HIV/AIDS responses.

 

 

Several on-line stories show that NGOs and volunteers continue to do remarkable, caring work on the ground. One describes community members flocking to Thaba N’chu clinic in the Free State province and hearing young soccer star Patrick Molakase say: “As youth we have to take the responsibility of taking care of ourselves first, taking care of the person next to you, and taking care of your community. As a result, we’ll be caring for the whole nation …so please let’s go out. Let’s test. Let’s care for each other”. In another, Wits University medical student Bongi Rubushe is deeply concerned about the scale of HIV stigma, and that if people come to test and receive inadequate treatment, all will be lost.

 

 

Credible politics: cheers for the positive and the negative.

 

 

President Zuma’s public declaration of his HIV-negative test result, announced to help de-stigmatise HIV, elicited a wide and mostly critical response.

 

 

Discuss it here.

 

 

Many saw it as a political and personal stunt, either to distinguish himself from his predecessor Thabo Mbeki’s denial and silence, or to thumb his nose at those who condemn his fathering a child out of wedlock five years after contending that showering post-unprotected sex is a viable precaution.

 

 

Lethiwe Zulu, field officer for the aid group Humana People to People, believes negative stereotypes could be changed if Cabinet members disclose their status. In the first week of May, SAfm heard Reverend Dandala of COPE acknowledging Zuma’s openness and the ANC’s recharged HIV response. In an on-line posting that elicited vigorous public response, NUMSA spokesperson Castro Ngobese said that Zuma had buried denialism by announcing his result.

 

 

Conversely, a KwaMashu reader of The Mercury, called Zuma “an unrepentant denialist” and questioned the silence from the TAC, NAPWA and SANAC on the matter. Satirist Pieter-Dirk Uys queried what message the disclosure would convey to our youth, given the president’s recent sexual history. An on-line posting was headlined “Irresponsible example sets AIDS campaign back”, saying that Zuma had defied science-based advice on HIV prevention and had given young people licence to engage in sexual Russian roulette. Editor Mondli Makhanya was also disturbed by the warped wisdom inherent in Zuma’s disclosure and the crowd’s raucous applause for it: “…people were queuing to take HIV tests. If the statistics ran true, roughly 10% of those who were tested would be positive. So my heart sank on behalf of all of them. … Were they the undesirables, the re-stigmatised? Were they no longer with the “in-crowd” that deserved cheers and ululations?”

 

 

IFP President Mangosuthu Buthelezi told a gathering that Zuma’s negative HIV status might give the wrong impression that one could have unprotected sex and avoid HIV infection. More pointedly, the ANC Youth League questioned President Zuma’s risky sexual behaviour, arguing that the campaign messages should apply to everyone; one official said: “South Africa will never win the battle against AIDS as long as we have a president who has more than one wife and even has a child out of wedlock”.

 

 

Author Jonny Steinberg offered a balanced view, telling the New York Times: “Everyone said we need a leader who can set an example. It just so happens we’ve thrown up a leader who makes a negative example, but it’s good enough. It’s started a conversation among ordinary people.”

 

 

“If we are to succeed, then I will need your help” - Dr Aaron Motsoaledi

 

 

Health Minister Aaron Motsoaledi should be nicknamed “Minister Motivation”. Media interviews have shown him to be a competent, confident and caring leader, with a humble and honest demeanour that belies the force of his courage and commitment to the nation’s wellness.

 

 

Discuss it here.

 

 

In a letter to healthcare workers published in The Sowetan of 11 March 2010, he writes: “If we are to succeed, then I will need your help”, and these words are an appeal to every citizen. The Minister’s refreshing statesmanship was also evident in his informative conversation with the host of the Motswako talk-show, flighted on SABC2 – a channel that stakes its reputation on nation-building – in which he urges for a massive, unified effort against the co-epidemic of HIV and TB.

