Nov 2, 2006 - Quarraisha Abdool Karim, Alan. Whiteside, Anna Coutsoudis and. Photini Kiepiela from the University of KwaZulu-Natal; Nicoli Nattrass and.
IZINDABA
BELLIGERENT ‘RETRO-MANTO’ MOVED SIDEWAYS Government has begrudgingly and reluctantly sidelined its chief headline grabber, that implacable foe of respected HIV/AIDS scientists and activists everywhere and dream subject of local satirists, Health Minister Dr Manto Tshabalala-Msimang. Yet, true to its historical form in responding to the ‘new struggle’ of South Africans, this came only when the abrasive and gladiatorial wife of highly respected ANC stalwart and treasurer, Mendi Msimang, raised this country’s international embarrassment to new heights. In a face-saving move calculated to counter a virtual tsunami of renewed calls for her head, cabinet appointed the Deputy President Phumzile Mlambo-Ngcuka to oversee its HIV/ AIDS campaign, relieving TshabalalaMsimang of sole responsibility.
Still in overall charge Tshabalala-Msimang remained however, unapologetically, the health minister and said she saw no shame in the sidelining. She described the inter-ministerial committee (IMC) to be headed by Mlambo-Ngcuka as ‘not a new thing, it probably wasn’t functioning as well as it should have’, and welcomed ‘the establishment and reinforcement of the IMC’. Cabinet reportedly split after its public relations ‘loose cannon’ fired off her latest defiant salvo in the form of woven telephone wire baskets filled with lemons, garlic, beetroot and African potato on South Africa’s stand at the XVIth International AIDS Conference in Toronto this August. Alongside these iconic items stood a bottle of multivitamins, a bag of samp and other nutritional mixtures. Behind them, a huge panel boasted pictures of President Mbeki, his deputy and the health minister and
proclaimed South Africa to have the most comprehensive HIV/AIDS plan in the world. True to form, just when the incidence and volume of questions from onlookers and journalists became truly uncomfortable, two vials of a flustered health department official’s own antiretroviral medication were quickly added to the stand.
Just when the incidence and volume of questions from onlookers and journalists became truly uncomfortable, two vials of a flustered health department official’s own antiretroviral medication were quickly added to the stand. Only later was the excuse of ‘missing baggage’ containing the ARVs offered, its credibility immediately shot down in flames by the Tshabalala-Msimang retort that it was ‘unlawful’ to display scheduled medicines. Apparently nobody was able to find an empty box
of the ARV medication at arguably the world’s greatest display of brand name and generic AIDS drugs yet seen.
Cabinet ‘compromise’ The cabinet split between President Thabo Mbeki and those closest to him, and those who voiced deep concern about the latest PR faux pas, was illustrated by the compromise outcome and the tenor of subsequent official statements. Thabo Maseko, chief government spokesman, said ‘We need to shift focus from saying the problem in the programme is the minister of health. It’s possible that in the presentation of the speeches, maybe she ended up giving the impression the focus is on nutrition and particular nutrients.…. But at no stage should we.… create the impression that we are putting nutrition as an alternative to other forms of treatment included in the programme,’ he explained. The new committee will consist of ministers who are members of the South African National AIDS Council
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(SANAC) and includes the ministers of health, education, social development, provincial and local government and the minister in the presidency. Treatment Action Campaign spokesman and AIDS Law Project director Mark Heywood said shifting power away from Tshabalala-Msimang was insufficient. ‘She has to be dismissed after all the untold damage she has done — these measures are good but not enough,’ he added.
What her detractors said… SAMA’s chairperson and outgoing World Medical Association President, Dr Kgosi Letlape, added his voice to international denunciation that included Mr Stephen Lewis, special advisor to the UN Secretary General and 81 of the world’s top scientists. Letlape called for Tshabalala-Msimang to ‘refrain from breaking the laws of the country’ by continuing to support the therapeutic effectiveness of several ‘quack’ remedies that had not undergone appropriate clinical trials or submission to the Medicines Control Council for approval. He said her continued misrepresentation of the facts on the role of nutrition in the management of AIDS was ‘regrettable and against the law’. Lewis called South Africa’s overall response to AIDS ‘obtuse, dilatory and negligent’. Dr Mark Wainberg, chairperson of the Toronto AIDS Conference, said in
his closing address: ‘We (initially) went to the Durban (International AIDS) meeting, expecting a South African government that would be on the same side as us. Instead, we found a denialist president who turned his back on us... and who began to convene committees that would articulate on his behalf that somehow it was in dispute whether or not HIV was truly the cause of AIDS... We were all completely taken aback, we were all insulted. ... ‘I for one am no longer prepared to take a back seat as a scientist and not express my personal concern that this situation seems to have continued unabated.’
Dr Mark Wainberg, chairperson of the Toronto AIDS Conference, said ‘I for one am no longer prepared to take a back seat as a scientist and not express my personal concern that this situation seems to have continued unabated’. The 81 signatories to the letter to Mbeki calling for Tshabalala-Msimang’s sacking include Nobel Prize winner David Baltimore, the co-discoverer of HIV Robert Gallo and local scientists Quarraisha Abdool Karim, Alan Whiteside, Anna Coutsoudis and Photini Kiepiela from the University of KwaZulu-Natal; Nicoli Nattrass and David Bourne from the University of
Cape Town; and Ed Rybicki from the University of the Western Cape. All supported and endorsed Wainberg’s words, additionally calling for ‘an end to the disastrous, pseudo-scientific policies that have characterised the South African Government’s response to HIV/AIDS’. A South African cabinet insider was widely quoted as saying, ‘we are feeling the heat of her (Tshabalala-Msimang’s) communication and personality problems’. Cabinet could not resist a dig at the media, however, stating that it ‘noted the impact of false allegations that were made at the International AIDS Conference about South Africa’s comprehensive programme’. It went on to say that work should be done, locally and abroad, ‘to enhance understanding of the country’s comprehensive HIV/AIDS programme to address any doubts about government’s commitment to the fight against HIV/AIDS. Under Tshabalala-Msimang’s leadership, 21% of South Africans needing antiretrovirals are getting them (an estimated 200 000 out of a potential 983 000), way short of the government’s own revised and much downscaled rollout target of 380 000 (source: WHO and UNAIDS). Chris Bateman
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