Important note: Information in this article was accurate in 2007. The state of the art may have changed since the publication date.
South African Press Association - August 24, 2007
In an open letter published on the DA's SA Today website today, she has offered the president a list of reasons why he should sack his controversial health minister, Manto Tshabalala-Msimang.
"In response to the numerous calls from influential quarters that you discharge from office... Health Minister Manto Tshabalala-Msimang, your office has asked that evidence for such an act be presented to you.
"... I respectfully submit the evidence you have requested, and trust that you will accordingly act promptly and decisively," she says in the letter.
Earlier this month, the presidency invited "anyone who may have evidence which demonstrates that any minister or deputy minister has acted in dereliction of duty... to forward such evidence to the presidency".
Zille said apart from the more recent allegations concerning Tshabalala-Msimang - including that she acquired a liver transplant through improper influence, needed the new organ because of alcoholism, and was convicted of theft in Botswana - the case for her dismissal rested on "incontrovertible" grounds.
"Through a combination of chronic mismanagement and poor judgement, she has presided over a marked deterioration in the quality, efficiency and morale of her department," Zille said.
This included:
* The inordinate delay in the antiretroviral treatment programme. A roll-out of antiretrovirals (ARVs) had began only two-and-a-half years ago, and only after legal action and civil disobedience at home and condemnation abroad;
* The minister's "bizarre" opinions on HIV and Aids. Among many other controversies, she had insisted ARVs were poisons and refused to authorise a cheap and easy Nevirapine programme to prevent the transmission of HIV from mothers to babies until the Constitutional Court forced her hand; and,
* On several occasions, the minister had provoked outrage with claims that fruit, vegetables and traditional medicines were equivalent treatments to ARVs.
In her letter, Zille reminded Mbeki that in September last year, 81 leading scientists had written to him, urging the president to fire his health minister.
They had said at the time: "To have as health minister someone who now has no international respect, is an embarrassment to the South African government."
Tuberculosis was another area where the minister has failed to exercise proper leadership.
"Little more than half of all tuberculosis patients are cured in South Africa, multi-drug resistant TB is on the rise, and government seems unable to address the disease."
Zille said the DA's call for Msimang's dismissal stemmed not only from her mishandling of epidemics.
"The department has also over the years become increasingly infamous for inefficiency, neglect and bureaucratic obstructionism.
"The minister presides over a department with a very poor financial management record - three disclaimers of opinion in the last four audit reports."
More serious was the "steady deterioration" of state hospitals.
"The revelation of appalling conditions at the Mount Frere pre-natal ward... are replicated by equally disgraceful conditions elsewhere."
Other areas demonstrating departmental inefficiency included:
* The restructuring of the Medicines Control Council, which had been on the government's agenda for 10 years, with little action;
* A four-year wait for regulations allowing nurses to prescribe certain medicines, including ARVs, with no action having been taken; and,
* A three-year wait for a system to regulate alternative medicines.
Zille said the question to be asked was not whether there was a case for firing the health minister, but how she had held onto her position for so long.
She appealed to Mbeki to take the action necessary to restore the credibility of the health department and South Africa's international standing.
"I respectfully urge that is its time to let Dr Tshabalala-Msimang go now," she said.
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