Moral Regeneration Movement

South Africans work to restore social fabric

Delegates from all sectors of South African society, including government, met at a summit in Pretoria this week to launch a broad social movement to promote moral regeneration in the country.

Speaking at the opening of the summit, Deputy President Jacob Zuma said this Moral Regeneration Movement (MRM) should facilitate, encourage, and co-ordinate the programmes of every sector of society in working towards restoring the moral fibre of the nation.

"We are here because we believe that something is wrong within the fabric of our society, and that we urgently need to do something about it. Moral degeneration cuts across the whole spectrum of our society, and that is why the renewal movement requires the participation of all South Africans through various sectors, as represented here today.

"This Summit offers a unique opportunity for us to redefine and reaffirm ourselves as moral beings, and collectively formulate tangible, practical and workable strategies and programmes that will see us endorsing values compatible with the new and democratic South Africa. It also allows us to reflect on, and harness, harmonise, strengthen, integrate and co-ordinate all the existing programmes, knowledge and tools for moral renewal," Zuma said. The MRM was initially a civil sector initiative, which arose out of a desire to find ways to regain the high moral standards endemic in all societies in Africa. Declining moral standards in South Africa and worldwide is a concern to all who seek a stable society in which decent people may flourish and prosper.

The moral regeneration process itself has been going on for some time. Following the 1998 Moral Summit, where former President Nelson Mandela spoke of an 'RDP of the Soul', several workshops were held in 2000. These workshops looked at how to involve broader society in a wider moral regeneration movement which goes beyond looking at specifically religious issues or seeing the process purely as an anti-crime drive. Morality issues go beyond religion and crime.

Government agreed to work with all sectors of civil society to set up the MRM, charging the social cluster of ministries with organising the launch of the MRM. In his State of the Nation address to Parliament in February, President Thabo Mbeki said the MRM would address "the issue of the responsibility that each and all of us should take for our lives, moving from the understanding that, as we were our own liberators in resistance against apartheid so too should we today act as our own liberators in dealing with its legacy".

In his opening address, Deputy President Zuma said the specific objectives of the summit should include:

• providing an opportunity to diagnose the past and present state of the moral crisis in South Africa;
• reflect on strategies and measures to reconstruct social values for a democratic South Africa;
• designing a vigorous programme of action for a sustained moral regeneration campaign;
• promoting an ethical, caring and corruption-free society.

Some of the symptoms of moral decay include the lack of respect for the sanctity of human life, the breakdown of parental control of children in families, crime and corruption, alcohol and drug abuse, abuse of women, children and other vulnerable members of society, a lack of respect for other people and property, and a general attitude of self-centredness and not caring about other people.

Zuma said he was confident the movement would achieve its aims because of the South African people's proven ability to bring together diverse strands of rich cultures and traditions, and their ability to work together, even in the most trying of circumstances.

"We have put aside our political differences, and are saying we will emphasise our national identity and celebrate our diverse backgrounds, traditions and cultures, and learn from each other. We came here prepared to spend the whole day charting a way forward that will make this a truly caring nation, and one in which our children and their children will grow up knowing the difference between right and wrong, bad and good," Zuma said.

HIV/AIDS

Government boost to campaign of hope

The fight against HIV/AIDS received a boost this week as the national cabinet moved to consolidate and strengthen government's comprehensive five year strategy on AIDS and sexually-transmitted infections (STIs).

Cabinet announced the establishment of a Presidential Task Team on AIDS, headed by the Deputy President, to strengthen the co-ordination and implementation of government's AIDS programme. It emphasised the need to continue and intensify the public awareness campaign focusing on prevention of HIV transmission. It also addressed measures to reduce the transmission of HIV from mother-to-child, including the current research on the use of the drug Nevirapine, and through sexual assault and 'needle-stick' injuries.

Cabinet emphasised government's commitment to effectively treating and managing opportunistic infections in people living with HIV/AIDS, and outlined its approach to the use of anti-retroviral treatments.

