Tasked with leading the South African National AIDS Council (SANAC) through its most ambitious and far-reaching reform yet, Fareed Abdullah has his work cut out for him.
A 2010 review of the country’s national strategic plan on HIV recommended SANAC undergo a variety of structural changes to improve its coordination of HIV responses, monitoring and evaluation.
Abdullah took his post in July 2012 as part of these reforms, relieving Zwoitwaho Nevhutalo, who served as interim CEO following the 2011 departure of Nono Simelela.
SANAC’s third CEO in as many years, Abdullah is veteran of the struggle to improve HIV treatment in the country. He sat down with IRIN/PlusNews to explain how this approach is different.
QUESTION: What reforms have taken place at SANAC?
ANSWER: The biggest change is that we’ve brought implementers front and centre - the provincial AIDS councils. Within our health system, provinces are responsible for most of the key delivery departments, such as health and social services.
We changed SANAC structures to focus on implementation and improve governance. We’ve also broadened the participation of sectors, particularly business, people living with HIV, and the research and science community.
We have two main committees, one which will look at programme implementation on an ongoing basis and the second that will look at the financing of the national strategic plan. These committees are much more streamlined.
An additional change is that we’ve created a separate sub-committee of the financing committee to deal exclusively with Global Fund [to Fight AIDS, Tuberculosis and Malaria]. The Global Fund portfolio has been struggling for a number of years. In addition, we ran afoul of the Fund’s conflict of interest policy, and they made specific recommendations to improve the governance of grants. We’ve now incorporated those changes and addressed the shortcomings.
Q: What’s been done to revive provincial AIDS councils?
A: What makes these reforms very different from previous ones is that the national secretariat has been tied hand-and-foot to the provincial and district AIDS councils. The national secretariat has the responsibility to support and strengthen the councils at the level of implementation, at provincial and district levels.
We now have a regular forum between the national secretariat and heads of provincial councils. Secondly, the national secretariat will provide resources to the provincial councils. Third, and most importantly, we’ve had - in all the provinces - leaders who’ve expressed a new commitment to making these councils work better.
Q: Previous CEOs have said SANAC’s resource mobilization role and limited staffing levels hurt the body’s performance. Will SANAC continue to mobilize resources and, if so, how will this be managed?
A: Resource mobilization is one of the secretariat’s highest priorities, as it has been in the past. Over the last two months, we’ve expanded our capacity; we have three times more staff at the secretariat than we did three months ago.
We’ve opened negotiations with the treasury about additional funding for [HIV] prevention programmes. We have a team of eight people working on the grant renewal process for about five Global Fund grants. We’ve committed two staff members to dealing with PEPFAR [the US-based President's Emergency Plan for AIDS Relief] and the new agreement to co-manage programmes, and we’ll expand [staff] as the needs expand.
Q: What will make this change in leadership different from the others?
A: The difference is that the deputy president has appointed a board of trustees who now, in the last 18 months, have worked hard to get the secretariat going. They did that by making one important decision: SANAC must be set up as an independent institution.
Our first task, then, was to establish the secretariat as an independent body - before, all SANAC staff were on the books of the health department. I’m glad to say that we’ve achieved this over the last six months. We’ve now had our independent institution registered as an employer with the South African Revenue Services and, in fact, I am the first employee of this new intuition.
We have our own board, we have our own budget, and we have our own human resources departments - all done in the last six months so we can be functional. We’d never had a bank account; now we’re operational, and we have our fund invested in the right grant portfolio and have been able to earn a billion rand in interest in the last four months. We were able to provide our first grant as an independent institution - that was to Sex Workers Education and Advocacy Taskforce (SWEAT).
That’s important to get the whole project going. I think that might be the difference and what gives me hope for the future.