The Treatment Action Campaign (TAC), Positive Action Campaign, SANERELA+, Positive Women’s Network and the National Association of People Living with HIV and AIDS (NAPWA SA) commend President Cyril Ramaphosa on the leadership in the response to COVID-19.  We are pleased to note the evidence-based approach taken in relation to targeted travel restrictions and port closures. Similarly, we commend the president for availing resources and forming the National Command Council, which he will chair. We are confident that such measures will help reduce the spread of this pandemic. However, much more needs to be done.

We are mindful that the onus is on all of us to work together to achieve our objective to stymie community transmission and end Covid-19.

We note that evidence has shown that people who are immunocompromised, including those with respiratory issues are the hardest hit by Covid-19. As a sector, we have been at the forefront of calling for a decolonised health care system that does not prize profit over lives through broader health systems strengthening. We have continually highlighted clinics in crisis through numerous reports and have demanded that the state fixes the broken healthcare system for years. Historically, through monitoring the HIV and TB response, we have called for more people to know their HIV status and for more people to be initiated on treatment. We have also called for the radical improvement of TB infection control in all public spaces, including health care facilities. These measures are more important than ever at this juncture.

We also reaffirm our call for more human resources for health, including community healthcare workers, a critical cadre to support contact tracing of people who have come into contact with those who have tested positive for Covid-19. These priceless measures taken in the fight against the virus must also support the TB response going forward. According to the World Health Organisation, TB was responsible for 63,000 deaths in South Africa in 2018. We will be in contact with the Department of Health about how best our non-immunocompromised volunteer staff and members can be of assistance, if at all.

While we agree with the president’s call for everyone to protect themselves by washing their hands with soap and running water, we are mindful that many communities such as in Makhanda, Amsterdam (Mthatha), Dokodweni and Qwaqwa are not able to access clean running water for long periods of time. We call on the state to provide a clear plan on how access to this fundamental right will be provided to communities. In this light, we applaud the South African Independent Community Pharmacy Association on their proactive approach, detailing how people can make their own sanitiser. While not everyone has the means to do so, this is the proactivity required of us all.

Importantly, while the president provided the leadership necessary, the plan was scant on details about how communities will be tested. We commit to disseminating such information to our branches and their communities as soon as this is made available.

In partnership with other civil society organisations, we support the president’s call for people to desist from spreading fake news. We will work in partnership with other progressive forces to debunk fake news and curb panic.

Importantly, we worry that community and civil society participation in the Command Centre is non-existent. TAC has been mandated by civil society to engage the relevant powers-that-be for more formal inclusion in the response. This resolution is not taken lightly. We do so because our perspectives as users of the public health care system may be of use going forward.

Sector interventions going forward 

After extensive engagement with public health experts, and mindful of the fact that we represent people living with or affected by HIV, some of whom may be immunocompromised, it would be morally reprehensible were we not to heed the calls to practice social distancing. We are urging all our employees and members, particularly those working in the field not to report to work for the foreseeable future, as we have a moral obligation to ensure that we protect them. We also have a moral obligation to protect everyone who comes into contact with us, particularly sick people in health facilities. 

We have taken the time to hold preliminary engagements with our funders and other stakeholders since last Friday and we are appreciative of their understanding in such a situation. As such, we will continue to pay staff, including casual labour. We strongly urge other organisations, companies, businesses and individual employers to do the same.

As per the president’s directive to stop all gatherings of over 100 people, our collective planned activities for World TB Day, our individual organisational health systems monitoring, as well as our planned massive march against ARV thefts, drug shortages or stockouts, have been cancelled. We will, however, continue to advocate for equitable access to quality healthcare services, with our national leadership continuing to work remotely throughout. Through engagements with experts, we have developed popular education material we will be disseminating to the public through using community media and social media.

Staff and members who were in high- and medium-risk countries during the stipulated time have been identified and are going to get tested.

We are also acutely aware of the lack of substantial evidence-based research into how the Covid-19 virus affects individuals with HIV generally. We call for more research into the correlation between Covid-19 and HIV so that people should protect themselves accordingly.

Lastly, we call for more social solidarity at this critical juncture. We call on the haves to help provide those who can’t afford sanitiser with some. We call on the haves not to panic buy and leave other people without access to life saving food. We call on the private health care sector to lower test prices to allow for more access.

Anele Yawa Treatment Action Campaign General Secretary, Sello Mokhalipi Positive Action Campaign General Secretary, Thandi Maluka Positive Women’s Network Executive Director, Mluleki Zazini National Association of People living with HIV/AIds National Director and Abubacker of the South African Network of Religious Leaders Living with or Personally Affected by HIV and AIDS  – Secretary. MC