JOHANNESBURG, 20 August 2009 (PlusNews) - The South African
National AIDS Council (SANAC), long perceived by activists as
largely dormant, awakened to make groundbreaking recommendations
to government earlier this month. Dr Nono Simelela, who takes
over as the new CEO on 1 September, spoke to IRIN/PlusNews about
where she would like to take the council.
Despite the challenges, Simelela said she was drawn to her new
post at SANAC primarily because it would offer her a chance to
work in a sector she feels passionately about, and in what she
called a "conscious environment" - given current political
leadership - which the country desperately needed.
Simelela was the first South African black woman to qualify as a
specialist obstetrician and gynaecologist, which led to a 20-year
career in the Department of Health, culminating as chief director
of the National HIV, AIDS and TB programme in 1998 until she left
in 2004. It was a time when HIV treatment was largely unavailable
and the fight against HIV/AIDS under the country's then health
minister, Dr Manto Tshabalala-Msimang, was heavily politicized.
"I think everyone knows it was a very challenging time in South
Africa ... in many ways. The magnitude of the epidemic was really
brought to the fore, and the need to move quickly, in terms of
treatment and care, was evident," Simelela told IRIN/PlusNews on
the phone from London, where she heads the technical knowledge
and support division of the International Planned Parenthood
"It was tough and you had to hang in there, [but] I think that it
was necessary. The fact that we did get a plan and have people
accessing treatment has been a huge positive outcome."
She said South Africa's antiretroviral programme - one of the
world's largest - remained one of its biggest achievements, but
also noted the recurring drug shortages, poor monitoring and
evaluation, and the need to slow new infections.
"We haven't really established a robust monitoring and evaluation
system across all sectors, including government. We've got the
National Strategic Framework, and targets that have been set, but
we need a robust tool to monitor progress so we know what needs
to be done," she said.
"The fact is that we have an epidemic that is raging, and new
infections are still occurring. We need to go back to the
prevention side of things to look at what we're not doing well
The road ahead
Simelela said she hoped the mix of local and international
experience of the HIV epidemic would help her and SANAC make much
needed changes. At the forefront would be strengthening
provincial and district AIDS councils, which are not only points
of service delivery but also collect crucial data.
"We have a lot of good policies, but when it comes to
implementation they falter," she said. "We need to be sure
provincial and district councils are able to implement their
HIV/AIDS plans. It should almost be a bottom-up approach - issues
would come up at the district level and the national council
would then look at ways of resolving them."
Although long inactive, SANAC still provides a crucial interface
between government and civil society, ensuring that the people
implementing policies at whatever level are held accountable.
Simelela told IRIN/PlusNews that the reawakened giant meant a
renewed opportunity to make a difference in people's lives.
"For me, it's almost more about an agenda for social justice, not
only to provide people with treatment but to raise issues around
HIV, such as the economic issues that, I think, South Africa is
grappling with now," she said.
"There's a way to respond but at the moment we need to coordinate
that response - I get the sense that if we work collaboratively
across all sectors, there is a chance we can turn things around."