Sunday Times (Johannesburg) - October 24, 2008
Francois Rank and Claire Keeton

Reducing the number of babies being born HIV-positive and making sure the South African National Aids Council (Sanac) is effective are two of the steps she plans to take.

In an interview with the Sunday Times this week, Hogan said she was committed to rapidly scaling up prevention of mother-to-child-transmission of HIV - an effective way to stop new infections.

The national programme only reaches about 30% of pregnant women at the moment.

"SANAC is the driver of HIV prevention strategy and needs a secretariat to be properly up and running. We are totally dependent on SANAC to drive programmes," Hogan said.

"We have the strategy for implementation on how to deal with HIV and Aids... But the pandemic is the most serious problem in South Africa from a health point of view and also from a social cohesion and the general point of view of wellbeing - psychologically, physically, emotionally."

Hogan also said she would prioritise finding a solution to staffing problems, as well as a way to ensure that provinces have the money they need to deliver health care.

"I think firstly we have one of the biggest issues we have got to deal with is the staffing of our health system from nurses through to doctors through to professional staff to workers in all our institutions," she said.

"There has been a low level of morale I think the working environment hasn't been ideal."

Hogan said it was critical to create a functioning working environment to attract health professionals who had left the country and gone into private practice, back into the public sector.

She said that it was important to find a way to "ring-fence" money for health in the provinces, since the current system allows provincial cabinets to determine the amount given to health.

"We have a very fragmented healthcare system coming out of our Constitution. It is becoming clear from the briefings that it is very unwieldy to try to manage," she said.

"I do not believe it's necessary to change the Constitution. There are other mechanisms in place to try and ring fence (budgets)."

Hogan said that a wholescale restructuring of the management systems of the health department was needed.

"I think management of our healthcare facilities is a major priority through from our primary health care clinics to our hospitals."

Hogan also says she believed consultation with health practitioners on all levels was important in order "to diagnose what's wrong" with the public health system.

The new minister said her team was looking at what they could do to turn around institutions over the next seven months and would be open to testing strategies in a few pilot projects.

She also flagged "lifestyle diseases" as a growing concern, warning that obesity, diabetes and hypertension in South Africa were rapidly rising.

Hogan also emphasised the constructive role that communities can play in promoting healthcare.

"Ironically, and very possibly, because of all the activism around

(Aids) treatment we have one of best treatment plans in the world."

She also urged people to overcome the stigma attached to HIV/Aids. "We need to make a more concerted effort for people with HIV not to feel like they need to conceal it. They should be encouraged to be open," she said.

Asked about experiences she'd had as a new member of cabinet, Hogan referred to a mistake she'd made as the new kid on the block.

"I went to cabinet with my cellphone and I was emailing and texting away when a deputy minister came to me and said: 'Comrade Barbara. You are not allowed to have your cellphone in here. Take it out immediately.'"

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