This is an archive of the Treatment Action Campaign's public documents from December 1998 until October 2008. I created this website because the TAC's website appears unmaintained and people were concerned that it
was becoming increasingly hard to find important documents.

The menu items have been slightly edited and a new stylesheet applied to the site. But none of the documents have been edited, not even for minor errors. The text appears on this site as obtained from the Internet Archive.

The period covered by the archive encompassed the campaign for HIV medicines, the civil disobedience campaigns, the Competition Commission complaints, the 2008 xenophobic violence and the PMTCT, Khayelitsha health workers and Matthias Rath court cases.

Resolutions of the Third TAC National Congress

Women and People with HIV Leadership for a People's Health Service

Cape Town, 23 – 25 September 2005

“We ask President Mbeki to lead the struggle against the HIV epidemic.”
-- Linda Mafu, TAC National Organiser

“Many people who were at the last National congress are not [alive] today. This is not a fashionable struggle but one which is costing us lives.”
-- Reverend Molefe Tsele, General-Secretary South African Council of Churches

Congress Declaration

Between September 23-25 over 600 delegates convened in Cape Town for the third TAC National Congress. The delegates represented over 250 TAC branches and districts from six provinces. They also represented health-care workers, faith-based organisations, trade unions and civil society organisations.

Regrettably, no government representatives attended, despite extensive efforts to invite them.

The Congress met against the background of South Africa's massive and growing HIV epidemic. Officially, over 6 million South Africans live with HIV, of which over half-a-million have progressed to AIDS and need antiretroviral (ARV) treatment immediately. According to Statistics South Africa, mortality rates increased by 57% between 1997 and 2002. Life-expectancy among adults decreased from over 60 years in 1996 to well under 50 by 2005. Additionally, over 400,000 are infected each year. Without the implementation of more effective prevention programmes, the public health system and the treatment programme, in particular, will fail.

Despite the harrowing rates of infection, South Africa has made some progress since our last Congress in 2003. Of the approximately 120,000 people that have access to treatment, over 60,000 are in the public sector. The mother-to-child transmission prevention programme has rolled out to about 1,500 clinics. This has been made possible through the efforts of dedicated civil servants and health-care workers, as well as the activism of TAC and its allies. While this marks substantial progress – shown by the fact that at the last TAC Congress an operational treatment plan was not yet in existence – it is still not enough. ARV treatment is available to less than 30% of those who need it. The mother-to-child transmission prevention programme remains sub-optimal and public messaging on HIV/AIDS remains confused.

The greatest challenge yet is HIV/AIDS denialism supported by some of the most senior political leaders in South Africa. Unless and until President Mbeki publicly accepts facts about the HIV epidemic and demonstrates firm leadership over the matter, treatment and prevention will remain sub-optimal, and millions will suffer the consequences.

The TAC Congress was rich in discussion and debates. It highlighted the enormous challenges facing the struggle for HIV prevention and treatment. Our members have drawn up numerous resolutions and are committed to intensifying our current campaigns. We have agreed to use our branches to mobilise people and districts for the improvement of health-care services, speedier rollout of ARVs, better access to medicines for opportunistic infections, food security, clean water, and properly implemented basic services. Most critically, treatment literacy work must be optimized.

The TAC Congress pledged to prioritize women's health issues and women’s leadership in the context of HIV/AIDS. TAC also commits to building stronger leadership among people living openly with AIDS within the organization.

For the first time, nine awards were granted in the honor of TAC activists who have died and to recognise those who provide leadership. We salute the memories of Queenie Qiza, Christopher Moraka, Edward Mabunda, Charlene Wilson, Sibongile Mazeka, Sarah Hlahlele and the hundreds of TAC members who have died of HIV. They remind us of the urgency of our struggle.

Resolutions

Congress developed resolutions in plenary sessions and in six commissions.

Resolutions in Plenary

The following resolutions were adopted in plenary:

Prevention and treatment campaigns

1. The Congress reinforces TAC's call for government to treat at least 200,000 people by March 2006, but substantially more than this must be treated by the next Congress. Scaling up the roll-out of ARV treatment is a priority. Treatment must increasingly be made available at the clinic level, as well as at district, regional and academic hospitals.

2. TAC must call upon international and national allies to pressure President Mbeki to distance himself from AIDS denialism and to provide leadership, discipline and inspiration in the fight against HIV. TAC will request an urgent meeting with the President to insist on greater involvement on his part and to challenge his silence on HIV.

3. TAC needs to collaborate with government and civil society to devise better strategies to overcome the failure of current prevention efforts – especially with condom distribution, clean needles, and drug replacement therapies. Congress was particularly concerned by the evidence that was presented on the vulnerability of girls and young women to HIV, the high rates of infection and the high levels of maternal mortality. This is an area that needs dedicated and urgent action.

