Treatment Action Campaign — Speaking Truth to Power

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The Treatment Action Campaign – having held its seventh national convention and reflecting 24 years of historic achievement – knows its mission to achieve primary health care for vulnerable and poor people is more monumental than ever. There is still “much to do,” says newly re-elected national president Sibongile Tshabalala.

The right to access health services, enshrined in Article 27 of our Constitution, is arguably one of the most important rights, because without health we cannot do much. Since its inception in 1998, the community-led Treatment Action Campaign (TAC) has campaigned for everyone to have equitable access to health care. He held his seventh national congress from August 27 to 29, 2022.

Delegates to the 7th National Congress of the Treatment Action Campaign. (Photo: Denvor de Wee)

“TAC is one of the organizations that maintains its independence from any political party or government institution. Our independence allows us to ask tough questions of government and demand transparency on issues that affect communities. The place of the TAC is to uphold the principle of putting the needs of the people first and to demand that the government listens and delivers on its promises. We are here to advocate for people to get services on the ground,” said newly re-elected TAC National President Sibongile Tshabalala. Citizen maverick.

TAC made history in 2002 when it won a constitutional challenge forcing the government to make nevirapine, or an appropriate substitute, available to pregnant women in public clinics. The Constitutional Court found that an extensive and inclusive antiretroviral treatment program was a realistic and reasonable demand from the government and the public health system. This meant that being infected with HIV was no longer a death sentence as people could access life-saving treatment.

And it’s thanks to TAC that death and mother-to-child transmission rates in South Africa have dropped dramatically, according to director of the Rural Health Advocacy Project, Russell Rensburg.

“When I think back to when HIV/AIDS was at its worst around 2001/2, our maternal mortality rate was skyrocketing, our under-five mortality rate was terrible. If it weren’t for the TAC, we wouldn’t be in the position we are in today where our death rate has nearly fallen to the universal health coverage goal [with a] significant reduction in HIV transmission from mother to child. I think all of this can be attributed to the activism of the TAC. They were the big push that changed the public health system,” he said. Maverick Citizen.

“With the professionalization of civil society, the TAC is still one of the few organizations that is still democratic and still has a direct link to its constituency and is organized in that way.”

Since its inception, the organization has used the Constitution as a means of advocacy, ensuring ordinary people know their constitutional rights, but has also consistently focused on understanding the science behind the drugs they take and their effects on their body – so they are literate about their own health care and adhere to treatment.

The measurable impact of TAC has saved millions of lives in South Africa, which has the highest HIV/AIDS infection rates in the world.

Speaking at the recent TAC Congress on August 27, TAC Chairman of the Board, Fareed Abdullah, said: “As little as 20 years ago, our healthcare system had a historically low life expectancy of only 55 years and maternal mortality was quite high. Without TAC’s leadership in early response to HIV, we would not be where we are today, where life expectancy has now increased to over 60 years. The insistence and power of activists to gain access to life-saving HIV treatment is what inspires us to stand firm with TAC in realizing the right to health for all.

Due to TAC’s large footprint across the country, it has conducted surveillance campaigns of public health facilities and reported its findings to the government to hold it accountable for the state of the public health system, as well as to ensure that the 80% of the population who depend on the public health system have “equal access to quality and dignified health services”.

tac makhura demonstration
Members of the Treatment Action Campaign spend the night protesting outside the office of Gauteng Premier David Makhura on Tuesday August 10, 2021. (Photo: Anele Yawa/TAC)

In the death of winter 2021, more than 70 TAC members slept for two days on the pavement outside the office of Gauteng Premier David Makhura following a protest that featured them holding a coffin symbolizing the many deaths at the hands of the department. It demonstrated their willingness to put even their bodies at risk for the rights of ordinary South Africans.

Looking forward

Talk to citizen maverick, Tshabalala said that while she was happy that the TAC had given her the leadership of the organization again, there was still a lot to do.

“Noting that the country’s policy is still changing in terms of health services, we have seen what is happening now in terms of people being driven out of hospitals for being ‘un-South African’. We cannot sit idly by and allow people to violate other people’s rights to services. It is a political question because the government says nothing. The health system is collapsing not because of non-South Africans, but because our government is corrupt and taking a lot of money from the health system, and we have evidence of many flaws in the system.


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“My focus during my tenure will be to strengthen TAC and develop our international solidarity with partners, and I would like to see TAC as a mass movement that is most effective on the ground and at the district level where issues are not not just at the national level.

tac world aids day
An activist from the Treatment Action Campaign addresses participants at a World AIDS Day 2021 event. (Photo: Denvor De Wee/Spotlight)

“I will also work to strengthen women’s leadership within the organization. I don’t want to be president forever; I want to evolve into a role of mentoring and supporting future female leadership. »

Tshabalala said TAC had been working on Covid-19 programming that involved going to communities to educate people about the virus as well as vaccines and why they should get vaccinated. “We have in many communities worked with the Ministry of Health so that after educating people about vaccines, the ministry is there to then offer vaccines to people, which has had such a big impact. As we did with HIV, people first need to understand what the vaccine is and also see others who have been vaccinated sharing their stories.

greater strength

Public health expert Dr Lynne Wilkinson said Maverick Citizen that TAC’s greatest strength has always been to be very independent-minded and guided only by the needs of the community.

“The role of TAC in community-led monitoring through the Ritshidze project is critical. This needs to be scaled to develop community oversight and ensure that people who actually use the public health system have an effective way to report what is wrong, what they want… without the TAC, which can play this role between individuals. users and the government, people’s voices will not be heard.

“We shouldn’t underestimate the power of a voice like TAC to push for things to get done. I think the hardest part is that there is so much to do for equitable access to medicines and health services and if you spread yourself too thinly you may not achieve any of these goals, and that is [for] the TAC to decide where they can have the most impact.

tuberculosis protest tac
Members of the Treatment Action Campaign and partner organizations march past Parliament in Cape Town, South Africa. The protesters demanded that the government do more to stop the spread of tuberculosis. (Photo: Gallo Images/The Times/Esa Alexander)

“A grassroots health care movement must be made up of multiple actors all working together, and the more TAC can play a role, the better. It can also mean framing and enabling more localized organizations to grow and tackle specific issues so that the TAC doesn’t try to take over everything.

When asked if the government takes the TAC seriously, Wilkinson said: ‘I think they take the TAC more seriously than we think they do, but where they don’t take it seriously enough is is to have a permanent seat at the table and not just when things go wrong like medicine runs out or [when] something terrible has happened somewhere and the TAC is calling it and people are getting up.

The government should not only assume its responsibilities when “the back is against the wall”.

It is clear that the role of a community-led mass organization is important in realizing people’s access to health care. The task at hand appears to be how the TAC can use its mass power to get the government to systematically provide primary health care to vulnerable communities who are not among the privileged 16% of the population who can afford aid. medical. SM/MC

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