/ 1 January 2002

High shock threshold

It has often been said that South Africa has an unusually high scandal threshold. It takes a mass murder, a rape of extreme brutality, or a body count of hundreds on the roads for anyone to pay attention. The same high threshold has begun to apply to right-thinking South Africans’ opinion of the government’s preposterous policies on HIV/Aids. It takes a particularly gruelling account of the state’s recklessness to make one sit up, listen, step back, and think again.

Two such tales have recently had that effect on this newspaper. The first was last week’s extraordinary account of how Northern Cape Health MEC Dipuo Peters slammed officials at the Kimberley hospital for administering anti-retroviral drugs to a raped nine-month-old. Perhaps the most chilling aspect of the story was its exposure of the pliancy and spinelessness of state employees in a remote corner of the country. Here were politicians and civil servants who confessed to stopping proven prophylactic anti-retroviral treatment because of national government thinking. The Kimberley hospital, like many other institutions, had been quietly giving the drugs, but has now agreed to toe the line. Particularly worrying is that the government has not codified its position but allowed it to seep informally into the consciousness of its minions across the country.

It remains unclear whether the province’s health MEC made the irate call to Kimberley hospital because she came under pressure from colleagues in the national government, because she feared reprimand if her colleagues also learned from the press that the young child had been treated or because she actually believed in the national government’s thinking. The other evidence of such compliance was the disciplinary action against a German doctor, Beatrix Weber, at Kimberley hospital who was suspended for writing a letter to her European sponsors about the confusion created in South Africa by President Thabo Mbeki’s utterances on HIV/Aids. Weber’s disciplinary charge sheet referred to her “unlawfully and intentionally” criticising the president. How embarrassing.

As if that were not enough, this week we publish a story about a study into the efficacy of anti-retroviral drugs in preventing HIV infection for raped women. The study confirms similar research elsewhere. It is heartening that the Health Ministry says it will look into this compelling, home-grown research. At the same time we hear encouraging rumours that the government is considering allowing state hospitals to advise patients to take anti-retroviral drugs.

Again, we must probe the logic behind the government’s thinking. State hospitals are free to administer anti-retroviral drugs to doctors who fear contact with HIV-infected blood. That means there is no obvious principle behind the government’s refusal to sanction the treatment of raped women or HIV-positive pregnant women. If the government really fears the drugs are too toxic and unproven, why give them to the country’s doctors?

The government’s policies are muddled and irrational – just like the president’s thinking on these matters. It is necessary now for state health professionals across South Africa to either openly or quietly get on with ignoring Pretoria.

Tito rises to the challenge

It is not difficult to understand why the markets were shocked by this week’s interest rate hike. The Reserve Bank’s monetary policy committee meeting that made the decision was unscheduled, and the finance minister said at the height of the rand crisis that interest rates should not be increased. Since then the currency has had bouts of recovery.

If currency weakness is the reason – because prices of imports will soar – why increase rates now, and not when the rand was far weaker? Why risk squeezing life out of the economy, making it far more likely we will slip into recession?

Apart from the possibility that the bank got it hopelessly wrong, there are several feasible explanations. One is that with Deputy Governor James Cross out the way – he resigned last year – the Reserve Bank’s conservative Bundesbank-style thinkers, who dominated policy under former governor Chris Stals, have been left to set the pace. Cross is said to have been a calming influence on the Calvinistic, inflation-obsessed approach for which the bank has become famous.

The other explanation is that the bank wanted to show itself capable of acting muscularly. Since the rand went into freefall, Governor Tito Mboweni and his team have been conspicuously quiet, leaving the Finance Department in the frontline. There has long been talk of tension and rivalry between the two, and in particular between Mboweni and Finance Minister Trevor Manuel. Intriguingly, Manuel and his Director General, Maria Ramos, were abroad when the rate hike was implemented.

Then there are the recent observations in the opinion columns of the mainstream financial press that the independent central bank appeared to be ceding its responsibilities to the government. All in all, the bank’s virility has, directly and implicitly, been called into question over the rand crisis. So Mboweni might therefore have felt justified in asking: why not rise to the challenge?