4. For nearly two years, government has been given evidence that dual therapy – AZT and nevirapine or triple therapy for pregnant women who need treatment – are a more effective means of reducing mother-to-child HIV transmission than the single-dose nevirapine regimen currently in use throughout most of the country. The fact that the Western Cape is the only province to have rolled out the better dual-therapy regimen marks a breach in government's constitutional obligation to provide a comprehensive mother-to-child transmission prevention programme for all. TAC must campaign better to demand that government improve the mother-to-child transmission prevention programme.

Building leadership

5. TAC must do more to create leadership positions for women and people living with HIV/AIDS. We must ensure increased participation of women and people with HIV/AIDS (PLWA) systematically in all levels of our work by setting clear targets and plans.

6. TAC must strengthen its work at the branch and district level to mobilise for better health delivery at the local level. Our campaigns must show that we address a broader range of issues to eliminate the false impression that we focus solely on ARV treatment. We campaign for better health services, sufficient health workers and quality care.

7. Campaigns to prevent and treat HIV should involve all classes and races in South Africa. Currently, the majority of TAC activists are black and poor. However, campaigns to prevent and treat HIV should involve all classes and races in South Africa. We need to encourage white, coloured, Indian and middle-class people to join TAC.

8. TAC must strengthen its international work and become more engaged in international campaigns.

9. The treatment literacy practitioner bursary programme must recruit TAC's best volunteers and be at most a year long. New volunteers should then replace the previous set of practitioners.

The TAC General Secretary

Noting:

• In the last 5 years TAC has grown dramatically as an organisation, creating vastly increased demands for internal management.

• TAC has also grown in terms of its public impact, the public awareness of TAC, and the expectations that exist of TAC both from our volunteers and other progressive organisations.

• TAC is governed by an elected NEC and secretariat. This is reflected in our constitution. The key positions on the secretariat (chairperson, deputy chairperson, secretary and treasurer) are not paid officials of TAC. Despite this, the secretariat has been able to play a vital role in guiding TAC on strategic, political and legal questions.

• Neither the secretariat nor the NEC has included a position formally vested with overall responsibility for representing them (and thus TAC) on a day-to-day basis. The position of Chairperson is an important symbolic and political position but it does not envisage hands on management and responsibility for TAC.

It was therefore agreed by the NEC that a post of General Secretary (GS) be created with effect from the third TAC Congress in September 2005. It was also agreed that

• This should be an elected and paid position.

• The GS position will be the most senior staff member in TAC

• The post of General Secretary will be elected every two years at the National Congress of TAC.

It will include the following responsibilities:

Internal:

• Directing TAC strategically and politically towards the attainment of its objectives.
• Working closely with and supervising the national manager and national organiser, to whom all the other national programme managers report.
• Monitoring the performance of Provinces and programmes in relation to workplans, objectives and resolutions.
• Convening meetings of the secretariat, management team and NEC as and when necessary.
• Working with the secretariat.

External:

• Representing TAC in the media, nationally and internationally at events as the leading spokesperson on behalf of the organisation.
• Representing TAC at key meetings with the national government and with key allies.

The NEC agreed that to be eligible for election a person must:

• Have been continuously active in TAC for at least four years in a leadership position, at branch, district, province or national level.

• Be nominated for the position in accordance with the existing provisions of the TAC Constitution.

• Be available for employment for two years from within one month of election.

• Provide two testimonials concerning honesty and integrity.

The NEC agreed that

• Conditions of employment will be decided by the NEC in consultation with the Secretariat.

• The General Secretary will be subject to all the rules and requirements governing all other NEC members, and may be removed or have the position terminated by a 51% or greater no-confidence vote by the elected NEC (i.e. excluding ex-officio NEC members). If a no-confidence vote takes place, the General-Secretary may not participate in the voting. A no-confidence vote may be called by any non-ex officio member of the secretariat, or by a minimum of five non-secretariat members of the NEC.

• In the event of the General-Secretary being removed through such a process, the NEC may appoint an acting General-Secretary to serve until the next National Congress.

• In the event of termination of service of the General-Secretary due to death, resignation or any other reason, the NEC may appoint an acting General-Secretary to serve until the next National Congress.

In agreement with all of the above, the TAC National Congress hereby amends the TAC Constitution at paragraph 6.1.5 to replace the word secretary with the words “a full-time general secretary”

Resolutions in Commissions

Commission 1: Building a People's Health Service

It is South Africa's constitutional duty to provide quality health services for all. The current health system is characterised by gross inequality between private and public health systems. The private sector absorbs the majority of funding, yet provides for a relatively small percentage of society. Human resource shortages, underfunding of the public sector and a lack of good management and leadership have aggravated the systemic crisis in the public health system. TAC resolves to spearhead the movement for a comprehensive people’s plan for health care in the country, in which a package of essential health services is provided for all, based on a primary health care approach.

