Sunday Times, South Africa - June 4, 2000
Laurice Taitz

Tshabalala-Msimang was invited to a debate hosted by the Centre for Development and Enterprise which posed the question: "Why is the government struggling to make an impact on the AIDS crisis?"

But instead of tackling it, she deftly rephrased the problem and asked the audience: "Why is South African society struggling to make an impact?"

While her question is an important one, this change in emphasis was a tactical manoeuvre to shift responsibility rather than an attempt to find real answers.

Instead of seizing the opportunity to acknowledge past blunders and inspire confidence in the government's present strategies, TshabalalaMsimang chastised the audience for believing that the government has a central role in tackling the AIDS crisis.

She shifted the focus from the government to individual responsibility - thereby inadvertently questioning the government's ability to lead.

She said : "As government we cannot outlaw sexual contact," and added, with a giggle, "It is too exciting to do so."

She said: "I am not saying this to minimise government responsibility but there is no way government can make an impact on AIDS unless every individual takes responsibility for their sexual behaviour."

Throughout the evening, she frequently returned to the same slogan: "Remember, every action counts."

While on the most simplistic level this approach seems to make perfect sense, it fails to take into account that the low status of women in South African society, violence, poverty and illiteracy all hamper the negotiation of safe sex between partners.

As Tshabalala-Msimang acknowledged later - contradicting her earlier approach - AIDS is not just about sex.

It is about attitudes and behaviour and a slew of socioeconomic and cultural forces.

The government may have no role to play in the bedroom, but that doesn't mean it can relinquish its responsibility to lead, to govern and to protect. That comes with the job. So far the government has struggled to make an impact on the AIDS epidemic because of an unwillingness to tackle the issue head on.

It has not listened to the advice of experts, nor acknowledged failures and mistakes in a way that would prevent their repetition. It should admit that present strategy has helped undermine confidence in efforts to preach prevention.

On Tuesday night, the minister preached that "every action counts". Perhaps she should heed her own advice.

Respected academic vs the government on the key issues around the epidemic

THESE are key points in the debate between the Minister of Health, Dr Manto TshabalalaMsimang, and the University of Natal's Professor Jerry Coovadia, the convenor of the International AIDS Conference, due to be held in Durban in July.

ON RESPONSIBILITY:

Tshabalala-Msimang: "We can make laws, we can attempt to change people's behaviour but we cannot change what's in people's minds and their hearts.

"That's the place where government responsibility ends and individual responsibility begins."

Coovadia: "There have been problems and mistakes that have affected government credibility. Sarafina 2 , Virodene, notification and the composition of the present Presidential AIDS panel have all contributed to today's problems with controlling the disease through prevention.

"Government is culpable."

ON THE PRESIDENT CONSULTING DISSIDENTS:

Tshabalala-Msimang: "The President never said HIV doesn't cause AIDS. The President said we have developed strategies and put in a lot of resources and we are not seeing returns. What is it we are not doing right?"

Coovadia: "Government has contributed to the present climate of confusion around HIV/AIDS by raising the possibility that HIV does not cause AIDS and that certain antiretrovirals are toxic and poisonous. When government says something that even raises an iota of doubt, the person in the street will ask: 'Why the hell should I wear a condom? Why should I stick to one sex partner?' "

ON THE ADVISORY PANEL:

Tshabalala-Msimang: "It had never been an idea not to put South Africans on the panel. But it was not going to be dominated by our scientists."

Coovadia: "[President Thabo Mbeki] had an alternative. He could have picked up the phone and said: 'Hello, William [Makgoba, president of the Medical Research Council], this is what some scientists in California are saying. Is it true or not?' "

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