SA’s HIV policies revisited

Since Thabo Mbeki’s resignation and the big cabinet clearout in honour of my birthday in September (who can even guess what the ANC may get me next year?), we have been blessed with a new Minister of Heath, Barbara Hogan. Babs (as she may or may not be known to her friends) has paradoxically inherited one of the easiest and most difficult jobs on the planet.  
Easiest because there’s absolutely no way she could do a worse job that her predecessor. Like managing England after Steve McClaren; becoming PM after Gordon Brown; presenting You’ve Been Framed after Lisa Riley.
Manto Tshabalala-Msimang was just rotten – perhaps almost as bad as Riley. Indeed, it has since been suggested that her (Manto, not Riley) and Mbeki’s outrageous denial of the link between HIV and AIDS and their subsequent (lack of) policies were responsible for the deaths of 330,000 people between 2000 and 2005. Barbara is going to have to be pretty ropey to even come close to matching that unfortunate legacy.

But on a (far) more serious note, South Africa is facing a massive crisis regarding HIV, exacerbated by those delays in implementing ARV drug rollout and adequate prevention policies since 1999. Hogan must now turn that around. Tomorrow – World AIDS Day – is her first big day and her plans have already been given the boost of £15million from the UK, something that was unthinkable under Mbeki and Manto:

On Monday, World Aids Day, she is to announce a return to the National Aids plan, dropped under Mr Mbeki’s rule, at a stadium event designed to mobilise the nation in the fight against the epidemic. The high-profile media campaign to raise awareness is planned, including persuading famous people to have themselves tested for HIV.

UK International Development minister Ivan Lewis said it was vital that Ms Hogan succeed in overturning myths about HIV/Aids. He said: “For too long, South Africa has been fighting Aids with its hands tied behind its back. Those ties have now been removed and the country has a fantastic opportunity to finally turn the tide in its struggle against this epidemic. Barbara Hogan has set a bold and exciting vision on HIV and Aids and that is why the UK is fully committed to working with her as she embarks on this new approach.”

Further good news in the fight against HIV is the Violari et al paper [PDF] mentioned in that BBC article, suggesting that early HIV diagnosis and implementation of antiretroviral therapy in neonates reduced early infant mortality by 76% and HIV progression by 75%. Startling.
One of the first tests of Hogan’s intentions and ability will be how quickly and effectively she is able to implement these sort of findings in her policies in order to start saving lives and redressing the appalling recent record of the SA Government on HIV.

Everyone is this country is affected in some way – directly or indirectly – by the scourge of HIV and AIDS. I think that because of that, together with the hope of a new dawn of availability of ARV drugs, HIV prevention, better education and care under Hogan, tomorrow will be probably the most marked and most optimistic recognition of World AIDS Day here in South Africa for many years.