Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - April 6, 2009
Claire Keeton
WHEN Health Minister Barbara Hogan closed the 4th SA Aids conference in Durban on Friday she delivered a powerful, sober speech but she did not grab headlines like her predecessor, Manto Tshabalala-Msimang.
"Dr Beetroot" made headlines for all the wrong reasons at four previous Aids conferences in Durban and at two international ones - in Thailand and Canada - during her term from 1999 to 2008. Since her removal, and that of her boss, Thabo Mbeki, the implementation of South Africa's national strategic plan for HIV-Aids has progressed under a revamped National Aids Council.
About 700 000 South Africans are on antiretroviral drugs.
In July 2000, at an international Aids conference in Durban, health professionals and activists demanded access to treatment and were forced to unite against Aids denialism.
More than 5000 scientists signed the Durban Declaration in July that year, affirming that HIV is the cause of Aids.
Three years later, at the 1st South African Aids conference, delegates - led by the Treatment Action Campaign - were still fighting for medicines, and protests echoed around the convention centre.
That conference ended with a victory on August 8 2003, when the Cabinet announced that the government would roll out antiretroviral drugs in public hospitals.
In 2005, at the 2nd South African Aids conference, Tshabalala-Msimang was divisive and disruptive. She did not confirm her attendance but pitched up for the opening ceremony anyway and attacked keynote speaker Mamphela Ramphele in her speech. She also attacked HIV-Aids scientists and promoted traditional medicines on and off the stage.
Between 2000 and 2005, about 330000 people died of Aids as the government stalled its ARV roll-out.
In 2007, at the 3rd South African Aids conference, Tshabalala- Msimang failed again to provide leadership. Instead, she and her director-general, Thami Mseleku, tried to sideline Deputy Health Minister Nozizwe Madlala-Routledge, who was taking the lead on HIV-Aids.
Another two years have passed and South Africa has the world's largest treatment programme, but it is buckling under the load and inadequate funding.
At this, the 4th South African Aids conference, the TAC led a small protest on the funding crisis and problems with antiretroviral access in the Free State.
Hogan tackled the "very serious financial crisis in the Free State late last year" by saying: "I hope that we will be able to address many of these issues but there are no quick fixes.
"We must ensure that health services are not cut but sustained."
In contrast to Tshabalala-Msimang, she picked up the priorities of the delegates, from TB to the prevention of mother-to-child HIV transmission.
She thanked the scientists and conference organisers for their contribution to stopping HIV.
Hogan also thanked international donors - such as the US, for its Pepfar programme - and called on them to sustain funding.
Francois Venter, president of the HIV Clinicians' Society of Southern Africa and chairman of the next South African Aids conference, in 2011, said of Hogan's speech: "It is good to have an honest appraisal of the successes and failures of the healthcare system.
"She understands the complexity and challenges, and has empathy for patients and professionals. Her comments on Zimbabwe and on preventing another Free State are heartening."
But it is unknown whether Hogan will be reappointed after this month's election. She is under fire for criticising the government on the Dalai Lama issue.
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