Government's comprehensive programme is backed by a massive increase in resources, Cabinet noted. The total budget to be spent mainly through the Health, Social Development and Education departments was increased from R350m in 2001/2 to R1-billion in this financial year, and will increase to R1.8-billion in 2004/5.

Government's review of the implementation of its HIV/AIDS policy comes a month after the ANC's National Executive Committee (NEC) concluded that the current approach to HIV/AIDS should be one of "continuity and change": continuity in broad strategy and policy, and change in intensity and coherence of implementation and articulation.

The NEC said the policies and strategies of government were, under current circumstances, "among the best and most relevant approaches required to manage the epidemic".

"However, we wish to assert, now, more than ever before, that many areas require improvement. Indeed, there would never be a time, as long as HIV and AIDS exists, that we could be satisfied with the work we are doing," the NEC said.

Prevention

Cabinet welcomed the progress made in ensuring the South African public and youth in particular are aware of the dangers of the epidemic. The challenge, it said, is to ensure that awareness continues to translate into a change in behaviour. It called on all South Africans to take full responsibility and care for their lives.

In conducting this campaign, government's starting point is based on the premise that HIV causes AIDS. "It is also critical for us, as a nation, to note that there is no cure for AIDS. In this regard, promoting awareness and life skills and HIV/AIDS education forms the core of our approach," a Cabinet statement said.

As part of prevention, research on the use of Nevirapine against mother-to-child transmission (MTCT) of HIV will continue, at the same time as government implements the temporary ruling of the Constitutional Court. The Department of Health is working on a Universal Roll-out Plan for MTCT once the research process ends in December 2002.

Cabinet decided that, with regard to cases of sexual assault, government will endeavour to provide a comprehensive package of care for victims, including counselling, testing for HIV, pregnancy and STIs. So they can make an informed choice, survivors will be counselled, among other things, on the risks of using anti-retrovirals to reduce the chances of HIV transmission. If they choose to, they will be provided with such drugs in public health institutions. This is also the case with needle-stick injuries.

Treatment

Government emphasised its commitment to effectively treat and manage opportunistic infections in people living with HIV/AIDS: "No South African should be sent away and not treated, whatever their HIV status."

The public was urged to help government monitor the availability of critically important drugs dealing with infections such as meningitis, oral thrush, tuberculosis and pneumonia.

Cabinet noted that anti-retroviral treatments in general that they could help improve the conditions of people living with HIV/AIDS if administered at certain stages in the progression of the condition, in accordance with international standards. However, because these drugs are too costly for universal access and, because they can cause harm if incorrectly used and if the health systems are inadequate, government will continue to work for the lowering of the cost of these drugs, and intensify the campaign to ensure that patients observe treatment advice given to them by doctors.

Alongside poverty alleviation and nutritional interventions, government will encourage investigation into alternative treatments, particularly on supplements and medication for boosting the immune system.

Care

"Government is deeply concerned about the conditions of families affected by the HIV/AIDS epidemic. We are intensifying the campaign to assist these families, including foster care grants, assistance to child-headed households, food parcels and so on", Cabinet said.

The programme of home-based care is also being improved, with the budget allocation for home- and community-based care increasing from R25,5 million in 2001/02 to R94,5 million this financial year, to R138 million in 2004/5.

Government called on all South Africans to join hands in a campaign of hope: "[T]o mobilise our strength as a nation and as individuals to ensure that, we are able to manage, reduce and, in the long-run, defeat this epidemic. We have it in our power to achieve this objective. What is critical is that we should work together as a united force to achieve the best interests of our society."