The Government has brought into effect the National Health Act, which is the framework for all health legislation. The Department of Health recently drafted a Health Care Charter which focuses on issues of access, equity, quality, and Black Economic Empowerment (BEE). However changes in ownership with the private health sector, as a result of BEE, does not necessarily translate into progressive transformation for the users of the health system. The Department of Health excluded civil society stakeholders from discussion while writing the first draft of the charter. TAC, AIDS Law Project, COSATU and the South African Medical Association called for it to be further debated through a forum such as NEDLAC.

In September 2005 the Department of Health eventually produced a plan to address the crisis in human resources. But the plan fails to clearly outline the specific steps it intends to take to respond to HR issues in the health sector, such as patient / health worker ratios or dates for implementation. Additionally, it fails to recognize the gravity of the HIV/AIDS epidemic.

In addition there are a number of other government strategies, such as the Risk Equalisation Fund and Government Employee Medical Fund (GEMS), which represent a general movement towards a social health insurance. We must campaign to ensure that it does not continue to strengthen the private sector and exclude the poor and unemployed.

Some of the issues discussed during the commission included:

• The need to re-orientate the health system towards primary health care as envisioned by the ANC health plan.

• Quality of care issues and weaknesses in the public health sector.

• The debate between different approaches of health funding (i.e. National Health Insurance vs. Social Health Insurance.)

• The drop in per capita funding devoted to public health in the last ten years.

• Appalling conditions of service for health care workers.

• The staggering and growing demand for health services (exacerbated by the HIV/AIDS epidemic).

• The inaccessibility of health care sites due to the excessive geographic distance people need to travel to reach them.

• The need to recognise and employ lay counsellors and community health workers

• A lack of political will to improve the health care service.

• Need for government employees and members of parliament to experience the public health sector to catch a glimpse of the urgency behind the need for a better health care system.

Taking into account all of the above, the TAC Commission on the People’s Health Service resolved:

• to coordinate our efforts with health care unions and organisations,

• that Health users must become part of the health system in order to influence it and therefore TAC and community members should study the National Health Act and participate in hospital boards and district health committees,

• that the upcoming local government elections be used to reflect on and put public pressure on the issue of improving local health services,

• to conduct training on the National Health Act for TAC members so that people can actively engage with health legislation,

• to hire a full time person to coordinate the health service campaign and that the job of this person should be to 1) coordinate research into health systems and 2) coordinate meetings for health workers,

• to create a database of health workers who are volunteers in TAC in order to create stronger networks for mobilisation of health-care workers.

Commission 2: HIV Prevention

There is a crisis of new infections. Levels of HIV incidence are increasing significantly with over 400 000 new infections every year. Access to all forms of prevention must be based on the right to life, dignity, equal access to health-care including reproductive health and privacy. HIV infection limits the right to life, reduces quality of life and places enormous burdens on individuals, families, communities and health services.

TAC believes that, despite success in some areas, HIV prevention is failing in South Africa as well as in other parts of the world. Current prevention messages are prescriptive and do not adequately educate the public around areas of healthy sexuality or HIV. Society needs to create more open spaces for people to discuss sexual practices. We acknowledge the complexity of factors driving the epidemic and that there are not easy solutions. Nonetheless, many prevention interventions, despite good intentions, have resulted in disappointment.

The structural impediments to HIV prevention efforts such as the economic inequality and dependence of women on men and families, the social and economic marginalisation of young people particularly young men and the cultural subordination of women to men must be systematically addressed as part of HIV and development work.

TAC intends to incorporate prevention efforts across a broad range of its work, especially through community mobilization. All TAC members require detailed knowledge of the scientific issues. In addition to immediate action, we must research more effective prevention strategies.

The TAC Congress believes the following measures are necessary:

Scaling up prevention

1. Prevention is far more complicated than the government’s Abstain Be faithful Condomise (ABC) strategy. We must encourage Khomanani to increase the frequency and visibility of their public education messages. Additionally, we must pressure LoveLife to collaborate better with other prevention campaigns and improve their public messaging.

2. Both the government and civil society require thorough assessment of the efficacy of current preventive interventions.

3. We must expand the numerous smaller-scale projects such as TAC's AIDS Action Committees in schools, TAC's public information campaign, Soul City, etc.

4. We must create new interventions that reflect recent scientific data:
   

   • Emphasize that people are most infectious in the months following infection, which is when they are unsymptomatic and unaware of their status.
   • Pending the outcome of the circumcision trials (and peer-review of the Orange Farm circumcision trial), the issue of medical male circumcision should be debated and put on the agenda of all levels of government, while countering the view that after circumcision you can have unprotected sex.

5. Address the dismissive attitude by most men to health issues though intensive work at the community level. Involve more men in programmes to end gender-based violence.

