Newly appointed deputy chairperson of the South African National AIDS Council, the Treatment Action Campaign's Mark Heywood, talks to SABCOHA about the challenges that lie ahead and the role he believes business should be playing.

Over the last six months the process has gone well. We have delivered an effective, far-sighted and ambitious National AIDS Plan around which there is a lot of consensus, and with which most major stakeholders, including business, have been involved. There is now broader support for the new five-year plan than has ever been the case previously. However, a piece of paper is one thing and implementation, another. SANAC has a key role to play in implementation but this still has to be constructed.

What role should business be playing?

Individual sectors have key responsibilities and business with its resources and capabilities should not wait to ask to discuss how to implement (the plan) at every level. It should also not be left to SABCOHA to initiate the process. Busa and other business organisations should have discussions on the document and look at the practical role they can play. Business plays an important role on other issues, it can do so too on HIV. There are many examples where business does play a positive role. For example, Anglo American, under the leadership of Brian Brink, now has some of the best HIV/AIDS practices in the workplace. They have created a culture where stigma has started breaking down; there is an increase in people testing voluntarily, an increase in people on treatment and a decrease in productivity decline.

But aren't many other companies playing this role too?

Business has to take a ‘business approach' as opposed to a ‘non-business approach' to HIV. It's about setting targets, assigning the right staff to manage the process ... this is very different from paying lip service, from writing a couple of policies to make it look like you're doing something about HIV but are really just doing business as usual. Generally, the business response to HIV is poor, big business's response to HIV is poor. Business needs to look not just at what it does individually but at how to combine its efforts and particularly help small business which is at sea at this point.

SABCOHA is a partner in BizAIDS, a project to help small businesses in the fight against HIV/AIDS.

SABCOHA functions as an NGO. It may be supported by business to some extent but ... it is not the operations room of business's response on HIV/AIDS. Business needs to put its senior faces behind the epidemic to be seen to be dealing with it ... I don't often support government but if government can have several cabinet ministers and senior officials (involved in SANAC) we should see the equivalent from other sectors. We see the likes of Cosatu's Zwelinzima Vavi, the government's Frank Chikane ... Where are the Tokyo Sexwales and Lazarus Zims from the business side? This is an indictment.

Why aren't these business heavyweights in the forefront of efforts to stem HIV/AIDS?

My view is that sub-consciously business doesn't really see AIDS as its responsibility. The sectors of industry that are heavily affected such as mining and transport are responding better but I don't think that business, like government, has internalised the long-term consequences. They think it won't mess up the economy - the most affected are the unemployed or easily replaced unskilled workers - but they are not thinking about how AIDS will destroy the social fabric which will have an impact on the business environment and the economy generally. We are losing economically active adults who are leaving children behind who are not being educated or fed ... This will impact on the general skills level of the South African workforce. It will have many other impacts that people have not thought through.

Are you positive about the new spirit of co-operation between government and HIV/AIDS activists?

The new co-operation in SANAC is genuine but it doesn't go deep enough in government. There will obviously be stresses in the months and years ahead, which this is not surprising because it's a complicated thing to do and there are complex policy decisions that need to be made.

I am still worried about leadership of the Department of Health. (HIV/AIDS) is not just a health issue but the Department of Health has a central role to play. If Health Minister Manto Tshabalala-Msimang comes back and there is a new period of ambivalence, false juxtapositions of ideas against each other, false juxtapositions of one priority over another, we won't break out into the same level of conflict of previous years but it could slow things down tremendously. If we lose momentum, we won't achieve anything like the ambitions we have set out in the plan. The impediment may not be the old denialism that was encountered but if the minister stills holds the view that the problem of HIV is grossly exaggerated, that there is too much spending on it to the detriment of other illnesses, this will slow progress.

What about working closely with Deputy President Pumzile Mhlambo-Ngcuka, chair of SANAC?

I'm positive as long as Phumzile (Mlambo-Ngcuka) continues to play a leadership role. I hope to establish a close working relationship with her. It is too early to say how deep that co-operation will go but I do have the feeling that she understands what needs to be done. The way I see her now, she is very serious. The only real concern is the health department (at a political level) ... I also haven't seen anyone in senior government who understands the pivotal relationship of health to the economy and the effects of good health versus bad on the economy and the differences it makes to the economy if you increase investment in health ... the health ministry is a very strategic one.

What about president Thabo Mbeki? Has his stance changed?

I am told the president fully supports the process that has been undertaken in the last six months. Phumzile (Mlambo-Ngcuka) couldn't do what she was doing if he hadn't given her the authority to do so.

Would you find it difficult to continue as deputy chair of SANAC if the TAC and government are pitted against each other again?

I would have no discomfort if the government and TAC were at loggerheads again but I do not expect that we will be. My intention is to try and make this position work. As we've always said in the TAC, we have to make government work. If there is conflict, we won't seek to avoid it but now that doors are open again, and with the new mood, there will hopefully be other ways to solve conflicts. However, we won't shy away from matters of principle, just because of this new relationship. For example, I am centrally involved in the recent court action around discrimination of HIV-positive people in the South African National Defence Force. This is a matter of principle.

But if in six months time I feel we're not getting anywhere because of the kind of resistance we've seen earlier. I won't hold onto this position for the sake of the position. Part of government has gone out of its way to find trust with us and we have to reciprocate. The real challenge is getting these progammes in place. Only in three months time will we be able to say there has been hard commitment to this process.

What are some of the challenges around the implementation of the National Strategic Plan?

The biggest implementation challenge concerns human resources - particularly regarding the health component. This is a big challenge for business too: how do we get the public and private health sectors to work in synergy? The private sector is absent when it comes to providing anything other than looking after their relatively small number of HIV/AIDS patients on medical schemes. The public health sector has been dumped with the whole thing. It can't generate the doctors and nurses needed overnight. We need a sensible strategy to work with what we've got. We need serious discussions between the public and private sectors on how to manage this. The public health system is bursting at the seams - we do not have enough counsellors, pharmacists, etc in rural areas and yet there is a surplus of staff in the private sector. But to be fair to the private sector, any suggestions of help from them in the past have been rebuffed by Tshabalala-Msimang.