Site navigation

Volunteer peer educators from the Centre for Positive Care practice their singing in rural Venda, Limpopo province. They are singing songs – often church or freedom songs from the apartheid era – adapted to promote a safer sex message. Photo: Paul Weinberg/OxfamAUS

HIV and AIDS in South Africa: a question of leadership

With as many as 900 South Africans dying every day because of AIDS-related conditions, communities can ill-afford any new barriers to the government's response to HIV. Given World AIDS Day's theme of "leadership", it is timely to ask whether those at ministerial level in South Africa have enough acceptance and understanding of HIV and AIDS and related issues  to continue to successfully lead the national HIV and AIDS agenda.

The impact of HIV and AIDS and slow roll-out of treatment on the social, political and economic fabric of South Africa is immense. More than 5.5 million men, women and children are living with HIV and AIDS with millions more family members and communities seriously affected. In KwaZulu-Natal province alone, approximately 40 percent of the adult population is living with HIV and AIDS. This creates an enormous financial burden with the cost of medical treatment, funerals of multiple family members, and caring for children orphaned by AIDS draining household and community resources and entrenching poverty.

With the dismissal of deputy health minister Ms Madlala-Routledge in controversial circumstances earlier this year, the leadership of the national HIV and AIDS agenda now falls back to Ms Manto Tshabalala-Msimang, the Minister of Health. Ms Tshabalala-Msimang has long courted disquiet among many for her track record of publicly supporting dubious attitudes and approaches to HIV treatment and for her lack of cooperation with some civil society organisations.

The first test of this leadership will be the fulfilment of targets set forth in the HIV, AIDS and STI national strategic plan. As some government ministers and other senior officials act to distance themselves from the views of the dismissed health minister, we should ask whether political commitment to this plan will remain, given that the former minister was intrinsic to its development and promotion.

In the area of international health and development, sometimes, despite political chaos, good service delivery happens; at others, despite excellent political and policy work, delivery can be chaotic. But in responding to a crisis as serious as the twin epidemics of HIV and AIDS which affect millions of South Africans, is an uncertain outcome acceptable? National success in tackling HIV and AIDS requires leaders of strong purpose and practice, together with an absolute commitment to addressing both the facts of the impact of HIV and AIDS and the huge, but not insurmountable, scope of the epidemic.