Sunday Times - Sunday, 22 February, 2004

Sindiswa Moya was catapulted from being just another unknown black South African woman to being a national heroine last week.

A former police officer, her fame did not stem from apprehending a criminal or saving someone's life - her acclaim came from pleading for her own life. The HIV-positive Moya asked President Thabo Mbeki to ensure that antiretroviral drugs, necessary to keep her alive, be distributed as the government had promised last year when it unveiled its supposed comprehensive provision plan.

In response to Moya's plea, Health Minister Manto Tshabalala-Msimang came up with what has become her stock answer to any question on the disease - an excuse. This time, she blamed the delay on a health system in shambles and said that only an irresponsible government would begin dishing out the drugs.

I'm sure Moya and the millions of other South Africans who had held out the hope that the government and Tshabalala-Msimang and her department would finally get serious about Aids, feel immensely grateful to the minister for being responsible on their behalf.

This week, Tshabalala-Msimang responded with her own letter to Moya, further explaining the difficulties her department faces in its battle to get the drugs to South Africans. Thus the minister continues her heavy-footed tap-dancing around the pandemic - something she has done for the past five years in the health portfolio.

With an election around the corner and a new Cabinet waiting, one has to wonder how South Africa manages to cope with this woman. It is difficult to recall moments of sane and competent words emanating from Tshabalala-Msimang' mouth, particularly where the Aids pandemic is concerned.

Seemingly there is little or no realisation that her behaviour affects the poorest of the poor - men and women like Moya whose CD4 counts are so low that they are incapable of working; who have no medical aid or savings that can cover their antiretroviral drugs. Seemingly the minister does not realise that as she dithers about the roll-out of antiretrovirals, she is condemning mostly black South Africans to death.

But, then again, one should not be surprised. It is during her tenure as health minister that we have witnessed the most decisive stand-offs between civil society and government over the disease.

Many South Africans thought a truce was finally reached in the Aids war two years ago when the Treatment Action Campaign and a large group of doctors fought all the way to the Constitutional Court to force the government to provide drugs to reduce mother-to-child transmission of the virus.

After a protracted battle in which the government fought the Pretoria High Court's judgment in favour of the TAC, many accepted that Tshabalala-Msimang and her department would begin to care about this country's ill citizens - even if forced by a court order to do so.

But they were wrong. Tshabalala-Msimang had hardened her heart - so much so that she stood side-by-side with Sibongile Manana when the Mpumalanga MEC sacked a hospital superintendent for allowing a rape crisis organisation to set up office on his premises. Dr Thys von Mollendorff's great sin was to show compassion to the Greater Nelspruit Rape Intervention Project, whose sin it was to provide antiretrovirals to rape victims.

Last year, Tshabalala-Msimang offended many by inviting Aids dissident Dr Roberto Giraldo to advise her department on how to fight the disease through nutrition. Giraldo, a member of Mbeki's Aids Advisory Panel, believes antiretrovirals causes HIV and that nutritional inefficiencies cause Aids.

Early last year she also invited Giraldo to a meeting of Southern African Development Community health ministers, where he announced: "The transmission of Aids from person to person is a myth. The homosexual transmission of the epidemic in Western countries, as well as the heterosexual transmission in Africa, is an assumption made without any scientific validation."

This is also the woman who has been called upon by Anglican Archbishop Njongonkulu Ndungane to resign, and whom Aids activists such as Pieter-Dirk Uys have accused of committing genocide against the people of this country.

The list of Tshabalala-Msimang's inconsistencies does not stop there. And I somehow doubt that her reign of incompetence will stop after the election, when Mbeki appoints a new Cabinet.

With his failure to fire her, Mbeki has failed to take the interests of his people to heart. He has blatantly failed the millions of children, women and men who live with the disease.

Why do we need threats of court action and civil disobedience programmes to get a government to care, and for a health minister to realise that her inaction is a deadly stumbling block? Will it only be when people like Sindiswa Moya die, begging for lives that could have been saved?

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