Tuesday, August 14, 2007

South Africa's Public Health Sidelined Over Political Power Play

During the Nationalist Party, or white government, days in South Africa, the only time the country made it into the international newspapers was when apartheid based atrocities and anti-apartheid campaigns were reported. It used to annoy the government immensely as they felt that the good stuff was being overlooked.

President Mbeki, and his apostles, must be feeling the same at this moment. The front page of the Independent in the UK says it all. ‘A President in denial, a nation denied hope’ is the headline. The article is in response to the firing of deputy health minister Nozizwe Madlala-Routledge.

Ms Madlala-Routledge had worked hard to obtain some form of credibility for the government. She had been outspoken about new treatment campaigns to ensure medication was available to infected people and co-authored a five year treatment action plan. She had visited hospitals and pointed out how bad the health services were in some areas such as the Eastern Cape.

Mbeki and his Minister of Health Tshabalala-Msimang have been ridiculed by the world for their denial of the epidemic. Mbeki ascribed to the theory that HIV and AIDS were not linked and Tshabalala-Msimang maintained that eating beetroot and garlic were more useful than anti-retrovirals which she said were harmful to people. This is the country where coffins are made from cardboard because the wooden ones can’t be made quickly enough to fill demand.

The Deputy was fired, according to the South African press, for having attended an AIDS conference in Spain. It was felt that this was wasting tax payers’ money. Besides which this trip had apparently not been authorised. One might remember a Christmas a season ago when the Deputy President used tax payers’ money to use the government jet to take herself and a couple of buddies off to a shopping holiday in Dubai. She certainly didn’t get fired for that unauthorised trip.

Which all points to the fact that the Deputy Minister’s firing had really very little to do with health issues. It has to do with political power. Mbeki has, during his years as president, surrounded himself with people whom he feels comfortable with and who have shown him total loyalty. These select few will remain within his orbit whether they do the job or not. The Deputy Health Minister, by undermining the power base of the Health Minister had to go.

Health Minister Tshabalala-Msimang is one of these apostles. She could decide to hand out arsenic pills at hospitals and she would not be fired. I suppose giving people beetroot and garlic to cure HIV/AIDS is about the same.

Political power is particularly relevant as the succession debate to Mbeki’s rule hots up. The issue centers around the new leadership of the ANC which will be determined shortly. At the same time, the head of the ANC is automatically appointed as president of the country. According to the constitution, President Mbeki may only serve two terms and he is completing his second term now.

This is not really a serious issue. One needs to remember that the ANC acquired over two thirds of the vote during the last general elections. This means the ANC is able to change the constitution. It could very well mean that Mbeki is padding his supporter base in preparation for re-election. He has indicated that he wishes to stand for the ANC leadership.

The consequences of the political maneuvers being played out are dire though. The public health system is falling apart at a rapid rate, and not only with respect to HIV/AIDS treatment. Reports on the state of public hospitals are dire. According to one Doctor quoted in the Independent, people are dying in the queues.

The absolute tragedy is that South Africa has money in the bank to improve the health system. Not only did Finance Minister Trevor Manuel submit a surplus budget in February this year, but today’s South African version of the Independent states that the taxman is heading for another big tax bonanza.

Never a more appropriate saying than the one that states that Rome burns while the politicians fiddle.

Anja Merret lives in Brighton, UK, having moved across from South Africa just over a year ago.

She now looks after the business interests of her daughter who is a Flash Developer and Accessibility expert. She started a blog at the beginning of the year under the heading of chatting to my generation. Although she is chatting to the baby boomer generation, she sometimes feels that all generations have the same issues to face, they just don't have hearing aids or walking sticks!

One of her pet peeves is the war in Iraq and in fact anything that causes innocent people to get hurt. But she also loves tech stuff, although only as an amateur. She considers herself a Silver Surfer Gadget Geek. She is even considering queuing for an iPhone in the UK later on in the year. But her daughter has offered, so she will only be taking hot food to the Brighton Geeks waiting in line.

Her musings may be found on http://www.anjamerret.com Her observations on personal power and self-development may be found on http://www.pinkblocks.com
Anja Merret

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