Aids in South Africa – Ministerial Visit

On Friday, 26 October, the Minister of Health for Kwa-Zulu Natal, South Africa?s most populous province, stopped over at KSG to deliver an address about the devastating virus that is affecting millions in Sub-Saharan Africa. Dr Zweli Mkhize was en-route to Washington, DC to attend a NIH conference on developing a HIV/AIDS therapeutic agenda for resource-limited countries. The atmosphere in the room during the lunchtime talk was charged with the warmth of old friends re-uniting, with at least 4 people present (including the speaker) from my alma mater, the Nelson Mandela Medical School in South Africa. But once the ?Howzits? and hugs were over, Mkhize had a serious message to deliver.

In a country that gave the world its first heart transplant, Mkhize indicated that approximately 19.9% of the adult population is currently HIV infected. Over the past year the national government?s handling of the HIV/AIDS crisis has received criticism from domestic and international commentators. More recently, critics have charged President Mbeki with downplaying the magnitude of the HIV/AIDS disaster by appearing to focus on outdated statistics regarding the common causes of mortality in South Africa.

Mkhize addressed the above issues early in his presentation and went on to discuss the government?s plans for the way forward.

He was emphatic that the national government was not in denial about the HIV/AIDS crisis and was doing ?everything possible? to provide a responsible health service to its citizens. He reminded the audience that South Africa?s first democratic government was only 7 years old and that other than the HIV/AIDS epidemic, it had inherited from its apartheid predecessor numerous other social, economic and health catastrophes that also were in need of limited government resources. According to Mkhize, it was essential for the government to also give attention to these other matters and this should not be perceived as undermining its HIV/AIDS initiative.

Mkhize pointed out that in the breathtakingly beautiful province of KZN, the Infant Mortality Rate is 52.1(US rate for1998 was 7.2- data from National Center for Health Statistics). Furthermore, less than 50% of the population has access to piped water and even if antiretroviral agents were routinely available within the public health sector (which they are not), the average distance a patient would have to walk to the nearest clinic to get the drugs is 2.8 miles.

Other than the competing priorities for limited resources, Mkhize listed financial, infrastructure and political constraints as well as limited human resources as confounding variables in the struggle against HIV/AIDS. These constraints were not restricted to the dilemma in South Africa but rather mirrored the dire situation in Sub-Saharan Africa.

He proposed various synergistic approaches on the way forward. One was the development of sustainable programs that would cater to the African situation taking into account African resources. Whilst such an approach required the assistance of the international community with respect to issues such as debt re-structuring to improve the overall economic climate in Africa, Mkhize emphasized the need for local economic development. Another approach within South Africa was the government?s plans to broaden its HIV/AIDS working coalition to include grassroots health workers, the private health sector and the corporate sector.

Mkhize concluded that the road ahead would undoubtedly present many obstacles but his team and the South African nation were up to the challenge.