Untangling SANAC

This is according to civil society groups and several sources working within the body, which was set up in 2000 to co-ordinate the country’s response to HIV.

SANAC has no budget and is wholly dependent on the Department of Health. It is based at the health department’s Pretoria offices and relies largely on departmental staff to run its secretariat.

This is a far cry from what was promised to SANAC CEO Dr Nono Simelela, former head of HIV/AIDS in the national health department, when she was appointed in August 2009.

The SANAC Trust, which was to be a conduit for donor money, was only set up two weeks ago.

There is also confusion about what SANAC is supposed to do, with some pushing for it to implement AIDS policy at the expense of co-ordinating sectors’ responses to HIV/AIDS.

A strongly worded statement from the SANAC civil society sector, signed by the Treatment Action Campaign, the Congress of SA Trade Unions and others, expresses concern that, despite big announcements and changes in strategic direction, the restructured SANAC secretariat has done little to energise a comprehensive national response to the HIV epidemic.

“Many people from civil society see SANAC as bureaucratic, out of touch, top-down, and unaccountable,” said the statement, which has been submitted to SANAC chairperson, Deputy President Kgalema Motlanthe.It has demanded that SANAC be revived as an effective and accountable institution driven by civil society priorities.

The SANAC secretariat was been singled out as being so ineffective that some members of national structures of SANAC say they have given up on all expectations of secretariat support.

“If these problems are not overcome by the end of 2010 we will reconsider our role in SANAC as we do not wish to be part of a structure that hinders the HIV and TB response,” the statement said.

Various stakeholders interviewed by Health-e accused Simelela and Chief Operating Officer Zwo Nevhutalu of failing to build a strong secretariat and provide strategic direction.

However, Motlanthe has lent his support to Simelela.

“The Deputy President has full confidence in the way that Dr Simelela is running SANAC. He is aware that there are some capacity problems at SANAC, particularly with the secretariat. But this is not the fault of Dr Simelela,” said Thabo Masebe, Motlanthe’s spokesperson

Three senior sources confirmed that the Programme Implementation Committee (PIC), which is the workhorse of SANAC, was supposed to meet once a month but it has only met twice this year.

“There is a distinct lack of leadership. The CEO (Simelela) is supposed to call these meetings but she doesn’t and when we ask, we are told that it is not her job to call meetings,” said one source.

Another HIV specialist said SANAC was being destroyed internally due to “incompetence”.

“We are distressed and disappointed and despite inviting the CEO repeatedly to meet so we can address the problems, we end up being confronted with a flood of tears or she simply doesn’t arrive,” he said.

Vuyiseka Dubula, Treatment Action Campaign General Secretary and a representative in SANAC said that the body had been functioning better between 2007 and 2009 compared to 2010.

“This year at SANAC felt like we were just meeting for the sake of meeting. However, it still remains a relevant and critical structure which needs to provide leadership on HIV/AIDS, TB and STI’s and it is critical they we strengthen it, especially at provincial and district level,” she said.

“Despite the announcement by government a year ago that there were new treatment guidelines, these have not yet been discussed within SANAC. This is despite announcements on how SANAC must support the implementation and track the progress of these guidelines,” said Dubula.

Dr Francois Venter, president of the Southern African HIV Clinicians Society said he was “really disappointed by the poor functioning of the SANAC secretariat after everyone had worked so hard to get it to where it was”.

He said it was now, more than ever, important for SANAC to get it right.

Deputy chairperson of SANAC Mark Heywood said that SANAC had not functioned well in 2010 but that nobody was prepared to give up yet and that he would do everything to save it.

He said the HIV Counselling and Testing (HCT) Campaign was a key yardstick and, although it had made major strides forward it also highlighted SANAC’s failure to communicate the campaign visibly and to mobilise society.

Khomanani, government’s former flagship HIV prevention communication, has not been revived since the previous consortium’s tender ended under a cloud of corruption. Around R90-million for communication has not been spent with a virtually invisible campaign in the run-up to World AIDS Day.

It is understood that health minister Dr Aaron Motsoaledi is concerned that SANAC is not functioning well. However, there is also sympathy that Motsoaledi has more than enough on his plate and was hoping that SANAC would be able to support him in the HCT campaign as well as reaching the NSP targets.

Motsoaledi’s spokesperson Fidel Hadebe refused to comment on SANAC, referring all queries to the council.

The SANAC secretariat, through communication manager Junaid Seedat, responded that the secretariat “has worked hard to re-organise itself into an increasingly effective organisation.”.

The secretariat said SANAC’s organisational capacity had been discussed at the plenary meeting held two weeks ago.

“At the Plenary it was agreed that the various stakeholder groups needed to better resource SANAC’s Secretariat to assist it to develop further. However there was no censure of the secretariat as it was recognised that the secretariat and its CEO are performing effectively.”

It said “legal and institutional changes” that are required to enable SANAC and the Secretariat to function more effectively needed to be put in place.

“These institutional issues are not matters that can be resolved by the SANAC secretariat but they must be addressed by the newly appointed Board of Trustees of the supervisory Trust.”

Source: Health-e News , By Anso Thom and Kerry Cullinan