The Health Minister’€™s charm offensive Living with AIDS # 317

KHOPOTSO: Health Minister, Dr Manto Tshabalala-Msimang was in remarkably jovial spirits at the launch of the survey. ‘€œAsk us any question you like,” she said. ‘€œWe’€™re always ready to answer’€, she continued. The general mood of the Department of Health’€™s entourage was one of friendliness. After all, the press briefing was about good news. The antenatal survey shows that for three years in succession, there has been a slight decline in HIV prevalence amongst young people aged below 24. And this was cause for celebration, said Nthari Matsau, the Deputy Director-General of the Department of Health.      

 

NTHARI MATSAU: How can we not celebrate? We’€™ve been doing this battle for quite a long time’€¦ And for the first time, we are really seeing a definite decline. We concede that the prevalences are still too high. But I really do think it’€™s cause for celebration. At long last, we are seeing a positive rate. And I do not see why we shouldn’€™t celebrate that. It’€™s been a long, hard battle’€¦ It has taken over ten years, yes. But it’€™s not something that is easy to achieve in a very highly infectious disease like HIV. So, we don’€™t want to apologise for using the word ‘€˜celebrate’€™.            

 

KHOPOTSO: Taking up the Minister’€™s offer to ask any question, a journalist asked her about the nature of her relationship with the German vitamin seller, Dr Matthias Rath, known for his hatred of antiretrovirals in the treatment of AIDS.

 

Dr MANTO TSHABALALA-MSIMANG: Well, you see, in the first instance you must appreciate that I’€™m the Minister of Health, exercising stewardship over the health care system in the country, both private and public. Other people, like Rath Matthias, fall in the category of private, the NGOs. So, anybody who wants to come and talk to me, my door is open’€¦ If that relationship is not accepted just because it’€™s Rath Matthias, then I am sorry, I don’€™t discriminate. I listen to anybody if I have an opening in my diary to come and make their presentations because we are all looking for possible interventions that might assist us. So, that is the relationship.          

 

KHOPOTSO: The Minister’€™s association with the vitamin businessman is still questionable to many. Another pertinent question was on why government continues its policy to offer a single drug, Nevirapine, to prevent women attending public antenatal services from infecting their unborn babies with HIV. Research shows that a programme comprising of two drugs is more effective. Only the Western Cape employs the method.

   

Dr MANTO TSHABALALA-MSIMANG: The issue of dual-therapy is a policy position that is in the National Strategic Plan 2007 ‘€“ 2011, adopted by Cabinet. Secondly, once Cabinet takes a decision, it is for that particular department to then implement that decision’€¦ What we are trying to do now in the Department, is to try and improve the guidelines, to facilitate appropriate training of health workers ‘€“ in other words ‘€“ prepare ourselves (for the dual therapy).                

 

KHOPOTSO: In a classic ‘€œI-told-you-so’€ manner, the Minister also threw in a lesson in history for great measure.

 

Dr MANTO TSHABALALA-MSIMANG: Let me remind all of you that when I raised the question about dual-therapy, it was like I was being very obstructive’€¦ Never mind that I had been taught that, ‘€˜please don’€™t use mono-therapy’€™. And I kept on asking, ‘€˜why is it that when we deal with pregnant women, it’€™s good enough to use mono-therapy’€™? And most of you, the newspapers here, really took issue with me: ‘€˜She is being obstructive. Why should she ask this question’€™? ‘€¦ But we had asked that question ourselves because we were concerned. And I think it is correct for government, in the protection of the women of this country (and) promotion of good health care to ask these difficult questions’€¦ So, we are happy today that the question that we asked is being answered, even though people won’€™t stand up and say, ‘€˜you were correct to ask that question’€™.  

 

KHOPOTSO: The question could be asked whether some of us attending deserved the wagging finger from the Minister. And what Tshabalala-Msimang didn’€™t point out in her lecture, is that even though Nevirapine is not the best form to prevent the transmission of mother-to-child HIV transmission, thousands of babies have been spared the unnecessary fate of inheriting HIV from their mothers. The press briefing in itself might have been a public relations exercise, but it certainly made me realise that the accommodating spirit of the Minister at that briefing is what is missing to improve communication with the public. Whether the comment was made genuinely or as mockery, don’€™t you wish she could say this more often?            

 

Dr MANTO TSHABALALA-MSIMANG: Please ask any questions that you want to ask. We are ready to answer those questions. We’€™re trying to make friends, here.

 

KHOPOTSO: But without Health Department Director-General, Thami Mseleku, speaking over her.

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