The South African government has effectively sidelined its controversial health minister, Manto Tshabalala-Msimang, as the country’s public face of policy on HIV and AIDS.
Dr Tshabalala-Msimang has denied that she has in any way been sidelined or silenced, claiming that she can and does say what she wants as the minister responsible for health.
However, the cabinet seems to have given the task of developing policy on AIDS to the deputy president, Phumzile Mlambo-Ngcuka. A cabinet statement issued after a meeting at which President Thabo Mbeki was reportedly not present confirmed the deputy’s role in the drawing up and presenting of AIDS policies.
President Mbeki’s absence would have been crucial to such a decision, as he is responsible for much of the ambivalence concerning the country’s AIDS policies. He infamously questioned the link between HIV and AIDS and vigorously opposed the use of antiretroviral drugs to help slow the progress of AIDS.
Dr Tshabalala-Msimang became the focus of intense criticism at the recent AIDS conference in Toronto. The South African exhibition at the conference displayed a variety of vegetables, which the exhibition claimed helped to combat AIDS. It was criticised for not displaying any antiretroviral drugs, despite the fact that the country’s antiretroviral programme, which is sponsored by the government, is one of the largest in the world.
Scuffles broke out at the stand between her staff and HIV and AIDS activists, and Dr Tshabalala-Msimang drew fire from the United Nations expert on AIDS, Stephen Lewis. She previously told him that he is unwelcome in South Africa, a position she continues to hold but which may be reversed by the deputy president.
The deputy president has already taken the unprecedented step of meeting representatives of several of the most important HIV and AIDS groups in the country, including the most prominent, the Treatment Action Campaign, whose only contact with the government for several years has been in bitterly fought contests in the courts over access to antiretrovirals.
The campaign is currently organising to get Dr Tshabalala-Msimang dismissed, a stance shared by scores of prominent local and international scientists who wrote to President Mbeki asking him to fire his health minister. The Treatment Action Campaign said that its meeting was very useful but thus far has not given details.
The deputy president has revived a moribund grouping within the government that considers AIDS issues across various departments, and she has tried to revive a council—comprising representatives of the government and of non-governmental organisations and which she chairs—that is also intended to deal with the pandemic and its devastating effects on the country.
The health minister has not been helped by another series of court clashes—one involving prisoners who are dying of AIDS and unable to get treatment, at the end of which a High Court judge said that if government departments were deliberately disobeying court orders a constitutional crisis would result.
The government faced serious embarrassment at the Toronto conference. It found itself a laughing stock among HIV and AIDS groups despite paying for a particularly thorough and costly treatment programme. The government has attributed this to miscommunication of its policies. And that communication is now being taken away from the health minister.
