Monday, September 29, 2008

Health Minister's Removal the Right RX

Hours after taking office, South Africa's new president announced he was removing Manto Tshabalala-Msimang as health minister.

At last, Dr. Beetroot has been uprooted.

Dr. Tshabalala-Msimang truly earned her reputation as an international laughingstock during her tenure as health minister. She met South Africa's AIDS crisis with all the medical sense of Dr. Seuss.

Scientists may believe antiretroviral drugs are the best way of fighting AIDS, but you couldn't prove that by her. She often expressed doubt over the drugs' side effects. Instead, she told HIV-positive people to eat beetroot, garlic, lemon, olive oil and potatoes.

That's how she came by her nicknames of "Dr. Beetroot" and "Dr. Garlic." It seems to me "Dr. Do-Little" works too.

Tshabalala-Msimang wasn't the only one in government with warped views. She was a close ally of former president Thabo Mbeki, who became infamous for denying that HIV causes AIDS. Clearly a world leader in the mold of Ronald "I-will-not-say-AIDS" Reagan.

The Treatment Action Campaign, South Africa's leading AIDS activist organization, regularly fought the health minister in the courts. "Over 2 million South Africans died of AIDS during the presidency of Thabo Mbeki. At least 300,000 deaths could have been avoided," said the group after Tshabalala-Msimang was removed. "Mbeki and his health minister pursued a policy of politically supported AIDS denialism and undermined the scientific governance of medicine."

In other words, nuts to your vegetables.

The opposition party, the Democratic Alliance, had a blunt response to her departure: "Tens of thousands of South Africans have lost their lives because of her ridiculous policies on HIV/AIDS, and she should have been fired nine years ago."

The bellows for her resignation peaked in 2006. At the International AIDS Conference in Toronto that year, the nation of South Africa, like many others, had a display. South Africa's exhibition was festooned with beetroot, lemons and garlic. Reportedly the resulting criticism prompted health ministry employees to toss on a few bottles of pills. I assume this didn't stop the criticism, nor add much aesthetically.

In a speech in Toronto, then-U.N. envoy for AIDS in Africa, Stephen Lewis, blasted the Mbeki government's AIDS policies as "more worthy of a lunatic fringe than of a concerned and compassionate state."

Tshabalala-Msimang then declared Lewis was as unwelcome in South Africa as nail fungus, prompting over 80 international scientists to pen an open letter to Mbeki.

"To promote ineffective, immoral policies on HIV/AIDS endangers lives," they wrote. "To have as a health minister a person who now has no international respect is an embarrassment to the South African government."

But Dr. Beetroot remained planted in office until now. Mbeki's successor as president, Kgalema Motlanthe, moved her to a lesser position in his office. She's now head of government communications.

If that means she deals with the media, expect fireworks. Consider how, speaking to reporters after being sworn in, she pooh-poohed previous criticism. "The only critics were the media, and the media had lost perception," she said.

Since her critics were actually everywhere, inside and outside South Africa, it seems she's the one who doesn't excel in the perception department.

Her replacement faces a mountain of a job. South Africa has the most people with HIV in the world, some 5.4 million. No sweat.

A group of AIDS activists saw to it that the new health minister got off to a good start. The activists, thrilled at Dr. Beetroot's re-assignment, gathered outside the Cape Town apartment of new minister Barbara Hogan, and serenaded her. She came down from her apartment and drank champagne with them. Hogan told them she was "deeply touched."

She must be to take on this job.