Aids and the Church: How Far We’ve Come

Sr Alison Munro OP – The Catholic response to the HIV/Aids pandemic has in many ways led the way. SR ALISON MUNRO explains what the SACBC Aids Office has done and looks at some of the new challenges.

The Aids Office of the Southern African Catholic Bishops’ Conference (SACBC) has provided a coordinating role since 2000 for the response of the Catholic Church to HIV and Aids in our region.

It replaced a previous poorly-funded programme at the SACBC at a time when HIV and Aids was escalating out of control in parts of Sub-Saharan Africa, and when life-saving antiretroviral treatment was not available in the public (government) sector.

There was a great need for funding and advocacy. More was required than what the Church alone could provide, even with increased funding.

Additional obstacles to giving people a second chance at life came from the government and its Department of Health through their refusal to recognise that HIV causes Aids, and their refusal to make antiretroviral drugs available.

Much advocacy, supported by the Catholic Church and the SACBC Aids Office, and a court case, finally compelled the government to provide drugs in the public sector.

Church’s pioneering role

Today South Africa has the largest antiretroviral treatment programme in the world—in addition, of course, to the highest number of people infected with HIV.

The Catholic Church played no small part in ensuring the initiation of many people on treatment, some of them in places where the Department of Health began its programme only later.

Today those patients are part of the government’s programme, and the Aids Office focuses attention on orphaned and vulnerable children, a group still unevenly provided for by both the Departments of Health and of Social Development.

The Church, through dioceses and local parishes, and in collaboration with schools, engages with local communities where the children live, and with government organisations at sub-district and district levels, trying to ensure that children and their guardians receive health, education and social services.

While these services are a right according to the Constitution of the country, they are not always delivered by government agencies, especially in more rural areas.

South Africa is a secular society, but one which includes many faith traditions.  New churches, and faith-based organisations continue to spring up, not all of which subscribe to the values that underlie the Catholic Church’s response to the poor and marginalised members of society.

There is an uneasy relationship between the institutions of faith-based organisations and government and the governmental organisations.

In the post-apartheid period there have been various overtures from the government to relate with Church and other faith leaders, an enormous challenge because of the impossibility of bringing people of all faiths into one body speaking for all of them.

Various networks or loose organisations have existed or do exist, but none can be said to include even representatives of all the different faith groupings. There is no one faith response around development issues, notwithstanding that most faith communities do render services of various kinds to people in their constituencies and beyond.

The Catholic engagement

Putting Gospel values and Catholic Social Teaching into practice has always been at the heart of what members of our own faith communities and their collaborators do.

Catholics rendering HIV and Aids services are often asked whether they serve only other Catholics. They don’t of course. And because Catholics number only approximately 7% of the total population of the country, it is true that the Catholic Church punches above its weight when one looks at the numbers and varieties of services offered, and the numbers of people reached in the various development programmes undertaken.

It is known that non-governmental organisation (NGOs), including faith-based organisations, provide an enormous service to people, often drawing on the services of unpaid volunteers or people receiving only small stipends. Were these services to be withdrawn, the picture around service delivery would change drastically.

Studies that have investigated the value of such volunteer services have demonstrated the costs saved by the government because people are providing the services it can’t or won’t provide. Faith organisations are often better placed to reach people far from government clinics, or people who do not readily access those services.

Despite sometimes difficult relationships and very little financial support, the government and governmental organisations nonetheless do expect the faith communities to be able to provide services they themselves are unable to provide.

Clearly this ambiguous situation has its particular challenges regarding implementation of projects, even when collaboration is presupposed.

Engaging with the government in this regard is not always easy, whether nationally or locally.

The voice of the Catholic Church is one that is recognised, at least on some occasions, even if not always appreciated.

Funding demands have required that more people are reached, not so much with direct service delivery, as with what is now being called technical assistance.

So rather than having the faith-based organisation providing all the services, it is expected that these organisations do what is necessary to ensure that services are accessed where they are available, for example at clinics, from a variety of NGOs, and from the private sector.

Bluntly put, this can mean that the faith-based organisations are landed with the work of government agencies, but not always getting the recognition for what they are doing.

Problem of cooperation

Problems also come when individual members of government seek out the collaboration of particular faith leaders, to the exclusion of others, and yet give the impression that what they hear is the voice of faith leaders in general.

Equally problematic is the unwillingness of some faith groups even to engage with government agencies, as well as the unwillingness of such agencies to work with faith-based projects in their local areas.

Some of our local Aids projects foster good reciprocal cooperation with government and other agencies.  Elsewhere there are challenges.

South Africa itself receives aid/funding for part of its HIV and Aids programme from PEPFAR and the Global Fund, but has increasingly been expected to provide services, and show the effects of development/take responsibility for its own HIV and Aids problems.

As a country, South Africa is now spending more on HIV and Aids than it did previously, and funding from PEPFAR, the Global Fund and various donors has been greatly reduced.

The Department of Health has to think differently and draw on the services of the churches/faith communities to assist it to be more effective in its provision of healthcare services to people on treatment and to vulnerable children.

Never may cooperation be taken for granted or guaranteed. Committed and serious work to make it happen and maintain relationships is needed.

Sr Alison Munro OP headed the SACBC Aids Office until early this year.