NACA shutdown
Tefo Pheage | Friday October 30, 2015 18:00
The government has, amid tension and fear from stakeholders, resolved to dissolve National Aids Coordinating Agency (NACA), an iconic government organisation that has been instrumental in the fight against HIV/AIDS.
Mmegi has established that government has decided to dissolve the organisation and integrate it into the Ministry of Health’s HIV/AIDS department.
Confirming the decision, the assistant minister of health, Dr Alfred Madigele, told Mmegi that the move was undertaken as part of the recent rationalisation exercise that was conducted two years ago by a special taskforce. He said the consultations and processes were expected to be complete next year March or April.
Madigele said it should be understood that the agency, which was formed under the Ministry of Health, was moved to the Ministry of Presidential Affairs in the early 2000s because the pandemic was at its worst, threatening to wipe out the nation.
“We are not saying we have won the fight but the situation has stabilised,” he said. “Moreover one reason why the agency was taken under the president was to facilitate funding but Botswana is now a middle income status country and funding has been dwindling as a result.”
NACA was established through a Presidential Cabinet Directive on December 14, 1999 at the Ministry of Health. It was later moved to the Ministry of State President with full-fledged ministerial portfolio and mandate. It was tasked with developing and supporting partnerships, harmonising, coordinating and facilitating implementation of the national response to HIV and AIDS.
The establishment of NACA was borne out of the realisation that HIV and AIDS had not only become the most important public health challenge facing the country, it also posed the most serious challenge to Botswana’s future socio-economic development.
The National Response came into being in 1987 as the then National AIDS Control Programme (NACP) under the Ministry of Health. A one-year Short Term Plan (STP) was developed to fast track the country’s response against HIV and AIDS. This was followed in quick succession by the development of the Medium Term Plan (MTPI) which covered a five-year period. During this period, the Ministry of Health coordinated the National Response, largely from the standpoint of a health problem.
The revised National Policy on HIV and AIDS articulated the government’s concern and position hence provided more encompassing guidelines. The policy marked a shift from a health-sector led response to a multi-sectoral one.
As a result the development of the Medium Term Plan (MTPII – 1997-2002) was underpinned by the pronouncements of the national policy and sought to operationalise these key tenets. Subsequently the National AIDS Council was established to coordinate the National Response with NACA serving as its secretariat.
What happens to NACA staff?
A task force has been set to ensure that the dissolution of the organisation is in order. This includes profiling NACA staff who will be integrated into the Ministry of Health.
However there are challenges. Those whose positions were equal to those who are already with the ministry will see themselves at sixes and sevens. It is understood that employees will have to be integrated under the sectors they were under while at NACA.
This process also means that others will be lost along the way. There has been a suggestion that NACA coordinator, Grace Muzila, may be demoted.
Mmegi has established that some workers have since resigned as a result of this uncertainty despite the government assuring them that no one will lose their job.
Asked about the issues of structure the assistant minister said, “Organisational structure issues are yet to be discussed by cabinet.” He said they are still consulting the relevant ministries and departments over the issue.
Stakeholders in the fight against HIV/AIDS in Botswana are in a state of panic following news that government has resolved to shut down the National Aids Coordinating Agency (NACA) in the next five months.
Stakeholders, particularly the civil society that were working with and reporting to NACA, have expressed concerns at government’s move to close down the agency, arguing that government should not have hurried to close down the organisation.
With guidance from the civil society, NACA has been able to, among others, provide strategic direction and set key priorities in the quest for lasting solutions against the epidemic; develop and support programmes and policies that can deliver on identified priorities; and develop infrastructure, tools and mechanisms used for monitoring and evaluation of progress of the national response.
The Botswana Christian AIDS Intervention Programme (BOCAIP) acting coordinator, Bridget Mphusu, said they are not happy with the decision.
“It is a worrying move,” she said. “We as the civil society have been working so well with NACA without any bureaucratic delays which we all know will haunt us at the ministry.”
Other organisations are worried that the government has not bothered to communicate NACA’s imminent closure with them. The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) Executive Director, Cindy Kelemi said, “As BONELA, a key stakeholder in the national response to HIV/AIDS in Botswana, we have not received any formal communication about how the integration of NACA into Ministry of Health will be effected.”
“However, we need to remind ourselves as to why NACA was established in the first place. And whether this function can still be performed in an integrated approach to health. It is also important to understand whether NACA will still maintain its current form in terms of structure.
But given the absence of detail regarding the relocation of NACA, it makes it very difficult to make this assessment,” Kelemi said in response to Mmegi.
“Coordination of the national response to HIV/AIDS should not be compromised by this move,” Kelemi said. “We want to see enhanced coordination of existing structures and a more robust management of the different players in the national response to HIV/AIDS.
She stressed that the multi-sectoral response to HIV/AIDS should be maintained and enhanced
“Communities including civil society should be recognised as equal partners in the fight against HIV/AIDS,” she added. “Therefore the integration of NACA into MoH should clearly define the structures of engagement.” She said they hope that the move will contribute towards health systems strengthening and that NACA will improve the functionality of Ministry of Health.
BONELA said they also hope that the move will still maintain HIV as a major health problem in Botswana, therefore allocation of resources will continue to recognise this fact.
The objectives of the NACA have been to, coordinate, develop and provide overall HIV and AIDS policy direction for the national response as well as coordinate and develop the national HIV and AIDS Strategy setting out priority goals to guide planning for all sectors.
The agency was also tasked with harmonising national and sectoral plans and programmes and facilitating mainstreaming of HIV and AIDS into national, district, private and civil society strategic plans.
It was further mandated with developing a national HIV and AIDS Monitoring and Evaluation Framework for the national response as well as coordinating the development and implementation of a national research agenda.
NACA recently received a P300 million global funding. It is understood that the government was of the view that NACA was duplicating the ministry ‘s functions. HIV/AIDS activist and the first Motswana to go public about his HIV positive status, David Ngele, also expressed worry about the move, “I don’t think it is a matter of dispute that the efficiency and effectiveness of the ministry will beat that of NACA.”
NACA was responsive and quick but ministries are generally slow to respond to issues.
“By being swallowed into the ministry, I see a few challenges resurfacing in the long run, but it is true that the issues that gave birth to NACA are no longer existent,” he said, further adding that those who will suffer the most are the civil society and the education part which was effective.
NACA takes the responsibility to ensure that HIV and AIDS is mainstreamed in the day-to-day mandates of sectors. The National Strategic Framework (NSF 2003-2009) outlines the roles and responsibilities of NACA and those of other sectors involved in the delivery of the Minimum Internal Package (MIP).