Editors note: The South African Government has taken the highly significant step of ending their AIDS denialism. The portfolio around HIV/AIDS has moved from the Health Minister Manto to the Deputy Minister of Health Ms Nozizwe Madlalala-Routledge. Ms Nozizwe Madlalala-Routledge has publicly acknowledged the weakness of government leadership on HIV/AIDS in the country. South Africa already has one one of the worlds largest ARV programmes covering some 180.000 PLHIV, but as there are over 800.000 PLHIV in need of ARVs still a lot of work has to be done.

Ending the government's AIDS denialism is the first step in creating an effective system for treating and caring for people living with HIV, and is an absolute necessity for prevention of new infections.

GNP+ commends the South African Government for its public admission, and we congratulate the Treatment Action Campaign (TAC) and other South African AIDS treatment activists, with this major milestone in their campaigns.

TAC has released the following press statement about the recent improvements in the attitude of the South African government towards the HIV epidemic in the country; and outlining what their next steps will be.

Treatment Action Campaign: Wednesday, November 8, 2006

Leadership on HIV/AIDS irrevocably defeats AIDS denialism!
Implement a credible plan with clear targets!
Join action against gender-based violence and World AIDS Day activities

WHERE ARE WE?
The eight year struggle to end government HIV denialism and confusion has ended. A renewed focus on local and global mobilisation with the prison HIV deaths, the unnecessary appeals in the Westville Correctional Services Centre matter, and, the country's painful embarrassment at Toronto created the space where government and civil society are jointly facing up to the challenge of saving lives. Our task is to end 1000 new HIV infections daily and to reduce daily AIDS-death rate of more than 900 every day.

As part of our commitment to partnership, the Treatment Action Campaign has offered to settle two major pending court cases against government. In particular:

The last two months have seen significant positive developments which could lead our country out of conflict on HIV/AIDS. We are now witnessing the emergence of a united front of government, civil society and communities in a common effort. To save lives we must address the deep-seated problems in the health system. This, together with bold, unambiguous but reasonable HIV prevention and treatment targets will build trust and save lives.

RENEWED LEADERSHIP BY GOVERNMENT AND CIVIL SOCIETY
The Deputy President Phumzile Mlambo-Ncguka has given renewed leadership on HIV/AIDS. With the support of Cabinet, she has met with the TAC and led efforts to review and consolidate the South African National AIDS Council. She addressed the recent Civil Society Congress on HIV/AIDS - the first time that the second most senior leader of government addressed a meeting co-hosted by TAC. At the same congress, the Deputy Minister of Health Ms Nozizwe Madlalala-Routledge acknowledged the weakness of government leadership on HIV/AIDS despite its clear fiscal commitments. She supported improvements in the care and treatment programme, addressed problems in the poorly implemented mother-to-child transmission prevention programme, reasons for the failed prevention programme, and the escalating human resources crisis in the health system.

In addition to these concrete actions from government to rebuild unity with civil society, there has been increasing consensus in our own ranks. The Civil Society Congress (Cosatu, SACC, SANGOCO, TAC) held at the end of October was a critical moment in the growing national consensus on intensifying the struggle against HIV/AIDS in South Africa. By bringing together trade unions, the religious sector, non-governmental organisations and HIV/AIDS activists, the Congress became a forum for focusing attention on addressing the HIV/AIDS pandemic including many of the problems in the public health system.

All these developments underline the importance of strategic thought, tactical flexibility and sustained community mobilisation. Without renewed mass mobilisation, boardroom meetings, even with the best will and strategy in the world, would not have created the emerging conditions which promise decisive action on HIV/AIDS.

HOW DO WE MAINTAIN PRESSURE ON GOVERNMENT BUT ELIMINATE CONFLICT?
We still have a health system in crisis which needs decisive and principled political leadership and action from government. This clearly shows the need for continued vigilance.

Our country needs an emergency HIV/AIDS plan with clear prevention and treatment targets. We need a long-term HIV/AIDS plan to deal with the drivers of HIV infection and AIDS death. These include addressing the crises of governance, social security, gender inequality and violence which drive the epidemic. The National Strategic Plan being designed will form the basis for dealing with these.

Despite several court decisions in favour of the provision of nutrition, treatment and prevention in the Westville prison case, there are still problems. We reiterate our call on government to take immediate action to end the suffering of inmates at Westville Correctional Centre that will allow the Treatment Action Campaign, the AIDS Law Project and doctors to assist with an emergency plan on HIV testing, counselling, treatment literacy, nutrition and access to care and treatment, including antiretroviral therapy. Beyond Westville, government must develop and implement an HIV/AIDS plan for all prisons.

The health department's role remains central in our country's efforts to manage HIV. Exceptional leadership is thus required to unite the country also on HIV/AIDS health programmes, and to rebuild a health-system in crisis. Government must ensure the department can do this urgently. We called for the Minister of Health's dismissal. Today, we remain quiet on the demand for the removal of the health minister because we want to allow government to sort the challenges of leadership in the department we have raised appropriately.

We urge the department of health to give urgent leadership on issues including the waiting lists, modifying the treatment model to be primary care level centred, changing the sub-optimal MTCT protocol, the TB and XDR-TB crisis and access to opportunistic infection medication including Fluconazole.

TAC believes that the recent positive developments mark a clear shift on the part of government in terms of providing political leadership and building the basis for co-operation and principled unity. We commit ourselves to nurture this momentum in a manner which goes beyond specific individuals. We will however remain critical and vigilant to ensure that any denialism and obstructionism within government or anywhere else is exposed.

We appreciate also the commitment expressed by various government ministries to deal with HIV/AIDS and look forward to strengthening partnership as necessary.

This moment means that the TAC - in its strategy, in its daily work, in all its structures - must strengthen itself, its capacity, effectiveness and impact. We are ready for the hard work.