Betreff: South Africa: Why the TAC supports COSATU
Datum: 1 Oct 2002 18:00:28 -0500

Why the TAC is Supporting the COSATU Anti-Privatisation Strike

On the 1st and 2nd of October, Treatment Action Campaign (TAC) members in Kwazulu-Natal, Gauteng and the Western Cape will be participating in the COSATU anti-privatisation strike activities. Some of our members will carry placards saying "Invest in the Public Sector", which is a key TAC message. The TAC is supporting COSATU's strike because investment in the public sector is crucial for ensuring South Africa's development and alleviating the worst effects of the HIV epidemic.

TAC calls on other organisations to come out in support of COSATU, including health professionals, religious organisations, NGOs, CBOs and AIDS Service Organisations. In our view, COSATU's action must be a mass demonstration to demand policies to combat poverty, unemployment and HIV/AIDS.

Over 5 million people live with HIV in South Africa. Over the next decade nearly all will require treatment for opportunistic infections and most will eventually require highly active antiretroviral therapy to continue living.

Yet, the public health system is inadequately funded to deal with this crisis. Since 1994, real per capita spending on public health has decreased, despite an increased need for service due to the HIV epidemic. More than 50% of South African health-care spending goes to the private sector, yet the public sector is responsible for more than 80% of the population. Many hospitals and clinics throughout the country are unable to hire more doctors and nurses because positions have been frozen. Public sector health-care salaries are uncompetitive, resulting in an inequitable distribution of resources between the public and private sectors and the loss of health-care workers to other countries. Throughout the country's public hospitals and clinics, one finds bed shortages, facilities in disrepair, demotivated, poorly trained staff, long queues and medicine shortages.

The recently released report by the UCT Centre for Actuarial Research (CARE) indicate that Government can prevent nearly 3 million AIDS deaths and new HIV infections by 2015. However, this will be impossible without considerable investment and increased per capita public health spending.

A costing analysis of the outputs of the CARE report (undertaken by the TAC) reveal that at current health spending, it is highly likely that the Department of Health is failing to meet its limited current commitment to treating opportunistic infections in people with HIV/AIDS. This is in breach of the Constitutional right to health-care; the situation will become substantially worse in years to come without a reversal of current Government policy. Furthermore, the burden of the HIV epidemic is resulting in people without HIV receiving worse service.

However, a decent quality of life extends beyond access to health-care. Millions of South Africans remain without access to adequate housing, clean water and sanitation, electricity, telephones, education, security, transport and basic municipal services. Government has made significant progress in some of these areas, but much more needs to be done and adequate progress will only be possible with increased public investment and with a halt to the privatisation of essential services, such as water, transport, local telephones, health care and education. In a country with such high levels of poverty and unemployment there is no market for many essential services - but there is great demand. Therefore selling off essential services to 'for-profit' organisations only excludes more and more people from access to essential social services.

Some examples of this are: In 2000, 30% of houses were still without electricity (and many that do face regular cutoffs). Access to clean water has increased since 1995, but the actual number of dwellings with running tap water has dropped (1999 statistic). Although formal housing increased by about 660,000, the number of informal dwellings doubled to over 1.3 million between 1995 and 1999. Although access to flush toilets increased during the 1995 to 1999 period, access decreased marginally in rural areas.

There were marginal improvements in access to refuse removal between 1995 and 1999, but the situation actually got slightly worse in rural areas.

This situation has parallels with the problem of access to essential medicines in Africa. Although there is a great need for medicines and health care services, there is no profitable market. Consequently tens of millions of people die of treatable and preventable illnesses. On its own the private sector cannot deliver health care. There is a desperate need for governmental investment, supported by bodies such as the United Nations.

While Government has made progress in public services, there has been insufficient investment and political will to meet the expectations of millions of poor people. The Government's privatisation programme is likely to result in a stagnation of these gains, because of the lack of incentive for private companies to provide service delivery to communities that do not have money.

So far, privatisation of water has been fraught with pitfalls. One contract has been nullified in Court (Fort Beaufort). Others have resulted in renegotiations after short time periods that have resulted in reduced services and increased prices (e.g. Siza at Dolphin Coast in KZN). An official from Vivendi, a multinational water supplier, has admitted that private investment in water in Africa will only be viable in big cities where per capita GDP is higher and, if necessary, Governments guarantee revenues (COSATU paper on privatisation). The same issues permeate the privatisation of other essential services.

The Labour Force Survey estimates that unemployment was 37% in 2001 (expanded definition). The Government acknowledges that unemployment is a serious problem, yet privatisation initiatives have resulted in substantial job losses. Furthermore South Africa's massive unemployment has resulted in enormous destitution and lack of food security.Lack of access to adequate nutrition exacerbates HIV and poor health-care. The privatisation of grant payouts, especially pensions, has resulted in corruption, long queues and inefficiency. Government must invest in the grant system to remedy these problems. In particular a Basic Income Grant would assist poor families with covering their essential material and nutritional needs.

It is for these reasons that the TAC endorses and will actively support COSATU's strike. Public investment since 1994 has resulted in improvements to the material well-being of many South Africans, but only a massive increase in this investment will meet the needs of the millions of South Africans whose standard of living has not improved since 1994. Only increased public investment, especially in health-care, sanitation and social grants, will prevent the development that has taken place since 1994 from being destroyed by the HIV epidemic.