In her opening remarks, Ms Madlala-Routeledge said, “At one time in the life of the icon whose name this Foundation proudly carries, Nelson Mandela said, ‘A time comes in the life of every nation when there are only two choices: submit or fight’. It is that time in the nation’s fight against a deadly disease that has engulfed us and threatens the very foundations for which many fought and died.
“On AIDS, Mr Mandela has said:
‘AIDS is clearly a disaster, effectively wiping out the development gains of the past decades and sabotaging the future.’
‘AIDS today in Africa is claiming more lives than the sum total of all wars, famines, and floods, and the ravages of such deadly diseases as malaria.’
‘AIDS has the face of a woman.’
Ms Madlala-Routeledge continued, “In life, some things are given, others we take. At the end of our lives we should be able to face ourselves and say, I was given an opportunity to lead, I took it and did the best I could. At times a ship at sea comes across a deadly storm. It is the task of every individual on that ship to apply his or her mind to the single most important task, that of saving lives. It might not be the captain whose idea it is that does that. It might be a junior officer, a cleaner, or a cook on the ship.
“Under the leadership of our Deputy President, the Honourable Phumzile Mlambo-Ngcuka, our country has entered an important phase in the national response to HIV/AIDS. She has succeeded in uniting our country in a way that has brought new hope and energy. I feel this energy and new hope in the Department of Health and the general public. I felt it in the clinic at Umzumbe when I visited yesterday. It is this that we have needed to make South Africans understand that each and every one of us has the responsibility to put the shoulder to the wheel in the campaign to stop AIDS. Under her leadership South Africans understand that we have to stop new infections and save lives.
“As people who have chosen not to submit but to fight, you have today given up very important work on your busy schedules to come here and apply your minds to the single most important threat to the life of this country, HIV/AIDS. You are all experts in your fields and we value your input. While this disease might not be conquered by a single person’s brilliant idea, your individual and collective wisdoms are what we so badly need. Together we have the solution.
“As funders and international NGOs, you know best where to put your limited funds and what interventions will make the most impact. You bring international best practice. As business, you are in the business of making and not losing money. You will know where and how to invest. Business has realised that they too are affected by HIV/AIDS and are therefore investing in keeping the workforce alive.
“As researchers and policy analysts, you have the tools to assess the impact of policy inputs and programmes. As clinicians and health practitioners you bring the wisdom from practice. Every day you experience the impact of the disease on the lives of people, your patients. You are able to discern what works and what doesn’t work. As advocates for people living with HIV/AIDS, you know what the people who are infected and affected want. You have the experience of seeing people you know and love get weak and die. But you also know heroes who have shown us it is possible to live positively with HIV.
“As policy makers, we need your input. We need to know from experts like you what impact our interventions are making. It for this reason that I have come here to support you in this dialogue, which you have planned today. Yesterday I visited a clinic that offers VCT in the Umzumbe Municipality on the KwaZulu-Natal South Coast. From that visit, I interacted with the nursing staff, local youth and community leaders. I was informed about the impact of policy on the implementers and its beneficiaries. It is always important to get feedback.
“The previous dialogue convened by the Nelson Mandela Foundation looked at Anti-Retroviral Therapy. There are important policy gaps and interventions that were identified. One of these were in the area of prevention of mother to child infection.
“The report made proposals that could lower significantly the rate of HIV infection of infants by their mothers, as well as saving the mothers themselves from premature death. It looked at policy around voluntary counselling and testing and made important observations about how to improve uptake. I have seen a growth in the number of health facilities that offer VCT, but I am concerned about the numbers of people that are volunteering to be counselled and tested. Yet, knowing your status is one of the most important tools for prevention, management, treatment and care. The report tells us it is possible to upscale the roll-out of HIV treatment even in limited resource settings. Some of the strategies include task-shifting and taking treatment, management and care to clinic level. These are just a few of the policy issues that I picked up from the report.
“Today’s dialogue looks at the total national strategy on HIV. I am sure you will come up with the same quality of report this time around as from the previous dialogue. One of the areas I hope you will touch on is the messaging on prevention. Is the ABC message enough? What else do we need to communicate to reduce new infections and deaths? How can we ensure co-ordination of all interventions, including those that must be carried out by other departments? What is the role of the private sector and how can we synergise inputs from the public and private sectors? There is also the area of monitoring and evaluation. How can we improve? The previous strategic plan had identified the need for provision of palliative care. How can this new strategy improve on this?
“You may be wondering where are the officials from the Department of Health who were invited to attend this dialogue. My office has been in regular contact with them and they have indicated their willingness and excitement about coming to join you. They, like you, had set aside everything to be here. However, they have been told to wait for the instructions of the Director General of Health, Mr Thami Mseleku, who has given strict orders that they cannot come until he says so. I am saddened by this but hopeful also that all will soon realise that the time for fighting one another has passed.
“I thank the Head of Policy Co-ordination and Advisory Services (PCAS) in the Presidency, Mr Joel Netshitenzhe, who has seen the value of this dialogue. He has sent a representative, Mr Lawrence Mthembu, to join you and participate in the dialogue.
“In closing, I wish to encourage you to document your inputs and distribute your report widely and to policy makers. As you know, as a member of the Executive I have a different role from yours and will therefore not participate in your discussions, but I look forward to the report. I know that like you were able to do with the dialogue on ART you will as swiftly and efficiently produce a report on the National Strategic Plan 2007 to 2011. I trust you and your process and look forward to the outcome of this dialogue”.