Health Minister Manto Tshabalala-Msimang’s “tacit” licence to provincial health MECs to roll out Aids drug programmes in their provinces might be seen as a cautious step forward by government. It is nothing of the kind.
The apparent purpose is to avoid a national climbdown on drugs policy, with its attendant loss of face, while defusing mounting pressure on all fronts to extend antiretroviral provision.
In reality, the “new” approach merely restates the existing one. Sensible African National Congress provincial governments, like Gauteng, will continue quietly broadening their programmes, while oddball MECs in provinces like Mpumalanga will continue blocking provision, and suspending doctors and volunteer counsellors who dare to cross the line.
It can be safely assumed that Mpumalanga’s Sibongile Manana and Northern Cape MEC Dipuo Peters, who disgraced herself by reprimanding a hospital chief for giving AZT to a raped baby, will not use whatever space has been created. But the problem is a broader one. The acting Eastern Cape MEC, Max Mamase, said this week there was no pressing reason to extend the programme in his province because only 30% of HIV-positive women transmitted the virus to their babies and transmission took place only during Caesarean sections. The medical facts are that in ordinary vaginal deliveries there is a 20% infection rate, and that infection can also take place ante-partum and through breast-feeding. Arguing that her province did not have a serious HIV/Aids problem, the Free State MEC said the focus would be on strengthening existing infrastructure.
The irresistible impression is that many provincial politicians are looking for reasons to limit provision. No one questions the need for adequate infrastructure to administer programmes. But an entirely different impression would be created if MECs set urgent deadlines and publicly committed resources, rather than using the lack of trained staff and facilities as an excuse for doing nothing.
The pattern in South Africa on HIV/Aids is the intrusion of politics into what should be a straightforward medical matter. Even doctors are not immune from political pressures, as shown by the Health Professionals Council’s invitation to South Africa’s leading Aids dissident, Medunsa’s Sam Mhlongo, to address it on the evil of antiretrovirals.
The tacit licence given by Tshabalala-Msimang to health MECs amounts to government by default, not decision. There can be no substitute for clear direction from the top on the treatment of HIV/Aids.
Buffoona Bafana
Poor Carlos Queiroz. In the past week he’s learned the meaning of the phrase “damned if you do, damned if you don’t”. The Mozambique-born coach, who achieved his brief _ to help South Africa qualify for soccer’s African Cup of Nations and the World Cup _ with ease, returned with his team from Mali to a hysterical chorus of calls for his axeing.
Bafana Bafana’s exit from the Nations Cup at the quarterfinal stage _ the country’s poorest showing in four appearances at the continental showpiece _ is the reason given. As the second-ranked country in Africa, the nation expected the team to at least reach the final, if not actually win. We’re living in dreamland.
Queiroz took a team to West Africa that was made up of several players who, although registered with big European clubs, seldom see first-team action. The rest were from the domestic Premier Soccer League (PSL), where the standard of play has been in decline for several years.
Moreover, some European-based players made the trip under protest: they faced bans from world governing body Fifa if they declined their international call-ups. The club-versus-country split also affected his preparations with home-based players as some teams refused to release their stars for training camps.
It was a recipe for disaster, with the final ingredient being the lack of support for Queiroz from his bosses at the South African Football Association (Safa). These vultures greeted him at the airport, already secretly discussing his replacement.
After Sunday’s woeful display, fans tried to analyse what can be done to remedy matters before the World Cup in June. Instead of constructive debate, we opted for the usual solution to South Africa’s sporting failures: fire the coach.
Queiroz has a proven track record (he was in charge of an allconquering Portuguese junior side that included world footballer of the year Luis Figo). But he cannot be expected to deliver the goods when half the team doesn’t want to be there, when the other half’s experience in a second-rate league is cruelly exposed at continental level and when his governing body seems determined to sabotage him.
What he needs is for Safa to back him to the hilt, insist that clubs (foreign and local) release players timeously and improve the quality of the PSL. But what he needs more than anything is a team with heart. Until representing South Africa becomes a source of pride again, rather than an irritating requirement for getting that all-important European work permit, Bafana Bafana will remain boys among men.