1. Presentation to IPU HIV/AIDS Advisory committee Mark Heywood Deputy Chairperson, SANAC

2. The role and place of SANAC in the NSP

3. Civil society in SANAC  17 sectors  Participation in all SANAC structures Plenary Resource Management Committee (RMC) & Programme Implementation Committee (PIC) Technical Task Teams:  Communication  Treatment and Care  Prevention

4. Positive achievements of SANAC  Growing support from government  Legitimacy within civil society  Constant engagement from civil society with different spheres and departments of government  ARV roll-out, over 500 000 people But still meeting less than 50% of need

5. Urgent Challenges:  Effective monitoring and evaluation Framework but no effective system

6. Challenges continued  Financing NGOs Of the government programme: As of 3 November 2008, when we received the order not to initiate patients on ARV in the Free State, we have only been putting children and pregnant women on treatment. Patients already on treatment are still getting their treatment. Drug readiness training has stopped except for the pregnant and kids. There has been reports of deaths among the patients awaiting drugs. The nurses at the clinics are frustrated - the have just been trained to prescribe ARV's and now they cannot do so. Further more they have to face the patients and their families who are getting sicker and even dying. It now also seems that the medicine for those already on ARV's are running out. The ARV pharmacies are constantly borrowing drugs from each other - to the extent that I don't think they know who owes who what any more. At present the pharmacy at National Hospital only has 3TC stock for 2 days - and the depo tells us they have not got much either. The poor patients are also sent from clinic to clinic in search of medicine - making control of drugs almost impossible. Some patients were given private prescriptions for certain ARV'S - who knows how many are taking mono or dual therapy because they cannot afford all 3 drugs. The people running the program in the Free State claim to be totally innocent - that NATIONAL are the ones that cut our funding. I don't care who is at fault but people are dying, and others are deteriorating so that even if we are able to get them on drugs, it will take so long to work through the back log that it will be too late for many. It is a sad situation to say the least.

7. Challenges continued  Delays in taking key policy decisions, NSP chapter 13 ‘Requirements for Effective Implementation’: Male circumcision Task shifting Social security  Civil society sustainability  TB and HIV integration, TB control

8. Challenges continued  Scaling up of knowledge, training and respect for human rights: Oversight and monitoring of human rights practice Non-compliance by government departments and the private sector