South Africa: Northern Cape Forgotten in South Africa's Strategic Plans to Fight HIV & Aids

analysis

Life Line Northern Cape (Life Line NC) is a community organisation based in the Sol Plaatje local municipality in Kimberly. Life Line NC is registered non-profit public benefit organisation with focus on four pillars: HIV&AIDS, sexual assault and gender-based violence; emotional wellness; and training. Life Line NC has a specific focus on key and vulnerable populations. The Kimberly-based organisation, which started operation in 2009, extends its services beyond Sol Plaatje local municipality and has beneficiaries throughout the Frances Baard and John Taolo Gaetswe District Municipalities.

The key and vulnerable populations that Life Line NC services are those identified in the South African National Aids Councils Strategic Plan 2017-2024 (National Strategic Plan). The National Strategic Plan is a roadmap to guide the national efforts of government, donors and community stakeholders in the nation's fight against HIV & Aids and Tuberculosis.

These key population groups as identified by the National Strategic Plan include sex workers, gay and bisexual men who are sexually active, transgender people, prisoners and people who inject drugs. Vulnerable populations groups are members of the lesbian, gay, bisexual, trans and intersexual community; migrants; undocumented foreign nationals; young women between the ages of 15 and 24 years; people living in remote areas, informal settlements and near national roads; people with disabilities and mental disorders; and children in general. These key and vulnerable population groups are people who often face stigma, isolation or some danger from their communities and societies. Life Line NC's offices in Kimberly used to have a well-equipped clinic that was accessible to the key and vulnerable population groups and community members in the surrounding area; however this has had to be closed due to the funding challenges.

Ms Brende Haaker, founder and Director at Life Line NC, leads a team of qualified and registered nurses, community outreach officers and professional counsellors - some of whom are specialists in HIV & Aids counseling. In addition, the organisation runs programmes to take HIV & Aids testing to key and vulnerable populations in rural and remote areas using their two mobile clinic vehicles. The community outreach officers and professional counselors also run programmes which take STI treatment, pre-exposure prophylaxis (Prep) medication, screening services, psychological support, condoms, emergency contraceptives, trauma counselling, referral services and other health care services to prostitutes, gay men, transgender people and drug addicts in remote areas. The programme ensures that people who normally would not want to go to public clinics because of existing stigmas around them are able to access these services, which are considered as vital in fighting the spread against HIV & Aids and TB.

Though Life Line Northern Cape started operating in 2009, the organisation expanded its services in 2014. The growth in services was made possible by the global fund support received through Nacosa for a programme focusing on sex workers, as well as funding that came in via Right to Care for Transgender rights and the MSM programme. According to Ms Haaker, the organisation through its programmes has made great strides in building trust and relationships with the key and vulnerable population groups in the districts in which it works. Life Line NC spends much of its time and resources prompting communities and beneficiaries to practice safe sex and get early HIV testing and treatment to reduce its spread.

According to Brende In 2018, the Northern Cape provincial government informed civil society organisations (CSOs) who were beneficiaries of international the Global Fund that they would no longer be able to access this funding for programmes aimed at fighting HIV & Aids and TB. The Provincial government informed CSOs that this was due to the fact that the Northern Cape province is not included in the current National Strategic Plan's focus on fighting HIV & Aids; and as a result, international donors would be discouraged from channeling resources to organisations in the province.

The South African National Strategic Plan for HIV, TB and STIs 2017 - 2022 (NSP) serves as a roadmap for the next stage on dealing with South Africa's public health problems. The purpose of the NSP is to enable the multitude of organisations and individuals working on the response to HIV, TB and STIs to move in the same direction and to coordinate their actions. The plan defines a number of goals including Goal 5 which speaks to grounding the HIV, TB and STI response in human rights principles and approaches.1 According to these principles it is thus imperative that all key populations are included in the response, with an eye towards achieving the substantive equality the Constitution envisages. It also requires working towards geographic equity and equal distribution. The Constitution mandates the state to respect, protect, promote and fulfil the rights in the Bill of Rights, including the rights to life; freedom and security of the person and access to health care and other services. Since the funding gap created by this decision has not yet been addressed by government, this leaves CSOs who are supporting the state unable to provide services required to give effect to these rights.

According to Brende May 2019 was when Life Line NC started feeling the impact of not being able to access the Global Fund for programmes aimed at fighting HIV & AIDs. Funds that they had previously received from the Right to Care for Transgender and MSM programme depleted and their prospects of attracting other international funding decreased. The organisation has since been struggling to mobilise international funding due to the current situation. This despite the impressive work Life Line has done in the in Northern Cape, servicing a large community of beneficiaries.

This has had a devastating impact on Life Line NC. The organisation has lost over 90% of its income and has had to scale down more than 80% of its programmes and activities. Since May 2019, Brende has been unable to pay staff and volunteers, which puts the organisation under the constant threat of losing skilled workers as well as losing contact and relationships with key and vulnerable population groups.

Since 2018, when provincial government shared the news with CSOs, Ms Haaker has mobilised community organisations and engaged provincial government to resolve this issue. In September 2019, Ms Haaker, who is also a participant in Democracy Works Foundation's Civil Society Participation in Provincial Legislature programme (CSPPL), approached project staff to support the organisation in reaching out to the provincial legislature in the hope of resolving its challenge through that avenue.

In October 2018, Life Line NC submitted a petition to the provincial legislature. In the petition LifeLine NC outlines the difficult financial situation they find themselves in and how this situation has limited their ability to reaching targets that they committed themselves to in fighting HIV/ Aids infections. The submission also shares the plight of many other affected organisations that had to close due to not being able to access the Global Fund. The submission raised the concern that the Northern Cape Province is the only province that has been impacted on this way. Through the petition Life Line NC requested the provincial legislature to take the Northern Cape's challenge before the National Council of Provinces (NCOP), the body with the constitutional mandate to represent provincial interests at a national level. The organisation also asked the Legislature, to join hands with it in bringing this serious matter to the attention of the national government and influencing the decision to change.

At time of writing, Ms Haaker had not received an official response from the Northern Cape Provincial Legislature, other than that the petition has been received. Since then, LifeLine NC has raised this issue at a meeting with the Legislative Sector Support Unit; has held virtual meetings with Members of Provincial Parliament, and participated in virtual parliament for women, hosted by the Northern Cape Provincial Legislature.

While the Northern Cape Provincial Legislature has not issued official correspondence, we have heard through word of mouth that the petition has been received and communications has taken place with the executive branches. Despite the fact that we have not had official responses to the very specific requests made, Brenda Harker remains hopeful that the Provincial Legislature will see the importance of using its influence to pressurise national government to again enable the Northern Cape to access the Global fund and be able to contribute positively in the country's strategic plans to fight HIV & Aids and TB and to ensure that all citizens - including key and vulnerable groups - get access to HIV & TB prevention services and support through the collective efforts of government and CSOs.

Lesego has a background in governance, policy development, and research. He previously worked at the North West University in Student Life, where he focused on student leadership development and training. His academic highlights include being part of the Linnaeus Palme International Exchange Programme in Sweden. He holds a BA Law and BA Honours in Political Studies and is currently studying towards his MA with a research focus on Legislatures and Democracy in the continent at North West University.

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