More Information:

• Cabinet Statement on HIV/AIDS, 17 April 2002

HIV/AIDS STATEMENT

Summary of government's position on HIV/AIDS following cabinet's discussion on 17 April 2002

[For the information of our readers, we enclose below the full text of a summary of government's position on HIV/AIDS released this week]

Intensifying our comprehensive programme against HIV/AIDS in partnership with all sectors

Government is intensifying the campaign to prevent infection by the HIV and to deal with its consequences. In that regard our starting point is the premise that HIV causes AIDS.

HIV/AIDS is a challenge for all of us. Defeating it depends on strengthening the Partnership Against AIDS launched in October 1998, in which all sectors society work with government to implement a comprehensive programme. Together we can overcome the disease.

The policy framework which government is following is set out in the "HIV/AIDS and STI (Sexually Transmitted Infections) Strategic Plan for South Africa 2000-2005". It is in line with international trends, and it is in fact among the best in the world.

As we continue to work within that broad framework, we are intensifying and expanding the programme; addressing problems of implementation; and improving our approach in line with changing circumstances. (Total funding in 2002/2003 is over one billion rand, three times more than the year before.)

Why does the programme put so much emphasis on prevention?

Because there is no cure for AIDS, preventing infection by the HIV is critical. Each of us must exercise our individual and collective responsibility to take care of our own lives.

Promoting public awareness and the life skills and HIV/AIDS education programme are the core of the efforts to prevent transmission of HIV. The latter is now a compulsory part of the school curriculum and full implementation is expected by the end of 2003. Though we have achieved a high level of awareness - over 90% - which is beginning to have an impact especially amongst the young, we are intensifying the work so that more people translate awareness into change of lifestyles. A new phase of the campaign by the agencies contracted by government, working with partners such as Lovelife, will start in June 2002.

The effective management of Sexually Transmitted Infections (STIs), which render people more vulnerable to the HIV, plays a critical role in reducing the risk of HIV transmission. This programme, which has so far ensured that there are trained healthcare workers in 80% of our public sector clinics, is being extended. Amongst other things there has been a steady decline in the prevalence of syphilis amongst pregnant women attending public health sector clinics, and ante-natal surveys show that that the rate of HIV infection is levelling off.

In the South African AIDS Vaccine Initiative scientists are working with government support and funding to develop a vaccine that will make people immune to HIV infection. It is important however to remember that success will not be quick and is not guaranteed - so prevention through awareness remains the key message.

What progress are we making on preventing mother-to-child transmission?

The Prevention of Mother-to-Child Transmission of HIV (PMTCT) is being run through 18 research sites accessed through over 230 hospitals and clinics. Over 38,000 mothers have gone through the programme. At the sites women are offered voluntary counselling and testing for HIV. Those who are HIV-positive are offered Nevirapine for themselves and their babies, vitamins to improve their health during pregnancy and after; preventive measures and prompt treatment of infections and formula-feed if they choose not to breast-feed. Babies are also given multivitamins and prophylaxis for opportunistic infections.

Where there is capacity to provide the package of care that is needed, and where the demands of research dictate, sites are being extended. Towards the end of the year, tests will be done on the babies and mothers being monitored, for us to then consider moving to universal access of Nevirapine. A Universal Roll-out Plan in this regard is being worked on and will be released in due course.

In the meantime, government is implementing the temporary Constitutional Court order; and we have provided guidelines to hospitals on the package of care they need, to be able to administer Nevirapine against mother-to-child transmission beyond the research sites. A special Task Team set up by the Health Minister in consultation with MECs will assist hospitals in this.

Regarding use of antiretroviral drugs following cases of sexual assault, government will endeavour to provide a comprehensive package of care for survivors, including counselling, testing for HIV, pregnancy, STIs. Survivors will be counselled, including on the risks, so that can make an informed choice, and will be provided with the drugs if they so choose in accordance with guidelines and protocols(as is done in the case of needlestick injuries)

What does government's programme offer in the way of treatment?

The quality of life of those infected by HIV is a major concern of government. Their health can be improved greatly through the effective treatment and management of opportunistic infections.

