Senior ministers, including Minister of Education Kader Asmal and Minister of Public Enterprises Jeff Radebe, played a key role in driving last week’s Cabinet U-turn on anti-retroviral drug treatment for HIV/Aids.
Senior party officials said that among those responsible for the government’s turnaround were the African National Congress’s head of elections, Manne Dipico; the former director general of health, Dr Oliver Shisana; and the party’s chief strategist and government communications head, Joel Netshitenzhe.
In a dramatic reversal after years of dithering, the Cabinet endorsed the report of a joint health and treasury task team charged with examining the treatment options to supplement the comprehensive care for HIV/Aids in the public health sector.
The government decided to ask the Department of Health “as matter of urgency” to develop a detailed operational plan on an anti-retroviral treatment programme. Its decision was welcomed by the United Nations this week.
According to ANC insiders, senior members of the Cabinet stalled meetings to discuss the report for several weeks to ensure they had enough support to push it through.
The insiders said the ministers knew they would hit opposition from Minister of Health Manto Tshabalala-Msimang and President Thabo Mbeki.
The Inkatha Freedom Party members of the Cabinet — Minister of Home Affairs Mangosuthu Buthelezi and Minister of Arts, Culture, Science and Technology Ben Ngubane — have previously criticised the government’s foot-dragging on a national HIV/Aids treatment plan.
The mood of key ministers was reflected in the statement issued after the Cabinet meeting. It said: “The government shares the impatience of many South Africans on the need to strengthen the nation’s armoury in the fight against Aids.”
Netshitenzhe, instrumental in issuing the Cabinet statement commissioning the joint task team report last year, is believed to have worked behind the scenes to ensure that the decision went through. On Thursday he downplayed his role. “Speak to people in the health department,” he said.
After the Cabinet decision the health minister was said to be “despondent”. A government insider said: “She is still very reluctant, but there is enough political pressure from within the ANC to ensure that the government goes through with it.”
Tshabalala-Msimang’s lack of enthusiasm for the policy shift was reflected in her statement on Women’s Day, when she repeatedly said: “I am not the one making the decisions; the Cabinet decides collectively.”
She said she could not promise a roll-out of anti-retrovirals in a specified time frame. “I can’t say we have a roll-out because the plan has not been adequately costed. We are really not happy with the costing yet.”
Dipico had indicated to the party that HIV/Aids was bound to be the main political issue in next year’s elections, followed by poverty and unemployment.
An ANC insider said: “[Dipico] told us that the ANC will lose this battle, when political parties start campaigning around HIV/Aids.”
Dipico is said to have told party leaders that while the ANC could rebut criticism on poverty and jobs, it was likely to lose the debate on Aids.
It is understood that in its election campaign the ANC is planning to tacitly concede to slow progress in addressing poverty and unemployment, but to stress that these will improve with the implementation of the Growth and Development Summit resolutions.
Dipico apparently pointed out that the party had neither a strategy nor answers to deal with opposition campaigns targeting the government’s failure to provide a comprehensive treatment plan for people living with HIV/Aids.
ANC spokesperson Smuts Ngonyama denied that the Cabinet decision was related to elections, adding that the Cabinet was merely reinforcing the stance taken by the party in April.
“We have been consistent about pushing the broad plan,” he said, adding that a recent Markinor poll showed that South Africans understood the government’s position.
Senior ANC members said Shisana, now a director of a national research programme on social aspects of HIV/
Aids and health at the Human Sciences Research Council (HSRC), had played an important role in lobbying support within the ANC and through the Nelson Mandela Foundation. Shisana refused to be drawn on the issue.
Shisana, who is widely respected in the ANC, is also close to Mandela. She was a principal investigator on the Mandela/HSRC study of HIV/Aids, the first systematic national survey of the disease’s prevalence.
Mandela, too, was said to have intensified his lobbying in the ANC to get the government to endorse the report.
One source said that at a private birthday party last month Mandela had spent two hours describing the Aids deaths of people he knew, in the presence of the first lady, Zanele Mbeki, Radebe and Minister of Intelligence Lindiwe Sisulu.
The ANC’s health secretary, Saadiq Kariem, was non-committal on the role of the health secretariat, but welcomed the government decision. “We hope this will also open the doors to a comprehensive plan for the treatment for opportunistic infections.”