Running out of time

When, in less than two years time, South African president Thabo Mbeki leaves office and looks back on his administration, he may reflect that succeeding Nelson Mandela was an often thankless task. At the same time, he should also realise that the great man was not infallible and by tackling AIDS, the area where Mandela himself admits that his government failed, Mbeki also had the opportunity to become an African icon.

Under Mandela, Mbeki saw the disease – which was only discovered in South Africa as recently as 1986 – infect 10 per cent of the population. Five million South Africans are now believed to be HIV positive, and up to 1,000 people die every day from AIDS-related infections. His resistance to the proven science of AIDS has become legendary. Several years ago, in a remarkable moment of political insensitivity, he likened scientists who opposed the accepted model of AIDS transmission with oppressed blacks in the apartheid area; both he alleged, were stymied by the unquestionable beliefs of their ages.

A chastising defeat in the country's constitutional court in 2002 forced Mbeki to roll out full-scale education and treatment programmes, but South Africa's commitment to AIDS has remained questionable while today's government ministers remain the same as those who faltered at the turn of the century. One such minister is Manto Tshabalala-Msimang, health minister since 1999. Only last year, she was publicly promoting the curative properties of potatoes, garlic and beetroot ahead of anti-retroviral drugs, to the horror (and disbelief) of the international community,

This week, Mbeki has denied reports made by a South African newspaper that he gave a leg-up to Tshabalala-Msimang who recently received a liver transplant, despite rumours of alcoholism. The official cause of her disease was recorded as hepatitis. The same report also alleged she was convicted of stealing from patients while working in Botswana in the1970s and was declared an illegal immigrant.

The Sunday Times scoop coincided with Mbeki's decision to sack the health minister's deputy, Nozizwe Madlala-Routledge, a headstrong woman who distanced herself from the notorious alternative remedies and was instrumental in promoting the country's AIDS programmes. Like her boss, she has been no stranger to headlines, albeit of a very different sort. She declared 'a national emergency' after an unannounced visit to a hospital in the Eastern Cape province. By contrast Tshabalala-Msimang saw nothing much to worry about, and argued mortality rates had been exaggerated. In June, Madlala-Routledge upset the government by flying to an international AIDS conference without official approval. The ANC was unwilling to sanction such renegade behaviour, but in taking such a stance, has opened itself up to the suggestion that it has fired the wrong minister.

The effect of her dismissal on the country's AIDS programme now rests largely with the president, whose tendency to value cronyism over efficiency is disappointing. Previous experience suggests the signs are not good, but the time still remains for Mbeki to leave office responsible for some significant developments.