The New York Times - August 31, 2009
The new government of President Jacob Zuma seems to have a clearer-eyed view of the problem, its remedies and the need to improve the overall health care system than its predecessor did. Fixing what's broken will not be easy, but we are encouraged by signs of a commitment to do so.
To see how far South African leaders have come, one needs to recall where the country was.
The former president, Thabo Mbeki, compiled a record that is still hard to fathom: he embraced crackpot theories that disputed the demonstrable fact that AIDS was transmitted by a treatable virus. He insisted that antiretroviral drugs were toxic and encouraged useless herbal folk remedies instead. He even claimed he knew nobody with the disease, although nearly 20 percent of the adult population is said to be living with H.I.V.
Thousands of Africans were needlessly sickened and died. And the most influential country in sub-Saharan Africa squandered the opportunity to contain the AIDS epidemic. Although it has less than 1 percent of the world's population, South Africa now accounts for 17 percent of the world's burden of H.I.V. infection.
A saner approach began to take shape last year after Mr. Mbeki was forced out of office and Barbara Hogan was named health minister. Last week, the new health minister, Dr. Aaron Motsoaledi, went further.
He accepted a withering critique by South African scientists, who said the governing African National Congress party's record on AIDS and health care was deeply flawed, and promised remedial action. "We do take responsibility for what has happened and responsibility for how we move forward," Dr. Motsoaledi said in an article by The Times's Celia Dugger.
South Africa's leaders must espouse sensible, scientifically based advice about AIDS and put in place programs that seek to both treat and prevent the disease. That means expanding efforts to prevent mothers from infecting their babies, discouraging people from having multiple sex partners and offering circumcision to men, a relatively simple surgical procedure proved to have greatly reduced the risk of infection in South Africa.
The problem is bigger than AIDS. Even though South Africa spends more on health than any other African country, tuberculosis is rampant and child mortality rates are rising. The government must work to improve the quality of health care, ensure that all South Africans have access to the system and fire incompetent staff.
None of this will reverse the damage and deaths of Mr. Mbeki's disastrous legacy, but it can offer the people of South Africa a better future.
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