Mpumalanga Premier Mandla Ndlovu puts officials on notice over HIV response

Mpumalanga Premier Mandla Ndlovu has demanded an end to “paper strategy” in the province’s fight against HIV, warning officials that underspending and misallocation of donor funding were compromising frontline services.

Barely a week after declaring government’s policy implementation “dololo”, Ndlovu turned his sights on the provincial HIV response on Tuesday, demanding aggressive execution, locally targeted budgets and accountability from structures charged with fighting the epidemic.

READ: Government’s policy implementation ‘dololo’: Mandla Ndlovu tells Mpumalanga workers

Addressing the Mpumalanga Provincial Aids Council multi-sector dialogue, Ndlovu said money provided by funding agencies and development partners needed to translate into results on the ground.

“Every cent of conditional donations from our funding agencies and development partners must be deployed efficiently,” he said.

“Underspending or misallocating these funds directly compromises our frontline capabilities.”

He then delivered his strongest message to officials:

“The way forward demands that we step away from pure paper strategy and push into intensive, aggressive execution.”

Old numbers demand new approach

The urgency comes against a stubborn HIV burden that Ndlovu’s administration has inherited and is now under pressure to reduce.

READ MORE: Concerns as Mpumalanga shows alarming HIV infection rate

The latest major HSRC survey estimated that about 7.8-million people were living with HIV nationally in 2022, when prevalence stood at 12.7%. About 890,000 were in Mpumalanga, which recorded the country’s highest provincial prevalence at 17.4%.

That was nevertheless an improvement from Mpumalanga’s 19.4% prevalence recorded in 2017.

Ndlovu acknowledged the progress but said it was insufficient.

“Whilst our provincial HIV prevalence rate dropped from 19.4% to 17.4%, Mpumalanga still carries the highest prevalence burden in South Africa. Gert Sibande District remains an epicentre at 20.5%.”

He demanded “immediate, localised models” for Gert Sibande.

Young people remain vulnerable

Ndlovu also highlighted young people aged 15 to 24, saying they accounted for 16.9% of people living with HIV who remained unaware of their status.

While viral-load suppression stood at 82.5%, he said too many patients were interrupting treatment.

“We must aggressively track down and support the missing patients who have absconded from their antiretroviral treatment,” Ndlovu said.

His tougher implementation message comes as Mpumalanga is among the provinces rolling out twice-yearly injectable lenacapavir for HIV prevention.

READ: HIV prevention jab is finally here, now comes the hard part

Councils told to account

Ndlovu said district and local Aids councils could no longer simply carry provincial policies on paper. They must use local data to determine priorities and ensure available budgets followed those priorities.

He called for a frank examination of logistical bottlenecks and told officials to challenge systems that were failing to produce results.

Most significantly, he demanded that those involved in the provincial HIV response “hold one another accountable for the commitments we have made”.

The approach follows Ndlovu’s criticism last week that government had good policies but poor implementation, which he described as “dololo”.

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