The Treatment Action Campaign (TAC), famously known for challenging and winning a constitutional case against the state to make ARV treatment available and accessible to all people living with HIV/Aids in South Africa, held their 7th National Congress in Johannesburg over the weekend of 26 and 27 August 2022.

Members from across the country gathered to reflect on their work and for new leadership elections to take place, presided over by officials from the Electoral Institute of South Africa.  The TAC has continued to advocate for an improved public health system and an end to the corruption that has plagued public health. In August last year members of the organisation slept outside Gauteng Premier David Makhura’s office for two days as they demanded Makhura attend to the corruption and broken health system in Gauteng. 

TAC National Chairperson Sibongile Tshabalala opened the Congress officially on Saturday morning. Tshabalala, who has now been seconded to the South African National AIDS Council’s (SANAC) coordinating committee, said she planned to ensure that all money allocated to SANAC goes to the intended recipients. “There are people running SANAC like private property and that is going to change,” she said emphatically.

“Congress offers an opportunity for critical self-reflection. It also offers us a chance to pat each other on the back for exemplary leadership. However, we cannot rest; this Congress is held at a critical time when the gains of the past need to be amplified in order to fulfill the Constitution’s promise of quality healthcare for all,” Tshabalala told the congress.

“We are in a country where [cases of] corruption have become commonplace. Many of these have been in the healthcare sector. These include the Digital Vibes scandal, which saw the health minister resign and several officials disciplined, the PPE procurement scandals which saw millions and millions of rands misappropriated, the Eastern Cape Health Department scandals, and the Midvaal municipality scandal.”

Tshabalala also said that it was necessary to acknowledge the role of whistle-blowers like Babita Deokaran, who paid the ultimate price “for trying to stop the disgusting theft of money meant for a hospital where patients were dying lonely and hungry.” On 4 August 2022  Deokoran’s family marked the first anniversary of Deokaran’s death.

In a message to the incoming leadership Tshabalala said, “While we are resolute in our conviction to protect the status of those who do not want to disclose, I plead with those leaders who will be newly elected to disclose their status should they be People Living with HIV (PLHIV) in order to destigmatise the pandemic and be a shining example of living positively.”

“Comrades, I worry about the declining state of activism in the country broadly and the organisation specifically. There has been an exodus of leaders at all levels, as comrades continue moving on to greener financial pastures. This has had a negative effect on the organisation.”

Tshabalala went on to call for a rethink of activist efforts and  to continue to use the law to effect change, saying, “What is clear is that traditional forms of protest action are no longer viable and there is a need for radicalisation and a more creative approach… it is important to draw inspiration from comrades in Argentina, who have fought for many years for progressive intersectoral laws that protect the rights of PLHIV.”

Tshabalala noted that Covid-19 had negatively impacted HIV and TB, with a Lancet report showing a 48% decrease in HIV testing within the first month of Covid-19 in South Africa. She said this meant that the TAC needed to redouble efforts to get people to test and ensure that health officials did their part as well.

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The TAC received numerous messages of support from national and international organisations. In a message of solidarity Russell Rensburg, director of the Rural Health Advocacy Project, said:

“Just 20 years ago our healthcare system had an all-time low life expectancy rate of just 55 years and maternal mortality was quite high. Without the leadership shown by TAC on early response to HIV, we wouldn’t be in the place where we are today, where life expectancy has now increased to over 60 years. The insistence and power of activists in getting access to lifesaving HIV treatment is what makes us stand firm with TAC in realising the right to health for all.”

Speaking at the congress Mluleki Zazini, National Director of the  National Association of People Living with HIV and AIDS, told the TAC that he admired the role they have played in advocating affordable, quality and accessible treatment. “You have never been shy to hold the government to account”, he said.

Mluleki said that during the congress the TAC must not forget, however, that the struggle is not over and that he hoped there would be deliberations on  programmes of support that could be initiated for key populations and teenagers, as well as the mental health issues of people living with HIV. 

TAC board chairperson Dr Fareed Abdullah commended the TAC on their work thus far and emphasised that they needed to maintain their credibility and good governance in order to continue to hold government accountable. 

Abdullah said that Covid had really done more damage than is immediately obvious and that as a doctor he had seen that more than 60% of patients have not been coming to clinics and as a result, there was a higher HIV mortality rate. “The next three years are going to be a tough time for people living with HIV. People who have had interrupted treatment will mean a major HIV rebound – all provinces have seen an increase in people dying from HIV and TB.”

Abdullah also highlighted that Covid had exposed complete failures of our health system, and showed that “every single contract in government is open to corruption, crooks and thieves who have no moral bar – they will steal from any tragedy”.

Also present at the opening of the congress was SAFTU president Ruth Ntlokotse, who told the TAC that she salutes the organisation’s “long and illustrious history of struggle”. 

Ntlokotse noted, however, that the TAC’s struggle had not been an easy one, pointing out that a major hurdle had been the denialism of former president Thabo Mbeki that had led to the deaths of millions of people, but that the organisation managed to defeat the government’s denialism and big pharmaceuticals’ profiteering in court.

Ntlokotse said that SAFTU stands in solidarity as the TAC represents the struggles of the working class to get access to healthcare, and said that they had to put pressure on the ANC government for not delivering services to the people.

Both Tshabalala and Ntlokotse were emphatic that their organisations were against and intolerant of xenophobia, particularly in the health system.  

“We need to unite against xenophobia in all its forms. Those who harbour hate are becoming louder and more outspoken. TAC has a key role to play in calling out xenophobia, whether it be in communities or in the healthcare sector,” said Tshabalala 

Tshabalala pointed out that the failure of the public health system meant that there were “Poor people who die in hospital queues or clinics with no medicines or waiting for ambulances that never come. While poor people die, those who steal the money live comfortable lives.” DM/MC