A dream no longer deferred!

Earlier this year we celebrated the 12th anniversary of our liberation from apartheid. In terms of measuring the progress we have made towards the creation of the non-racial, non-sexist, equitable and prosperous society to which we are committed, some in our country said the glass is half-full, and others that it is half-empty.

Given the important challenges we continue to face, it is natural that all of us should continue to be driven by a sense of urgency in everything we do, inspired by the need further to accelerate our advance towards meeting the goal of a better life for all our people.

At the same time we must recognise some realities that will continue to impact on everything we do. One of these is that we are still a young democracy. Twelve years in the life of a nation as new as ours is very short indeed. Another of these realities is that we face the task to eradicate a deeply entrenched legacy of poverty, inequality and underdevelopment that was nearly 350 years old at the time we won our freedom in 1994.

Despite this objective reality, many a time one gets the feeling that some in our country express views and act in a manner that is based on the entirely unrealistic expectation that the legacy of the catastrophic damage visited on our country and people over centuries can be eradicated in a very short time.

Various moments this year have served to remind the nation that in reality we are not that far removed from the challenging period of the apartheid years, which marked both the apogee and the end of colonialism in our country and continent.

I refer here specifically to the commemoration of the 50th Anniversary of the Women's March and the 30th Anniversary of the Soweto Uprising. I refer also to the passing away a short time ago, on 31 October, of one of the titans of the apartheid system, PW Botha.

Inevitably, the matters to which I have just referred would have given many in our country the possibility to make a comparison between the situation then, and the situation now, which should in any case always be part of the armoury of measures we use to estimate whether the glass is half-full or half empty.

Twenty years ago, on 17 June 1986, one decade after the beginning of the Soweto Uprising, and a mere four years before the apartheid regime was obliged to negotiate with the ANC, the then Minister of Finance, Barend du Plessis, addressed the apartheid House of Assembly during the Third Reading of the Appropriation Bill. Among other things he said:

"Any Minister of Finance would probably have preferred to rise to his feet in this House under easier circumstances, to review the state of the economy and to announce what the government can do to boost the economy and at the same time help to improve the living conditions of the people.

"The situation in which the country finds itself at present is serious enough to justify the proclamation of a state of emergency...

"Besides the state of emergency, we are also dealing with the debt standstill, the threat of economic sanctions and boycotts, and a period of low or even negative economic growth. Apparently there is a lack of confidence among businessmen, industrialists and even consumers.

"Obviously this is not a situation that can be changed overnight by means of magic formulas or a few announcements, but it is no use our wearing the sackcloth and ashes like Job.

"Our present problems can only be counteracted and successfully overcome by a country and its people that do not lose hope because of such setbacks, but roll up their sleeves and get down to the job; people in fact, who do not allow themselves to be misled by false rumours and malicious and depressing gossip...We are determined to achieve success...

"It is not only our actions as such but also our demonstrated will to govern ourselves and to develop according to our nature, that must cause our opponents to abandon their plans. This will must, in the midst of all the storms that are about to be unleashed on us, characterise every action on our part...

"The statistics for the first quarter of 1986 have become available, according to which the (economic) upswing has seemingly lost momentum...

"The gross domestic product...declined in real terms by 1,5% during the first quarter of 1986...In respect of private consumer spending the real decrease was 2,5%, in respect of private fixed investment it was 3,5%, and in respect of fixed investment by the public sector it was 40%...

"The annual inflation rate rose in January 1986 to a peak of more than 20%, but has since levelled off and stood at 18,6% in April...Gross fixed investment has shown a sustained decline since 1981...

"Having outlined those elements of the (budget) package that address the first leg of (our) strategy - the promotion of a soundly based economic growth...I now turn to the second leg, which embraces a programme of social and economic upliftment by way of work creation and the upgrading of skills on the one hand and the provision of the physical and other infrastructure making for a better quality of life on the other hand...

"These twin, people-oriented programmes, aimed at employment on the one hand and upliftment on the other, have brought comfort and hope to many hundreds of thousands of people...The need is of such proportions that further expenditure is urgently called for...

"It is our wish to respond positively and adequately to the challenges of our time...We can do no better than to invest in the betterment of the life circumstances of all the people of our country. We are for growth but balanced growth that is both an input into and an outcome of our best national endeavours. We seek to invest in our greatest asset - the people of this great country."

Twenty years later, on 25 October 2006, our Minister of Finance, Trevor Manuel, presented the Government's 2006 Medium Term Budget Policy Statement to the now democratically elected and non-racial National Assembly. Among other things this Statement says:

"South Africa is experiencing a sustained period of economic growth. Sound macroeconomic policy, an expansionary fiscal stance and a supportive international environment have seen growth average 4.2 % over the past four years. Rising consumption expenditure and strong increases in investment in productive capacity have resulted in expanded employment, with the creation of more than one million jobs over the past three years.

"The economic challenges facing the country are to sustain this growth, broaden participation and extend opportunities to all, strengthen industrial development and trade performance, and accelerate the pace of job creation. These challenges will be met..."