It is important for those with recurrent opportunistic infections to know their HIV status. The programme to provide voluntary HIV counselling and testing (VCT) was started in 2000 - at the moment 359 VCT sites are operational out of 495 identified by provinces.

However, no one should be sent away and not treated, whatever their HIV status. Therefore treatment of opportunistic infections is available at public health care facilities irrespective of HIV status. Government will continue working with pharmaceutical companies to lower the cost of drugs to treat these infections.

As part of this programme Government signed an agreement with the pharmaceutical company Pfizer in December 2000 for the provision of Fluconazole (Diflucan) to the public health sector for two years. The agreement includes funding for the training of healthcare workers in the diagnosis and management of oral thrush and cryptococcal meningitis. So far 20,000 patients have benefited from the programme.

We call on the public, especially People Living with AIDS, to help us in monitoring the availability of such drugs; so that we can work together to improve treatment for the infected, and public health care in general.

Government recognises that antiretroviral drugs can improve the quality of life of People Living with AIDS, if administered at certain stages in the progression of the condition and in accordance with international guidelines and protocols. Because these drugs are costly and can cause harm if incorrectly used or if health systems are inadequate, we will:

• continue working to lower the cost of anti-retrovirals, including through discussions with the producers of the main drugs, and investigation into possible production of generic drugs;
• work through the Global Fund to fight HIV/AIDS, TB and Malaria to access resources for the overall campaign against the spread of HIV, TB and Malaria;
• intensify the campaign to ensure that patients generally, and those infected with TB, thrush, meningitis and HIV in particular, observe the treatment advice given to them by doctors.

Though antiretrovirals are not generally available through the public health sector, guidelines for their use in the private sector have already been developed and research on their targeted use will continue.

A further initiative arises out of the fact that conditions of poverty lower the body's natural immune system making it more susceptible to infection, and more vulnerable to its effects. Alongside poverty alleviation and nutritional interventions government will encourage investigation into alternative treatments, particularly on supplements and medication for boosting the immune system.

What about care and support?

Government is deeply concerned about the conditions of families affected by the HIV/AIDS epidemic. We are intensifying the campaign to assist these families, including foster care grants, assistance to child-headed households, food parcels and so on.

We are also improving the programme of home-based care. In this regard the budget allocation for home-based care and community-based care increases from R25,5 million in 2001/02 to R94,5 million this fiscal year, to R138 million in 2004/5.

What can be done about discrimination against people with HIV/AIDS?

This is a very important matter. Negative attitudes in our society can result in people being denied the treatment, care and support they need. They discourage people from being tested to find out their status or from declaring the cause illness or death in their family. Amongst other things this leaves us without vital information our country needs to know the extent of the disease and its patterns.

Government will intensify its campaign and awareness programme against discrimination and continue investigating further legal avenues to the affected and infected.

What does partnership mean in practice?

Because of the scale of the disease, because it affects every aspect of our society, and because of the need for awareness, care and support, defeating it depends on a partnership of all sectors of society with government to implement a comprehensive campaign.

In the beginning the response to HIV/AIDS came just from the Health sector. The launch of the Partnership Against Aids in 1998 by then Deputy President Mbeki brought other government departments and key sectors of society together in a broad-based and multi-sectoral fight against the disease.

In January 2000 the partnership was formalised in SANAC, the South African National Aids Council under the leadership of Deputy President Jacob Zuma. SANAC has been reviewing its two-years of work and is preparing to strengthen itself to play the key co-ordinating role in our national effort against HIV/AIDS.

Government will strengthen its own contribution to the partnership, establishing a Presidential Task Team on AIDS consisting of Ministers led by the Deputy President.

As government focuses its efforts and resources ever more intensively on the public policy challenges of HIV/AIDS, it will draw whatever it can from science to use in this fight. As in all areas of science research and debate will continue, but government is not a protagonist in those debates.

Issued by Government Communications (GCIS), 17 April 2002

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