RESEARCH BRIEF ON South African Cities and the Challenge of HIV/AIDS:



This brief summarises the main findings and actions of the South African Cities Network (SACN) report on local government responses to HIV/AIDS.


In South Africa there have been a number of initiatives launched to support local government authorities in developing a response to HIV/AIDS. However, to date there has been no concerted attempt to take stock of the challenges facing cities in crafting and implementing mitigation strategies. The South African Cities Network (SACN); a recently established alliance of South African cities and partners that encourages best practices in urban development and city management have embarked on such an effort.

The current members of the SACN are as follows:

South African Cities Network – HIV/AIDS Mainstreaming Programme Research Brief Jan 03

  • Buffalo City Municipality (East London)
  • City of Cape Town
  • Ekurhuleni Metropolitan Municipality (East Rand)
  • EThekwini Metropolitan Municipality (Durban)
  • City of Johannesburg
  • Mangaung Local Municipality (Bloemfontein)
  • Msunduzi Municipality (Pietermaritzburg)
  • Nelson Mandela Metropolitan Municipality (Port Elizabeth)
  • City of Tshwane (Pretoria)

South African Cities Network – HIV/AIDS Mainstreaming Programme Research Brief Jan 03

The SACN focuses on research and information sharing on issues central to the sustainability and performance of cities. The HIV/AIDS Mainstreaming Programme has been a priority of the SACN since its inception in 2002. In an effort to assess the readiness of SACN members to counter HIV/AIDS in their respective municipalities, this report was commissioned to meet the following objectives:

  • To describe the problems and challenges facing cities in mitigating effects of HIV/AIDS
  • To document emerging models and frameworks for responding to HIV/AIDS at city level
  • To provide a resource for cities to learn from innovative approaches currently used in other cities.
  • To inform the development of the SACN HIV/AIDS programme and facilitate tailored mainstreaming initiatives in member cities.

South African Cities Network – HIV/AIDS Mainstreaming Programme Research Brief Jan 03

Key Findings

Across the board South African cities are grappling with newly mandated responsibilities including an ever-expanding developmental agenda. As a result of the recently completed demarcation process, municipalities throughout the country and more especially the nine largest cities have been tasked with balancing the requirements of restructuring to absorb redundant structures while concurrently delivering basic services to households and industries within municipal boundaries. It is within this context that cities have been challenged to develop and execute a comprehensive response to HIV/AIDS.

There is universal acknowledgement of the urgent need to address HIV/AIDS. However there are a number of structural barriers to establishing a satisfactory HIV/AIDS response. Chief among them has been:

  • The need for capacity—vacant posts, delays in appointment, lack of financial resources to complete hiring process have contributed to a the response at local government level
  • An absence of strategic planning at city level around this issue and its consequences.

These items represent major challenges to formulating appropriate infrastructure and adopting sustainable HIV/AIDS responses. All of the SACN cities have begun developing HIV/AIDS programmes. However progress to date shows the most effective programmes have been those that transcended the gap between policy development and consistent implementation. The following elements were found to be critical success factors in the SACN cities:

  • Community mobilisation and capacity building
  • Partnerships
  • Co-ordination
  • Multi-sectoral focus
  • Effective use of information

They also form the basis for a tool developed to measure the efficacy of existing responses and areas for attention.


The challenges outlined in the previous section are sure to become more acute in the near future as the National Department of Health develops a programme for the national rollout of anti-retroviral therapy slated for 2004. Local government will continue to be the agent for national government and tasked with tailoring programmes for their communities. With this in mind, cities are positioned to adopt the following key strategies in the development of a comprehensive response to the pandemic:

  • Take stock of current HIV/AIDS programmes that are functioning within the municipality. This means learning what stakeholders in other sectors are doing to mobilize funding, human resources and public support in their activities and look for linkages with municipal programming or ways in which the municipality can assist these programmes to reach larger areas of the community.
  • Link HIV/AIDS programming to other developmental issues such as poverty alleviation.
  • Develop clear guidelines for mainstreaming such that it becomes an activity that all municipal departments can identify and prioritise activities directly related to their functions that can be included in an overall mainstreaming policy.
  • Develop stronger intergovernmental relations with provincial and national government across sectors in the implementation of national AIDS strategy.

The SACN will use the above recommendations to strengthen its programme of support to members cities through the following activities:

  • Promoting a shared-learning partnership between different spheres of government to support the governance of South African cities
  • Collecting, analysing and disseminating the experience of large city government in a South African context
  • Promoting innovation and strategic thinking between cities and other spheres of government
  • Fostering cooperation and exchange of best practice

Through strategic alliances, the SACN will continue to encourage best practices in urban development and city management

South African Cities Network – HIV/AIDS Mainstreaming Programme Research Brief Jan 03