In his Address to the National Assembly to table the Budget Policy Statement, he quoted a short soliloquy by Styles, one of the characters in the Athol Fugard play, 'Sizwe Banzi is Dead'. Contemplating a family photograph and praying for a life of freedom and prosperity for ordinary working people like himself, Styles says:

"This is a strongroom of dreams. The dreamers? My people. The simple people, who you never find mentioned in the history books, who never get statues erected to them, or monuments commemorating their great deeds. People who would be forgotten, and their dreams with them, if it wasn't for Styles. That's what I do, friends. Put down, in any way, on paper, the dreams and hopes of my people so that even their children's children will remember..."

Trevor Manuel then spoke of the effort in which our movement and government are engaged to transform the strongroom of dreams of those you never find mentioned in the history books, into a strongroom of dreams in the process of fulfilment. He said:

"South Africa is in the midst of its longest sustained economic expansion. Robust economic growth, supported by strong consumer spending and rising investor confidence, has created over one million jobs in the past three years. While unemployment remains our most pressing social and economic challenge, for the first time in a generation, the economy is creating jobs faster than new entrants are joining the labour force...

"The expansion of the social security system has contributed to poverty reduction and reduced the vulnerability of many households. At the same time, real income tax relief for low and middle-income earners has raised disposable income. People have purchased more durable goods such as televisions, fridges, furniture and cars...

"At the same time, many companies have taken advantage of the low interest rate environment and relatively strong currency to retool - to invest in new machinery and technology to expand their businesses. Boosted also by rising public sector infrastructure spending, the construction sector has boomed, growing by 10.7% a year in the past three years. The pace of fixed investment has surprised many of the upstream input sectors. As a result, we are now experiencing periodic shortages of cement, steel and refined fuel...Gross fixed capital formation has risen from 15% of GDP in 2002, to 18.4% in the first half of 2006...

"Fiscal space provides government with an array of options: to spend more, to provide tax relief, to invest in infrastructure or to improve savings. More importantly, it provides a firm platform upon which we can reform our economy to ensure that we broaden opportunities to those still marginalised...

"The budget framework makes provision for increased salaries for certain categories of professions, especially in the health and social welfare sectors. It also makes provision for higher staffing levels in health, police, justice and social welfare...

"The solid performance of the economy, in particular the creation of job opportunities and rising household incomes, allows us to turn the dreams of ordinary people into new realities. The expansion of infrastructure investment and the management of our public finances provide us with the capacity and resources to improve the services we provide to our people, to build hope, and expand opportunities."

The Medium Term Budget Policy Statement itself says: "Research confirms that a marked decline in poverty has taken place since 2000, due largely to the expansion of social grants and rising employment. Access to services such as electricity, piped water, sanitation and telecommunications improved substantially between 1995 and 2004, and the largest benefits are evident among the poorest households.

"Severe social and development challenges remain to be addressed, however. Investment in people needs to be accelerated, health and social development services improved, crime prevention reinforced, job creation and community development bolstered."

When the South African Minister of Finance addressed the House of Assembly in June 1986, he was obliged to say, "Any Minister of Finance would probably have preferred to rise to his feet in this House under easier circumstances...The situation in which the country finds itself at present is serious enough to justify the proclamation of a state of emergency."

When the South African Minister of Finance addressed the National Assembly in October 2006, he could say: "The solid performance of the economy, in particular the creation of job opportunities and rising household incomes, allows us to turn the dreams of ordinary people into new realities...The Medium Term Budget Policy Framework invites this House, and all South Africans, to embrace the challenges ahead as we prepare for 2010 and as we progressively broaden participation in a growing economy, with confidence in these shared commitments."

The radical divergence between these two pronouncements makes the firm statement that we have made a qualitative break with our past, sufficient for us proudly to affirm that we have left our Age of Despair behind us, and entered our Age of Hope. What remains for all of us to do, together, is to embrace the challenges ahead with confidence.

In the poem by WB Yeats, 'Fergus and the Druid', King Fergus speaks of his disillusionment with his kingly powers, despite the attendant glory, pomp and circumstance, and says:

A wild and foolish labourer is a king, To do and do and do, and never dream.

To which the Druid responds:

Take, if you must, this little bag of dreams; Unloose the cord, and they will wrap you round.

HIV and AIDS

Towards a new era of partnership and progress

As we build up to World AIDS Day on 1 December, we would like to express our gratitude to the thousands of health workers and all partners of the Department of Health who are working tirelessly to intensify the implementation of the Comprehensive Plan for Management, Care and Treatment of HIV and AIDS.

Ranging from managers at different levels, various health professional categories to those working in the field reaching out to our people in need of care, these health workers have not been distracted by those who continue to falsely accuse some of us in government of being HIV and AIDS denialists. They have rather focused on what matters most:

• recruitment and training of the necessary personnel to support the implementation of the programmes;
• assisting patients to access prevention, care and treatment services;
• ensuring that the supply of medicines and other consumables runs as smoothly as possible;
• building infrastructural capacity to provide quality health services;
• expanding laboratory services;
• increasing the number of facilities where people can access quality care.