6. The marginalization of women inhibits them from being able to negotiate safer sex. Violence against women is on the rise. Efforts around prevention must deal with these issues.

7. Highlight the needs of sex workers, prisoners, soldiers, gay men and people with HIV by including them in media campaigns.

8. Challenge misplaced complacency among coloured, white and Indian people by emphasizing that HIV is an epidemic across all races.

9. Partner with faith based organizations, including South African Council of Churches, to pressure churches to accept the value of condoms and to openly promote their use.

10. Create standardised counselling that addresses safer sex and distribution of condoms, more mobile and youth friendly clinics, in order to encourage VCT.

11. Improve youth prevention through the development of creative, entertaining strategies. Integrate TAC's youth programmes into other TAC programmes.

Improve Access to prevention measures

12. Create more effective strategies to decrease mother-to-child transmission prevention. This must include the use of better regimens than single-dose nevirapine.

13. Condom distribution should be improved and access to female condoms needs to become more widespread.

14. Scale up the syndromic management of sexually transmitted infections (STIs) because untreated STIs contribute to increased HIV incidence.

15. Improve access to post-exposure prophylaxis for rape survivors and health-care workers and ensure that it is universally available in SA.

16. Intensify the development of microbicides.

Address Social Issues that spread HIV

17. Poverty, unemployment and poor housing lead to the breakdown of social structures, loss of dignity and increased HIV incidence. We endorse the call by COSATU and others for urgent action to address high unemployment, the housing crisis and general social security through the implementation of a basic income grant (BIG).

18. Mining companies must escalate the termination of the migrant labour system and enable mineworkers and their families to live together in decent housing.

19. Some people are forced to choose between grants and ARVs. We need to find ways to address this.
    

20. Support youth recreational programmes at the community level (and not only through workshops).

Prevention Summit:

21. Noting the failure of HIV prevention, and the fact that the state's Strategic Plan ends in 2005, TAC calls for a national HIV prevention summit with all other HIV/AIDS organisations. This summit must develop strategies for implementing better and more comprehensive prevention strategies.

Commission 3: HIV Treatment

A series of factors challenge the Operational Plan from proper implementation. These include the shortage of health care workers, confusing messages from the Department of Health, ongoing politically supported AIDS denialism, the need to implement the down-referral system and insufficient training for caregivers who provide ARV treatment to children. Instead of addressing all these problems, Congress wishes to highlight the following areas of concern:

• Speeding up the provision of ARV treatment

• Stigma

• Community mobilization

• Engaging the Minister of Health and senior officials in the Department of Health

Speeding up the provision of ARV treatment:

Action at the national/provincial level:

• Health care workers need more substantial incentives to work in rural areas. Government must do more to allow private health care workers to service the rollout of ARVs in the public sector. Pharmacy assistants must be employed to work with professional nurses.

• Accredited sites should explain (where appropriate), why they are failing to meet their targets. Government should conduct a site-by-site audit with follow-up commissions of enquiry into the poor performance provinces. There is a need to accompany assessment efforts with directed campaigns aimed at addressing the lack of political will (wherever identified) whether at the municipal, provincial or national level.

Action at the policy level:

• The ARV treatment guidelines adopted by national government are based on an international consensus that incorporates the World Health Organisation (WHO) guidelines. Though these guidelines have been updated, national guidelines have not kept pace with these changes. Of immediate concern is the use of stavudine (D4T or Zerit) in the first-line regimen. The vast majority of people who use stavudine are doing well on this drug. But a minority of people suffer acute side-effects such as peripheral neuropathy and fat redistribution (lipoatrophy). An even smaller minority of people particularly black (African and coloured) women who are overweight develop lactic acidosis. Without early intervention by trained nurses or other health care personnel, this can be fatal. Guidelines must be established to warn people who are affected and the drug must be contra-indicated for black women who have obesity disorders. We have also observed dramatic advances with an alternative drug – tenofovir. Tenofivir has much lower side-effects and is slower at developing resistance to the virus. This could be used as a substitute because it will increase regimen options, it will make the first-line regimen last longer and its side-effect profile is better for the individual patient and public health.

Action at the local/facility level:

• TAC must produce a fact sheet on stavudine to inform people about how to use the drug and how to manage side-effects and switching drugs when necessary. Government should also distribute an accurate scientific leaflet that explains this work.

• Local problems with the ARV roll-out need to be identified and assessed— especially ones that are not already well-known (such as under-staffing). Now that the National Health Act is operational, TAC must ensure it is properly represented on hospital and clinic boards and TAC branches should assist by monitoring health care facilities in their areas.

Addressing stigma

• Stigma causes delays in testing, treatment, and leads people to default on treatment. Stigma should be addressed by the Department of Health through positive messages about the benefits of ARV treatment. Mixed messages from the government must also targeted because they aggravate already existing stigmas.

