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Page last updated at 13:25 GMT, Monday, 6 October 2008 14:25 UK

New era for S Africa Aids fight?

South Africans protesting to demand ARVs

By Peter Biles
BBC News, Johannesburg

South Africa's fight against HIV/Aids is likely to receive an important boost, following the appointment of a new health minister, Barbara Hogan.

She was sworn in last week, after President Kgalema Motlanthe named his cabinet.

Ms Hogan's predecessor, Manto Tshabalala-Msimang has been sidelined, and appointed a minister in the presidency, without any clearly defined responsibility.

Mr Zuma is still remembered for his highly irresponsible statements

Dr Tshabalala-Msimang, who became known as "Dr Beetroot", had been a highly controversial health minister.

She was ridiculed at home and abroad for her unorthodox approach to the HIV/Aids crisis, which included the strong advocacy of remedies such as beetroot, garlic, olive oil and African potatoes.

Denialism

According to Professor Nicoli Natrass of the University of Cape Town, Ms Tshabalala-Msimang created confusion by describing anti-retroviral drugs (ARVs) as toxic:

Barbara Hogan
I would thoroughly endorse the roll-out of anti-retrovirals and any way we can accelerate that
Health Minister Barbara Hogan

"She undermined, rather than energised the roll-out of ARVs."

South Africa's leading Aids lobby group, the Treatment Action Campaign (TAC) is confident that Ms Hogan has the ability to improve the country's health system.

"She has been one of the few members of parliament to speak out against Aids denialism and to offer support to the TAC, even during the worst period of Aids denialism by former President Thabo Mbeki and former Health Minister Manto Tshabalala-Msimang," said a TAC statement.

In one of her first interviews since last week's appointment, Barbara Hogan told South Africa's News 24 that she sees HIV/Aids as her biggest challenge.

With more than 5.5m people HIV-positive, according to UNAids, South Africa is the country with the largest number of infections in the world.

Serenaded

"The previous cabinet believed HIV/Aids was a very serious issue and I would thoroughly endorse the roll-out of anti-retrovirals and any way we can accelerate that, the better," said Ms Hogan.

HIV/AIDS IN SOUTH AFRICA
Number of people with HIV: More than 5.5m
Percentage of the population with HIV: 11%
Patients receiving ARVs in June: 495,000
Patients in need of ARVs: 520,000
Reported HIV/Aids deaths: 591,000
Sources: South Africa At A Glance 2008-09, UN Human Development Report 2007, Avert

After years of open hostility between Dr Tshabalala-Msimang and the Treatment Action Campaign, the new health minister and the TAC are both looking forward to a new era of co-operation.

TAC's deputy general secretary Zackie Achmat, led a delegation which serenaded Hogan outside her Cape Town home on the night of her appointment.

"As with any NGO [non-governmental organisation], I would welcome their participation and assistance", Ms Hogan said.

"I'm not saying we will always agree, but I've always had a good relationship with the TAC and NGOs involved in that sector.

"I think you need to mobilise every possible sector of society at the moment, from the private sector to the NGO sector to the government sector, to improve our health services," Ms Hogan told News 24.

Tide turning?

Barbara Hogan has a long history of political activism in South Africa.

ANC leader Jacob Zuma
We want more action with regards to the reduction of HIV infections... as well as widespread HIV prevention, treatment and support programmes
ANC leader Jacob Zuma

A caller to Talk Radio 702 this week described how when Hogan was a teenager, he witnessed her flat in Johannesburg being raided by the security police in 1975.

She was later imprisoned for eight years by the apartheid state.

It had been thought possible that the new minister of health would be Nozizwe Madlala-Routledge, the former deputy minister, who was sacked by Mr Mbeki last year, much to the dismay of health activists.

They had applauded her open and refreshing approach to the HIV/Aids crisis.

However, she has now been made the new deputy parliamentary speaker.

This year, UNAids has reported that the HIV epidemic in South Africa, Malawi and Zambia appears to have stabilised, even though southern Africa continues to bear a disproportionate share of the global Aids burden.

In his first televised address to the nation after taking office, President Kgalema Motlanthe highlighted the primary tasks set out by government at the time of the last election in 2004, including the need to "turn the tide against HIV and Aids."

Rape case

ANC President Jacob Zuma, who is favourite to become South Africa's head of state after elections next year, has also given a strong commitment to address South Africa's health needs.

South Africa's former health minister Manto Tshabalala-Msimang
Manto Tshabalala-Msimang was ridiculed at home and abroad

"We want more action with regards to the reduction of HIV infections, in effective treatment for tuberculosis and other infectious diseases, as well as widespread HIV prevention, treatment and support programmes," he wrote in the latest ANC newsletter.

However, Mr Zuma is still remembered for his highly irresponsible statements in court in 2006 when he was on trial, accused of raping a 31-year-old HIV-positive woman who was a family friend.

He was acquitted of rape, but admitted having unprotected sex with his accuser. He also told the court he had taken a shower after intercourse as this might reduce the likelihood of contracting HIV.

The comments enraged Aids activists who argued this had set back South Africa's fight against HIV/Aids.

Two-and-a-half years later, the country's leading cartoonist Jonathan Shapiro, known as Zapiro, still depicts Mr Zuma with a shower fitting on his head.

South Africa now boasts the largest ARV treatment programme in the world, but accurate statistics are hard to come by.

The TAC cites the Actuarial Society of South Africa, which reckons that by June 2008, 495,000 people were receiving ARV anti-retroviral treatment, while another 520,000 were in need of treatment.

South Africa's stance on HIV/Aids may be changing for the better, but the scale of the crisis does not lessen the task that awaits the new team in government.


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