COSATU is responsible, leadership is responsible, members are responsible – getting to zero on non-discrimination is our responsibility.
As the world commemorates World AIDS day it is important that we as a country ask ourselves if we are doing enough, given that the HIV epidemic in the country is still at a very high and unacceptable level.
Communities are still being infected by HIV; there is stigma and discrimination; babies are still dying through mother-to-child transmission; TB infection is increasing and control is very low.
The WHO has recommended that countries consider a CD4 count of 350 to provide citizens with ARV, and we applaud our government for implementing the recommendation, so that today we have 1.59 million people receiving ARVs.
We have noted that the National Strategic Plan (NSP) for HIV and AIDS, STIs and TB for 2012-2016 envisages achieving universal access and would like to see a clear implementation programme and budget for this objective.
The government contributes about 40% of all its expenditure on health, 11% of the government's total budget, which is allocated and spent by the nine provinces. The public health sector provides services to about 80% of the population. The question is: will government and the department of health achieve its target to have 2.6 million people on ARVs within 2013 and 2014?
Tuberculosis continues to be the worst killer of people living with HIV in South Africa, despite there being medication to cure it; the new NSP 2012-2016 is providing for co-infected patients to be placed on lifelong ARV treatment regardless of CD4 count, and this must be given priority. It is not acceptable that we still have people who can die due to TB. We must also guard against people getting the dangerous multi-drug resistant and extreme drug resistant forms of TB.

The country’s new TB and HIV integration guideline, provides for nurse-initiated TB and ARV treatment at the primary health care level, but how far are the all the health care workers being trained on these matters? If this is not done adequately we might not achieve our goal to cut in half the number of new TB infections and TB deaths by 2015.

We have noted that last week the Global Fund to Fight AIDS, Tuberculosis and Malaria has taken a decision to not continue with Round 11 grant approvals. This will have a huge impact on the country. South Africa’s Round 10 Global Fund grant was $302 million over a five year period for the prevention, treatment and care of HIV/Aids and TB.

Of this, $196 million is allocated to ARVs, $33 million for medical male circumcision, $10 million for strengthening health systems and community response to HIV/Aids and TB, and $8 million for direct support of TB programmes.

A total of $128 million, 65% of which is allocated towards the provision of ARVs, has been approved for the next two years. This sum is in addition to the health department's R4.28 billion tender for the procurement of antiretroviral drugs. Given all this, does government have its own budget to continue without any outside funding, and if not what are we going to do to make sure that we have our own funds to protect our own citizens?

We believe that this must be a lesson for the country that as much as we expect the world to provide aid, we must also have our own measures to provide as stipulated in the constitution.

As COSATU we would like to bow our heads for all the people that have died of AIDS, and further commemorate the day by asking and encouraging every person to be responsible and know their HIV status, support every person with HIV, support all the orphans, and encourage government to take the struggle against HIV to a higher level.