• Treatment literacy is a powerful tool in the fight to end stigma. Special attention should be directed towards HCWs and PLWA.

• The media need to be engaged regarding the positive use of local dramas to discuss HIV stigma (in a way that avoids using stereotypical HIV positive characters). Its portrayal of HIV positive people should be criticized constructively.

• Both Khomanani and LoveLife need to be challenged in their messaging about what it means to have HIV.
  

Mobilizing communities

• A wide range of campaigns need to be employed, such as door-to-door distribution of pamphlets and books, presentations in local public meetings, collaboration with local councils, litigation as a means to raise awareness on key issues, and networking with existing structures in communities to promote treatment literacy. In particular, treatment literacy should be made part of the formal curriculum of high schools students. Wherever possible, campaigns should make use of people’s faces rather than just names.

Engaging the Government, the Minister of Health and senior officials in the Department of Health

• Congress deplores the Minister of Health's failure to respond to repeated invitations by TAC to attend our meetings. With this in mind, delegates called for continued action to pressure the Minister, MECs and officials in the Department of Health in a constructive manner. TAC would prefer a constructive relationship with the Ministry, but if need be will resort to litigation and protest to compel the Minister to follow her duties as laid out in the Constitution.

• In addition, we must take advantage of the upcoming local government elections by pressuring local politicians. Voters should be alerted - through protests and public meetings – to the unjustified delays in the provision of ARV treatment as well as to the weakness of health services. We urge parties to make concrete commitments concerning health care delivery in local areas.

Commission 4: Women, HIV and Human Rights

While appreciative of the fact that the theme of the Congress emphasizes the need for women's leadership, the Commission on Women, HIV/AIDS and Human Rights is critical of the organizers’ failure to provide child care. Several women were forced to bring along children in order to participate in the Congress, thus inhibiting them from full participation. Failure to provide childcare also means that other parents of small children were prohibited from equal engagement.

Noting:

• The existence of colluding systems of oppression that undermine the dignity and rights of all women (poor women in particular);

• Unequal power structures and sexist cultural beliefs shape unjust understandings of the world;

• Basic human rights of women are limited on the basis of their gender, race and class;

Recognizing:

• That the TAC is faced with a challenge of working against gender oppression within the organization and in the broader social-economic and political context;

• Hereby resolves that the TAC should begin implementing the principles of the theme of building women’s leadership within TAC and outside of TAC.

• In particular, the Commission calls for the TAC’s NEC to commit itself to the following:

Organising Public Forums on Gender Equality and Women’s Health

1. Forums, directed by provincial co-ordinators, must be created for discussing important gender-related issues. Possible topics for the forums could include cervical cancer, pap smears, termination of pregnancy, prevention of mother-to-child transmission of HIV and the rights of women living with HIV/AIDS.

2. Without creating separatism, TAC should create safe gender-specific spaces to allow for issues that are generally difficult to speak about to be raised. We should also develop a language that allows women to speak about their experiences of gender and gendered oppression.

3. Men are to lead public education efforts for other men on prevention, HIV, stigma, discrimination, sexuality, men’s health and the urgent need for men to access treatment.

4. TAC must conceptualise and prioritise a public campaign on the theme of the Congress.

5. Factors that underpin patriarchy, such as tradition, culture and the vulnerability of women, demand serious discussion.

7. TAC should organize a conference on gender to explore the issue fully and develop a more comprehensive national gender equity plan by March 2006.

8. Recognizing the crisis of prevention advocacy and the failure (especially in respect to women) of the existing “patchwork” approach to prevention, the TAC should campaign at the time of the April 2006 Microbicides Conference to highlight gender inequality and HIV prevention.

9. The Commission also called for a transparent consultative process – to be lead by the Department of Health – to develop and implement a comprehensive prevention campaign that is linked to treatment and women's human rights.

10. We must develop a campaign that addresses the age and frequency of access to the pap smear test in the public sector. A discussion of rape, exposure to herpes and cervical cancer exposure are also critical.

11. We must work closely with other organizations that address socio-economic inequalities and gender.

12. Organize a march at the opening of parliament to address women's special vulnerability to disease and other social ills.

Conclusion

13. The Commission noted the following concerns that also need to be taken up more comprehensively:

• Conduct an audit of what TAC is doing on gender. This should be monitored regularly through the implementation of an institutionalized accountability system.

• The use of disaggregated statistics as a political advocacy tool

• Drug and alcohol abuse as a manifestation of socio-economic inequalities

14. TAC at branch level must visit clinics and carry out campaigns to assist and support women at voluntary counselling and testing sites by providing information and support.

15. TAC should take special note of the impact of poverty on women in rural areas, such as limited access to condoms.

16. The Lorna Mlofana trial has taken over two years. During the 16 days of activism against violence against women, TAC must increase our commitment towards ending violence against women and children.

