Len > is Africa destined to be impoverished because of its own political leaders?
Without any doubt. Does one need a better example than this?
news.independent.co.uk
>>A President in denial, a ravaged nation denied hope
Thabo Mbeki's stance on Aids has left South Africa with the world's worst HIV epidemic. Yesterday, he silenced the woman fighting to end the suffering of millions
The fight against Aids in South Africa, the epicentre of the global pandemic, has been dealt a devastating blow.
President Thabo Mbeki stunned and outraged campaigners yesterday by sacking the country's deputy health minister, the woman credited with ending a decade of Aids denialism at the heart of the South African political leadership.
Activists fear that the decision spells a disastrous political regression on Aids, which could cost the lives of hundreds of thousands of people. More than 1,000 people a day in South Africa die of Aids. One in 10 is HIV positive, which is significantly higher than anywhere else in the world. And 1,400 people are newly infected with HIV every day. But only a third of those who need life-saving Aids drugs receive them.
The sacked minister, Nozizwe Madlala-Routledge, is an outspoken critic of President Mbeki and his Health Minister, Manto Tshabalala-Msimang and the way they have handled the epidemic. She was the co-architect of an ambitious new five-year plan to accelerate the rollout of free, life-saving Aids drugs, tripling the numbers on treatment by 2011. That plan could now be in jeopardy.
For years Mr Mbeki was the world's most prominent Aids denier. His government only began making free Aids drugs available to sufferers in 2004, after an international outcry and that was years after other, poorer, African countries. But by sacking his cabinet's most forceful advocate of an aggressive campaign to provide drug treatment, Mr Mbeki has reopened questions about his own acceptance of the science surrounding Aids.
"He has once again shown his contempt for those seeking scientific approaches to Aids," said Professor Nicoli Nattrass of the University of Cape Town. "This is a dreadful error of judgement. It indicates that the President still remains opposed to the science of HIV," the Treatment Action Campaign (TAC), South Africa's biggest Aids advocacy group, said yesterday.
His decision represents a victory for Mrs Tshabalala-Msimang, who has been discredited and derided as "Dr Beetroot" for telling HIV patients to eat more of the vegetable, and for her view that antiretroviral drugs are "poison".
Although she has been condemned as a representative of the lunatic fringe by the United Nations' special envoy for Aids in Africa, and by 60 of the world's HIV specialists as disastrous, Mr Mbeki has remained her loyal ally.
"It's an absolute disgrace," said Mike Waters, the opposition Democratic Alliance's health spokesman. "The fact is for the first time we had a deputy minister with a clear direction in the fight against Aids. Both the President and the Minister are denialists, while the deputy minister has her feet stuck in reality."
Mrs Madlala-Routledge, speaking to The Independent, said: "I can't say what the reasons are for the President's decision. But with the Health Minister back in the driving seat she wanted to reassert her ideas.
"We are dealing with an emergency where large numbers of people are dying."
Ostensibly the reason for firing Mrs Madlala-Routledge was that in June she travelled to Madrid to speak at an Aids conference without the President's written authorisation.
Her real crimes, say insiders, were to challenge the President's handling of the epidemic and help drive through the new treatment strategy. That happened earlier this year when liver transplant surgery forced Mrs Tshabalala-Msimang out of the picture. But "Dr Beetroot" came back. In the past few weeks she has, officials say, set about undermining the treatment plan.
She has also launched into a fresh defence of one of her favourite themes: traditional African remedies. "You can give your patients as many tablets as you want to, if the nutritional status is weak and is not up to the mark, those tablets will not do the trick," she told MPs on her return.
Health Department staff, under Mrs Tshabalala-Msimang's direction, have recently again begun drawing a distinction between "HIV and Aids" and "HIV/Aids". The semantics and the infighting, say doctors such as Ashraf Grimwood, who works on the HIV front line, is the equivalent of fiddling while Rome burns. "This is a complete distraction. We have people dying in the queues. It is obscene and it is unacceptable."
The long-term impact of the epidemic is almost incalculable. The country has 1.2 million Aids orphans. A generation of women is being lost. Teachers are dying at the rate of 14 a week; child mortality rates in some areas have trebled in the past 15 years. And life expectancy, because of Aids, has fallen to around 47 years. "This is medieval," said Dr Alan Whiteside of Kwa-Zulu Natal University in Durban. "Why are we not shouting it from the rooftops?"
Officially, Mr Mbeki's government is committed to the drugs rollout, but staff struggling to rush out the treatment, complain of constant delays. Anti-retrovirals can only be dispensed in accredited sites, but applications routinely get bogged down in red tape. "It's bureaucratic nonsense. All it means is people can't access treatment," Dr Grimwood said.
Campaigners said it was "unfathomable" that Mrs Madlala-Routledge had been given the boot. They challenged Mr Mbeki to pledge his public support for the treatment strategy. "Our country has waited, vacillated, hoped, pained and fought too long over HIV/Aids," said Nathan Geffen of the TAC. << |