 

 

Also on SABC-2, the programme House Call featured an hour-long interview on 22 May with Minister Motsoaledi, offering an even more comprehensive take on the multi-faceted HCT campaign. He noted that the larger, more accurate statistical base created by achieving the targets of the stepped-up access plan will improve projections, measurement of outcomes, and further response planning. “We have a chronic capacity shortage,” he admitted, “but we’re doing everything possible to address it. Retired health practitioners, army medics and medical student volunteers are coming on board. NGOs have trained at least 9 000 Community Health Workers, and Clicks and Link Pharmacies have offered all their sites as test facilities, free of charge.” He was to discuss this issue the following week with 192 Ministers of Health at the World Health Assembly.

 

 

Explaining the HCT drive’s features, Motsoaledi offered solid technical and moral reasoning for the inclusion of aspects such as PEP (Post-HIV Exposure Prophylaxis), TB tests, male circumcision, PAP smears, and HIV tests for children under 12 months. “HIV and TB are now one disease in South Africa; we have the largest co-epidemic of all the world’s 23 high-burden countries. PAP smears are essential for women who test HIV-positive, because the rate of cervical cancer is terribly high in correlation with HIV infection.” An immediate course of ARVs (PEP) is critical for victims of sexual violence, as the HIV status of the perpetrator is unknown. “This has been a very unfair process in the past,” he said. “Thugs who are wounded during arrest are taken to hospital by the police, but rape victims have gone from pillar to post to seek medical attention and have often been denied this care.”

 

 

He had strong words for all citizens about HIV and children’s rights: “In South Africa, 70 000 children are born with HIV every year, while in France, four children are born HIV-positive annually. We must eradicate mother-to-child transmission. This is about the child’s rights and the country’s future. If a woman falls pregnant, she cannot not test and get treatment for HIV, because she can prevent the illness and death of another child, and everyone around her should support her in this.”

 

 

Acknowledging the costs of the HCT plan, the Minister said that alongside help from international donors, the private sector is already contributing. “Discovery Health has donated R5-million, Bonitas R2,5-million, and Roche Pharmaceuticals are offering free glucometers for diabetic testing.” Another issue is the high cost of ARV drugs. “UNAIDS has shown us that we’re buying the most expensive ARVs in the world – 60% more than any other country – yet we have the highest ARV requirement globally. We must and will adjust our plan to benefit from economies of scale.”

 

 

His message to all South Africans was that we have no other option but to achieve mass mobilisation for better health. “AIDS is a daunting enemy, and our country will collapse under it unless every individual signs up. You must join this campaign, and get others to do it with you.”

 

 

“I am what I do”: marketing the HCT message

 

 

How can we, as the individuals making up the masses, follow Minister Motsoaledi’s leadership, and live out the mantra of “I am – We are – responsible”? Do we need laws rather than appeals? After all, the surcharge on plastic packets has us carrying our own shopping bags, and no-one smokes in public spaces anymore. Has the time has come to stop building concerts and parties around AIDS awareness?

 

 

Discuss it here.

 

 

According to UN Radio, the government is using the excitement generated by the FIFA 2010 World Cup to rev up South Africa’s HIV and AIDS prevention and treatment programmes. Dr. Yogan Pillay of the national Department of Health told listeners: “We have been working with FIFA to find creative ways of increasing and heightening the social mobilisation and communication around HIV and AIDS throughout the World Cup, with the tourism sector. They are working with hoteliers to ensure that condoms, for example, are available in rooms.”

 

 

Condoms in hotel rooms aside, we definitely need a powerful suite of mass media messages, especially in the run-up and during the FIFA 2010 World Cup. Despite the slogan “FIFA 2010 World Cup – Celebrating Africa’s Humanity”, the event is seen by many NGOs as a serious threat to anti-HIV efforts, with shebeens opening at 16h00 every day, children and youth on holiday, and thousands of soccer fans marking match wins with celebratory sex or team losses with the consolation prize of “skin-to-skin”.

 

 

The South African Football Players Union has launched the “Show Me Your Number” programme, with football players advocating AIDS awareness at testing sites in public venues. HIV has affected their families and friends, says footballer Ronny Zondi, and “the World Cup gives us an opportunity to reach as many people as we can.”