Commission 5: Children and HIV

The South African Constitution delineates the legally enforceable rights of children and has ratified the United Nations Convention on Rights of the Child. These rights include the rights to health and family care.

In South Africa, 42% of the population is under the age of 18 years old. Approximately 200 to 250 children under 15 years old become HIV positive every day. During the course of the commission, about 10 children became HIV positive. Without proper treatment for parents, it is projected that 5 million children will be orphaned by 2010. In speaking about children, we refer to people under the age of 18; thus, the quantity of children with HIV are higher than the above stated figures. Children, especially babies, are more susceptible to illness and death than adults. The health, care and development needs of children vary according to age.

Children have been found to respond well to treatment. However, many are kept from getting properly tested, and thus treated, because many adults neglect to get their children tested. Even more, many health facilities do not provide testing and treatment for children.

As members of civil society organisations, as members of TAC, as members of communities and families, we hereby resolve that:

On Access to Treatment for Children

1. The TAC NEC should:

• Negotiate with government to increase the number of ARV sites.

• Create a working group about the Children's Bill. It should address the mortality rise among children between the ages of 0 and 2.

• Advocate for health workers at the sites to receive trainings on children and HIV; decentralisation of treatment to a local clinic level; treatment of children, as well as adults, at all clinics; speedy implementation of PCR testing for children under 18 months; and integration of mother-to-child transmission prevention linked to ARV programmes.

• Compel the state to finalize and distribute widely the national paediatric guidelines of treatment of children. Health care professionals must be supported and trained on the new guidelines.

2. The TAC Provincial Executive Committees should:

• Produce treatment literacy material about and for children with HIV

• Coordinate the national campaign on how, when and where to get treatment for children;

• Engage Department of Home Affairs for mothers, or caregivers, to obtain birth certificates for their children.

3. The TAC Branches should

• undertake door-to-door campaigns to raise awareness about children’s treatment literacy issues,

• initiate school campaigns on adult and children treatment literacy,

• hold workshops on adult and children treatment literacy with faith-based organisations and
  

• hold mother-to-child transmission prevention site workshops for mothers about HIV testing and testing for new born babies.

4. PLWA support groups linked to TAC should:

• include more on children’s treatment issues in support group treatment literacy programmes and
  

• form relationships with local representatives of civil society, social welfare and Department of Social Development to establish systems to coordinate referral for children in need of support, and this support must be sustained and regular.

5. TAC must
   

• continue to call for 20,000 children on treatment by 2006

• increase understanding of community members and health workers about the importance of PCR tests for babies, and about their inclusion in the new treatment guidelines,

• support campaigns for simpler drug regimens for children,

• include children in informational posters and lealets on people who live with HIV, testing and treatment and
  

• develop greater awareness of the need for mothers’ and caregivers on getting children tested.

6. TAC Gender and Youth Programmes must
   

• include both parents in education programmes,

• actively encourage fathers to be involved in support (eg. emotional) and

• include children's organisations in our work and meetings.
  

On Treatment Literacy and children

7. Increase PEC and NEC awareness of children's treatment issues by regularly reporting to both on these issues.

8. Target children's NGOs to educate them on testing and treatment.

9. Ensure that every TAC member is able to refer parents and caregivers of children to a site closest to them.

10. Improve understanding of and support to guardians and caregivers about testing and treatment.

11. Develop clearer understanding, information and messages on children and disclosure.

12. Work with the Department of Education to create public education programmes on Life skills. This should include treatment literacy workshops and age appropriate life skills programs at schools about sexuality and HIV/AIDS prevention for the life orientation teachers.

On Support of children affected and infected by HIV/AIDS

13. The government’s Human Resources plan should include more social workers, employed by Government, to handle needs of families and children at a local level.

14. TAC must continue to work with BIG and ACESS to advocate for the extension of social grants for children to the age of eighteen.

15. Feeding and nutrition schemes should be extended to secondary level.

17. TAC Branches should

• conduct workshops for TAC branches on the basic income grant, child support grants and other forms of social assistance and protection,

• nominate branch members to serve on ward committees,

• develop actions to improve nutrition for HIV positive children. (Starvation and malnutrition are major problems for all children. To this end, economic development programmes should be implemented to empower caregivers to provide for themselves, especially when social grants are no longer available. e.g. planting vegetable gardens.) and
  

• together with support groups and partners assist people to register for social grants, i.e. through door-to-door campaigns and informing the community of the criteria and requirements that enable individuals to apply for specific grants.

On Prevention

19. The NEC should

• develop HIV/AIDS prevention materials that particularly address the needs of children at various ages,  e.g. for children under 12 years, focus on abuse prevention;
  

• improve TAC members’ understanding of sexual assault of children and what preventative and re-dress actions can be taken linked to public education campaigns.

