Thabo Mbeki’€™s dismissal of the deputy health minister has earned him swift condemnation both internationally and at home, with the New York Times warning that unless the President ‘€œfinally starts listening to sensible advice on AIDS, he will leave a tragic legacy of junk science and unnecessary death’€.

‘€œUnlike other African countries, South Africa has the financial resources and the medical talent to successfully take on its HIV./AIDS epidemic. What it lacks is a president who cares enough about his people’s suffering to provide serious leadership,’€ said the New York Times editorial this week.

Renowned scientific magazine Nature this week described Nozizwe Madlala-Routledge’€™s dismissal as a ‘€œserious error of judgement’€ that ‘€œaugers very badly for South Africa’s HIV/AIDS response’€.

The British medical journal, the Lancet, said of the ‘€œmany injustices’€ relating to the dismissal, the most concerning was that ‘€œMbeki has put a question mark over his government’s commitment to the AIDS treatment plan that Madlala- Routledge drove through, thus potentially denying the right to life for a large proportion of the population’€.

The Lancet noted that the ‘€œFreedom Charter, still central to African National Congress policy, states that no government can justly claim authority unless it is based on the will of all the people.’€

‘€œGiven the public outcry about the firing of this much respected deputy health minister, and the possibility that this act could signal the government’s back-tracking on a national AIDS treatment strategy, it is questionable whether President Mbeki is acting according to the will of the people,’€ concluded the Lancet.

Adrienne Germain, President of the International Women’€™s Health Coalition, said that after her organisation had met Madlala-Routledge in March ‘€œwe were convinced that a new era was possible for HIV and AIDS in South Africa’€.  

‘€œSadly, within a few weeks, these steps of progress were reversed as soon as Minister Manto Tshabalala-Msimang returned to her post.   And now, a bright ray of hope has been extinguished with the unwarranted and politically-motivated dismissal of Deputy Minister Madlala-Routledge,’€ said Germain.

Organisations within the country have also rallied around the dismissed deputy minister with both the Rural Doctors Association of SA (Rudasa) and the SA Clinicians Society describing Madlala-Routledge as a symbol of hope in the struggle against HIV/AIDS.

‘€œWe believe that the deputy minister has played a fundamental role in bringing civil society and professionals together to support the government’€™s National Strategic Plan (NSP) for HIV/AIDS, on an unprecedented level,’€ said the SA Clinician’€™s Society, which represents over 12 000 HIV health professionals.

The Society asked the Minister of Health to clarify why the mother-to-child HIV prevention programme (PMTCT) has not been expanded beyond 30% coverage after five years, and why more effective regimens have not been implemented and why fewer than 20% of adults needing antiretrovirals are receiving them, after more than three years of publicly available ART.  

 ‘€œAt a time when South Africa’€™s international profile was tainted by unfortunate, albeit perhaps well-meant, actions and pronouncements by Minister Manto Tshabalala-Msimang and the Office of the Presidency, Madlala-Routledge stood out as someone who, together with Deputy-President Pumzile Mlambo-Ngcuka, understood the importance of scientific action to be taken against the HIV/Aids pandemic,’€ said Rudasa.

‘€œShe endeared herself in the hearts of South Africans, and international observers, by understanding and acknowledging the important role of the Treatment Action Campaign, and by embracing them, and other NGOs, in the fight for dignity of all South Africans.’€

Meanwhile, the Joint Civil Society Monitoring Group ‘€“ representing 20 organisations including Wits University’€™s Centre for Health Policy, Positive Women’€™s Network, AIDS Consortium, AIDS Law Project, UCT School of Public Health and Family Medicine, described the dismissal as a ‘€œmajor setback to the development of a unified national response to HIV/AIDS’€.

‘€œContrary to the statements from the Presidency, she has been a team player ‘€“ by earning the respect of leading health academics, researchers, scientists, doctors, lawyers, health care workers. People living with HIV/AIDS and other users of the public health sector,’€ added the Group.

However, Deputy President, Phumzile Mlambo-Ngcuka says the dismissal of Madlala-Routledge ‘€“ her close ally in developing the new AIDS plan ‘€“ had not caused ‘€œa crisis’€.

‘€œThe government and the department of health will continue to work on HIV and AIDS. Whether from inside or outside government, people will work on things that they feel strongly about. It is important to do so. There isn’€™t a crisis,’€ Mlambo-Ngcuka told a gathering of the SA National Editors’€™ Forum.

However, the Deputy President conceded that government could be working faster to implement the new plan.

‘€œTo some extent I agree that we could have done some things much faster since the national strategic plan was adopted,’€ said Mlambo-Ngcuka.

There had been some ‘€œto-ing and fro-ing with Treasury as the new plan had targets and these needed to be costed.

Mlambo-Ngcuka said that the government departments that had moved the fastest to develop plans for implementing the new plan were Education, Social Welfare and, to a certain extent, the public service.

She made no mention of the Department of Health, which is supposed to be the lead department in the implementation of the new AIDS plan. ‘€“ Health-e News Service.