Johannesburg — BRAVO Minister of Health Aaron Motsoaledi, for frankly acknowledging the dismal state of the nation's health.
Earlier this week Motsoaledi welcomed a series of reports published by the respected medical journal The Lancet, which describe a population overwhelmed by the quadruple epidemic of HIV, tuberculosis, violence and lifestyle-associated diseases. The authors lay the blame squarely at the feet of governments past and present.
On Monday Motsoaledi said the Lancet articles echo the government's own thinking on what ails the public health sector, telling the New York Times "we do take responsibility for what has happened". Before the launch he was briefed by the Lancet authors, and by all accounts gave them a warm reception and listened carefully to what they had to say.
It is truly heartening to see a health minister embrace the scientific community following the hostile approach of his predecessor, Manto Tshabalala- Msimang, who eschewed science for quackery on all matters AIDS- related. Refreshing too to have a health minister with some gravitas who can take criticism without becoming furiously defensive.
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The articles reflect how years of mismanagement and neglect in the public health sector have taken a devastating toll. SA among only a handful of countries where infant and maternal mortality rates are rising, and our tuberculosis and HIV epidemics are among the world's worst. Better care for pregnant women infected with HIV could save 37200 lives a year by 2015, the scientists say.
It is no easy task for a health minister to acknowledge that the governing party has made mistakes. So well done to Motsoaledi for continuing the fine tradition that began with Barbara Hogan (who briefly occupied the health portfolio after president Thabo Mbeki was axed and Tshabalala-Msimang sidelined, before she was moved to Public Enterprises in May) .
Hard though it may be to eat humble pie, putting the mess to rights is going to be a lot tougher. It's one thing to identify the problems, quite another to fix them. If Motsoaledi is to make any headway at all, he needs to replace the widely discredited management team he inherited from Tshabalala-Msimang, including the singularly unimpressive director-general Thami Mseleku, whose contract expires later this year. There is no reason the health department shouldn't pay him out and appoint someone with decent experience. Mseleku's appointment as the health department's top civil servant stunned the sector in 2004 as his career had until that point been solely in education.
Once he has a good team in place, the true test of Motsoaledi's mettle will be the extent to which he can stand up to the hard-liners in Luthuli House. The stage is already set for conflict between the party ideologues who are pushing an extreme version of a national health insurance system, and the technical experts who question its affordability. It will be up to Motsoaledi to guide us through it. Let's hope he lives up to his early promise.
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