20. The Provincial Executive Committees should

• promote age appropriate prevention programmes at clinics, schools and churches

• ensure that branches, support groups and treatment literacy practitioners are trained to work with children and their care givers.

21. TAC branches and members should

• work with local facilities to ensure that post-exposure prophylaxis is widely available and educate people to ensure they take up this intervention within 72 hours of being exposed to HIV,

• focus more on public education efforts to encourage more pregnant women to participate in the mother-to-child transmission prevention programme,

• encourage clinics to offer the initial group counselling for mother-to-child transmission prevention to smaller groups, and where possible, ‘one-on-one,’ to allow each individual to ask specific questions relating to risk of HIV transmission to babies, breastfeeding, tests done on babies and management of children living with HIV,

• campaign for more counsellors and other support for pregnant women around mother-to-child transmission prevention and testing of babies.

• ensure that those interested in children’s treatment issues engage in regular and open communication with each other and the NEC Children’s Sector representative.

22. Support groups should

•  encourage mothers to educate their children about their status and safer sex,

• call for more facilities and resources to be given to helping care for orphans and children living in families with HIV+ caregivers,

• demand that teachers, parents and caregivers have access to HIV/AIDS counselling and support to care for children with HIV (schools should be encouraged to be a centre for support and prevention),

• take the initiative in public education efforts to build support for children as PLWAs,

Commission 6: Organising and Engagement

This commission took resolutions with the objective of building TAC into an organisation that is vibrant, functional, strong and capable of realising its goals in a changing South Africa. The commission recognised the need to build TAC internally through political education, skills development and programmatic campaigns. It noted the achievements, strengths, weaknesses and challenges facing the TAC as a growing organisation. There is a need to consolidate basic organisational and political skills in all TAC structures. TAC is made up of people from diverse backgrounds who have joined the organisation for many different reasons. A concern that has been raised is that, at times, TAC focuses excessively on ad-hoc campaigns, while neglecting efforts to systematically build capacity to implement programmatic campaigns.

We acknowledge concerns about the existing tensions between remunerated Treatment Literacy Practitioners (TLPs) and unremunerated volunteers that can demotivate members and result in loss of members.

Therefore, the commission resolved to:

• Encourage branches and districts to prioritise campaigns that improve access to ARV treatment sites, work towards the target of the Treat 200,000 by 2006 campaign and that address waiting lists at ARV sites.
  

• Construct an education programme for new members, volunteers, branches, districts and provinces to strengthen political, analytical and organisational skills. Ideally such a political education programme would include

• the history of TAC as a non-racial organisation;

• recruiting members and building the TAC in Coloured, Indian and white communities, and amongst middle class constituencies;

• building PLWA leadership in the TAC;

• actively encouraging openness about living with HIV in the TAC;

• induction of new branch members and leadership development programme at branch and other levels;

• Regular mentors for district organisers;

• the politics and economics of health, HIV/AIDS and access to services in the community;

• guidelines for maintaining branch member participation;

• computer skills;

• organizational skills (time management, chairing, minute-taking, planning and running a campaign, etc.);

• conflict resolution and negotiation skills;

• fundraising and financial management skills.

• Develop better accountability measures within TAC:

• Implement a system whereby inductions and probations for members are handled. It should include a pledge form and regular reviews of new members and volunteers.

• Ensure that branches report to districts regularly.

• Branches should keep regular records of their work by utilising formal reports, internal media and other means.

• At the Commission the TAC National Organising department committed to:

• Improving the capacity of districts and provinces by implementing sustained programmatic campaigns through the integration of TAC programmes (treatment literacy etc).

• Creating a guideline for financial resource planning, ensuring that emergency funds are always available to the branches for unanticipated meetings and this must include accounting processes from the branches to district organisers.

Strengthening the role of the TAC in building a broader civil society agenda

The Commission resolved that it was necessary to

• continue building partnerships with community based organisations, trade unions, religious organisations, and other NGOs;

• train branches on alliance building with partners in local areas and techniques for building community support for HIV prevention and treatment;

• highlight and reflect related issues of poverty, social security, unemployment and access to basic services as central in TAC's programmes and campaigns.

• strengthen activities on HIV/AIDS in relation to poverty, unemployment, social security, and access to basic services

• educate members, branches and districts on the above issues;
  

• conduct training and coordinate activities on HIV/AIDS with local trade unions;

• be more considerate of comrades who are employed and have limited time.