 

 

Everyone needs to hear and see Minister Motsoaledi’s inspirational presence, but how many could or would have this opportunity at 09h00 on a Saturday morning, when the House Calls TV interview was broadcast?

 

 

Huge chunks of provincial budgets have been spent on radio and TV promos to hype the tournament in their areas, or showing the national Police Commissioner striding down the street in an effort to quell World Cup security worries. For the same price, these adverts could have incorporated a call to test for HIV at mobile clinic services around fan-parks, and featured local and international soccer celebrities to champion the cause – but they have not.

 

 

Let’s become consumer activists and ask why not.

 

 

Let’s phone in to radio talk-shows and push for inexpensive ways of spreading the HCT message.

 

 

Let’s use Facebook and Twitter to target all companies that advertised their 2010 brands across our media channels, calling on them to sponsor SANAC’s HCT marketing strategy.

 

 

Let’s use every micro-interface we can to remind people that, like the World Cup, AIDS is here. Feel it.

 

 

Cue vuvuzela.

 

 

Related Reading:

 

 

- Jonny Steinberg: “The State wants our blood, to stop the three-letter plague”. Sunday Times, 2 May 2010.

 

-Khopotso Bodibe: “Backing for SA’s huge HIV testing campaign”. Health-e News, 29 April 2010.

 

- Akanyang Merementsi: “HIV test results for Zuma and Motlanthe are…”. Akanyang Africa, 22 April 2010,

 

- Michael Sidibe: “SA gets positive about HIV”. Mail & Guardian, 16-22 April 2010.

 

- Faranaaz Parker: “Finally, the right HIV tactic”. Mail & Guardian. 23-29 April 2010.

 

- Kerry Cullinan: “Enthusiasm as premier launches KZN’s HIV campaign”. Sunday Independent, 2 May 2010.

 

- “VW support for AIDS campaign”. The Herald Weekend Post, 26 May 2010,

 

- SABCOHA. “Western Cape Business Sector Conference sets the tone for Business HIV/AIDS and Wellness Strategy”. 13 May 2010,

 

- Janet Smith: “World watches as SA launches its bold war against AIDS”. Independent on Saturday, 1 May 2010.

 

- Jen Pollakusky: “One test at a time”. Elizabeth Glaser Pediatric AIDS Foundation, 10 May 2010.

 

- Canada.com: “Zuma breaks taboo in launching S. African HIV tests”. AFP, 26 April 2010.

 

- IRIN PlusNews: “I think it is good that President Zuma announced his HIV status”. 28 April 2010.

 

- Natasha Tay: “South Africa, changing tack on AIDS, faces lack of resources and stigma”. San Francisco Examiner, 8 May 2010.

 

- Mondli Makhanya: “Zuma revels in being negative – and HIV keeps its stigma”. Sunday Times, 2 May 2010, Page 8

 

- Pieter-Dirk Uys: “In Brief”. Mail & Guardian, 30 April – 6 May 2010.

 

- Vumani Mthethwa: “How can we trust a president who is an unrepentant denialist?”. The Mercury, 4 May 2010.

 

- Sipho Khumalo: “Zuma’s wrong message”. The Mercury, 4 May 2010.

 

- Mzilikazi wa Afrika and Moipone Malefane. “Malema’s followers turn on Zuma”. Sunday Times, 16 May 2010.

 

- Sibusiso Ngalwa: “ANCYL challenges Zuma’s lifestyle”. Sunday Tribune, 16 May 2010.

 

- The Mercury Editorial: “Cut to the chase”. 18 May 2010, page 11.

 

- Mail & Guardian Online: “Zuma AIDS-test disclosure ‘buries denialism’”. 26 April 2010.

 

- Patrick Maigua: “South Africa uses World Cup to fight HIV /AIDS”. UN Radio, Geneva, 10 May 2010.

 

- Lisa Schlein: “South Africa Links HIV Awareness Campaign to World Cup”. VOA News, 29 May 2010.