They are driven by a common goal of the Department of Health to provide quality treatment, care and support to all qualifying HIV positive patients in an equitable manner.

In the process of pursuing this goal, they have achieved what no other country in the world has been able to attain in terms of significantly increasing the accumulative number of people initiated on antiretroviral treatment. This has risen above an average of 10,000 patients being enrolled in the programme a month, particularly during the period June - September 2006.

This was same period when their government was under a sustained attack within the area of HIV and AIDS. A group of fellow South Africans had teamed up with their partners at the occasion of the International AIDS Conference in Toronto, Canada to portray our government as uncaring and indifferent to the plight of its own electorate - the very people who reaffirmed their confidence in the ANC by giving it a close to 70% majority in the general elections two years ago.

Those given the responsibility to implement the government programme on HIV and AIDS were vilified and millions of rands were raised to fund an unsuccessful campaign to oust them from the office in which they are currently deployed by our movement.

The incident of my illness was portrayed as an opportunity to turn others into champions of a campaign to rid our government of the so-called "HIV and AIDS denial at the highest level".

Our government and the ANC have faced severe attacks in their effort to ensure that the global response to HIV and AIDS takes into consideration the peculiar challenges facing the African continent.

We were all expected to follow the route taken by developed countries of the North in responding to HIV and AIDS. For them, the challenge of HIV and AIDS has been perceived as a problem affecting marginalised communities such as immigrants, men who have sex with men and injecting drug users.

With much more resources at their disposal and more sophisticated social and health systems, antiretroviral drugs ­- which were introduced into the market at a very high price - became the main element of the response of the developed world.

The under-developed Africa on the other hand is faced with a challenge of HIV and AIDS that is affecting the general population. The continent has very weak health and social systems and very limited resources to meet the many needs of its populations.

These populations face many social challenges including unemployment and lack of access to basic services such as water and sanitation, education and housing. Even before HIV infection, their health is already compromised by poor nutritional status and a lack of access to basic health services.

These circumstances meant that we had to fight for the reduction of the prices of medicine and improvement of health systems and the general living conditions of our people. The court case by pharmaceutical companies against our government over drug prices, international engagement over recruitment of health workers from our continent and other struggles against global injustices bears testimony to the efforts of government to create a better life for all including people living with HIV and AIDS.

For the first time in history, the World Health Organisation (WHO) held a global meeting looking at the role of nutrition in the response to HIV and AIDS and acknowledged the role of South Africa in highlighting this element of the HIV and AIDS response by holding this meeting in Durban.

Nutrition is critical in prolonging progression from HIV infection to development of AIDS defining conditions. It is also critical in enhancing the effectiveness of medical treatment. Unfortunately, others chose to interpret this simple and straight-forward statement as suggesting that nutrition might be an alternative to treatment. It is not.

Again understanding our peculiar conditions as Africans, we highlighted the need for research and development of traditional medicine which, according to the WHO, is used by almost 80% of people on our continent. In August this year, the WHO Afro regional director, Dr Louis Sambo, advised that: "Countries should embrace traditional health practitioners as partners in the health system. The proximity of these practitioners to the community makes them a reliable resource to support families and individuals."

As a result of the progress made in reducing the prices of drugs, the increase in social budget allocation and the improvement in the capacity of the health system through a number of strategic policy interventions, government added antiretroviral therapy to a series of interventions that now constitute the Comprehensive Plan.

As we implement all these programmes, we remain conscious of the fact that there is still no cure for HIV and AIDS. Therefore, prevention should remain the mainstay of our response.

In this regard, we are encouraged by the outcomes of the first South African HIV and AIDS Communication Survey for 2006, released last week. The survey indicated that various HIV communication campaigns, including that of government - Khomanani - are having a significant impact in modifying sexual behaviour.

The outcomes of this survey came at an opportune time as the Department of Health is in the process of finalising the revised Strategic Plan for HIV and AIDS and STI for the period 2007 to 2011. The revised Strategic Plan will guide the country's response to HIV, AIDS and STI in a manner that ensures continuity of the current strategies while introducing additional interventions required to keep up with recent advances in knowledge.

The need for the strengthening of partnerships in the response to HIV and AIDS cannot be overemphasised. The process of reviewing the South African National AIDS Council (SANAC) as the expression of our multi-sectoral response to HIV and AIDS is being capably coordinated by Deputy President Phumzile Mlambo-Ngcuka.

The magnitude of our social challenges and the scarcity of resources available to us as a developing nation require that we rise above sectarian interests and complement each other in improving the lives of the people of South Africa. Let us use the occasion of the World AIDS Day to join hands and reaffirm our collective commitment to curbing the spread of HIV infection and reducing the impact of AIDS.

** Manto Tshabalala-Msimang is a member of the ANC National Executive Committee and Minister of Health.

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