Strengthening the capacity of the TAC to take advantage of opportunities within local, district and provincial government

Noting the important role of local government, the district health system and provincial governments in service delivery, it was recommended that TAC

• train members, branches and district organisers on the new local government system, ward committees, Integrated Development Plans and the District Health System;

• develop strategies and programmes to advance TAC programmes through structures and systems in local and provincial governments;

• members should be active in ward committees, community health committees, water committees, and other local structures in order to bring TAC's concerns about health and poverty to their agenda;

• develop a TAC platform and programme for the coming local government elections to ensure that all political parties and candidates are interrogated about the various TAC demands and programmes in local areas;

• branches and districts engage municipalities and ward councillors on HIV/AIDS issues in the community and that TAC participate in local and municipal health and HIV/AIDS structures;

• through its organising department develop a programme of how to engage the SA Local Government Association (SALGA) and the provincial local government associations on the role of municipalities in fighting HIV/AIDS and for TAC participation in HIV/AIDS structures within the municipalities;

• branches and districts increase active participation with community media;

•  branches and districts effectively use government imbizos and other public forums for advancing TAC demands and campaigns;

• branches and districts ensure that local health facilities have adequate supplies at all times of the drugs in the Essential Drugs List;

• branches and districts build and strengthen relations with the SACC, its local structures and affiliates, and other religious forums and organisations and

• branches and districts invest in building friendly relations with clinic and hospital staff linked to working with health worker unions.

Strengthening the capacity of TAC to work and campaign at a local health facility level, the district health system and provincial health structures

Local health facilities, the district health system and provincial health departments are critical to TAC's work. Many local, district and provincial health facilities do not provide adequate services and operate with inadequate resources. Additionally, many TAC structures are not fully aware of how the district health system and the provincial health departments and structures operate.

Therefore the following was resolved:

• Increase the capacity of branches to build community alliances with local health care workers uniting the demands of health care workers together with community demands for a people’s health service.

• Call on branches to lead sustained community mobilisation on ARVs, treatment of opportunistic infections, and other health problems in local areas through building progressive and democratic community health forums.

• Encourage branches to build alliances at local facility level with trade unions, community organisations, religious organisations and other NGOs.

• Call on the organising department to develop media or resource packs to raise awareness about TAC among local branches of trade unions, community organisations, religious organisations and other NGOs.

• Call on the organising department to improve the capacity of local branches and districts to work together with health care workers including issues around the working conditions of healthcare workers;

• Strengthen confidence among TAC members who are active in political parties to push TAC's concerns onto their political agendas;

• The organising department should conduct training for members on the structure of the health system to enable greater participation of TAC in hospital boards.

• Organising department must educate branches and districts on the district health system, the provincial health structures, provincial health acts, municipal health by-laws, district and provincial health structures and decision-making systems.

• Campaign to build a more efficient, high-quality and affordable public health system including the provision of adequate services based on adequate resources.

• Call on branches and districts to engage district health and HIV/AIDS structures.

• Call on provinces to sustain campaigns and work with provincial health departments and the health portfolio committees in provincial legislatures.

• Provinces should take part in Provincial AIDS Councils.
  

• Build working relationships with the Department of Social Development in provinces and districts.

• Build a TAC position and programme on access disability grants for PLWA.

• Campaigns should consider whether lay councillors are to be trained to do HIV testing. This may encourage more people to get tested.

TAC role in gender education, taking forward women’s health issues and developing women leadership

Noting the theme of the Congress and the fact that 70% of members are women, TAC resolves to improve its programmes in gender education and women's particular needs in planning campaigns. TAC affirms the role of women as members, volunteers and leaders. Therefore we resolved to

• encourage branches to prioritize women's leadership,

• establish targeted leadership training for women members and leaders of the TAC,

• develop an education programme on gender in HIV/AIDS, health and broader society.

The TAC role on issues affecting rural areas

Rural populations experience a disproportionate burden of low functional literacy and poverty. TAC recognizes that rural areas in South Africa require greater attention in terms of treatment literacy and organising skills. This is why it is necessary for the NEC to develop an extensive programme and approach to building TAC's work in rural areas; We have also noted a concerning increase in virginity testing schools in rural areas.

TAC resolves to

• establish a policy regarding traditional virginity schools and develop a programme to respond to the way such schools affect AIDS and gender equality;

• create a programme dealing with the ways traditional birth attendants and traditional healers deal with HIV/AIDS and treatment;

• intensify treatment literacy in rural areas;

• improve collaboration with genuine traditional healers and promote knowledge of and compliance with the Traditional Health Practitioners Act;

Further issues were raised in the Commission but not sufficiently discussed. These included (1) taking up issues affecting children and youth, (2) building PLWA leadership, (3) issues relating to TAC organisational structure, (4) issues of clarity on the Thekwini report (page 10 of the TAC organisational report).

ADOPTION OF COMMISSION AND PLENARY RESOLUTIONS

The resolutions of the Commission were presented and discussed in a plenary session of the TAC Congress on 25 September.

After discussion COSATU proposed that they be adopted at Congress.

Formal Mover for adoption: Thabo Cele, PWA sector, KwaZulu Natal.

Seconder: Phindi Madonsela, Deputy Chairperson, Gauteng.

Adopted unanimously.

[END OF RESOLUTIONS]