Anti-retroviral drugs: Zuma's promise rings hollow

Today's statement by Health Minister Aaron Motsoaledi that South Africa will not meet the target President Jacob Zuma identified in his State of the Nation Address - of providing anti-retroviral drugs to 80% of people living with HIV/Aids by 2011 - due to logistical problems and a lack of personnel is a further example of an unrealistic promise, based on poor planning and which has had the effect of damaging public faith in the ANC administration's ability to deliver.

Reality is slowly but steadily being enforced on President Zuma's administration. For much of his first few months in office, the South African public was treated to a series of promises and goals which distinguished themselves in spirit from President Mbeki's tenure, but in practice lacked the substance and foresight to make them reality.

Put another way, there was an intense focus on problems at the top end of the scale at the expense of basic fundamentals. And if the basic fundamentals are ignored or denied, in much the same way there were under the previous administration, the problems at the top end of the scale will only ever get worse. The anti-retroviral programme is a good example of this trend.

Just 100 days after President Zuma made the commitment, the Department has had to manage expectations. Quite clearly, in making the announcement, the President failed to account for:

• The chronic lack of human resources in the Department;
• The huge funding implications (the programme is running at a deficit of R1 billion); and
• The enormous management and logistical challenges that implementing a programme of this nature requires

Unless these fundamentals are addressed any plan will be dead in the water.

The consequences of all of this are borne by those people living with HIV. It is their expectations that were lifted by the President's announcement and their hopes that will now be diminished.

If the government cannot run a programme of this importance and size effectively and efficiently how does it envision managing the National Health Insurance Scheme, a proposal which dwarfs the anti-retroviral roll-out programme both in terms of its practical implications and the financial management necessary to make it work.

I will be submitting a written question to the President, asking whether or not his administration costed his undertaking or made an effort to determine the logistical implications of it and, one way or the other, how it has come to pass that his commitment now rings hollow.

Statement issued by Mike Waters, MP, Democratic Alliance shadow minister of health, September 15 2009

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