Cost of denial

2009-03-16 00:00

Now that George W. Bush has left the White House, Barack Obama is starting to reverse some of Bush’s more controversial policy decisions. In somewhat similar vein, Thabo Mbeki’s presidential legacy is coming under increasingly critical scrutiny, not only from political rivals and opponents but also from more objective analysts. Among the most damning is the study by Nicoli Nattrass, director of the Aids and Society Research Unit at the University of Cape Town and visiting scholar with the Health Economics and HIV/Aids Research Division at UKZN, which shows that the delay in the government’s roll out of antiretroviral treatment has led to approximately 171 000 HIV infections and 343 000 deaths that might otherwise have been prevented. Those are appalling figures, and the fact that they include mother-to-child infections makes them all the more distressing.

Nattrass arrived at that estimate by comparing infection rates in the Western Cape, where national policy was set aside, with the rates in the rest of the country where it was more rigorously imposed. And this grossly misguided national policy can be traced to two key sources: ex-president Mbeki himself, with his aberrant views on HIV/Aids and its causes, and his controversial Minister of Health, Manto Tshabalala-Msimang. Mbeki’s denialism affected many facets of his leadership in both domestic and international affairs, but there are few in which the cost to the people, in suffering and death, has been so evident and so terrible.

For the 343 000 dead, there is no way to retrieve the situation. For a nation soon to choose new political leaders, however, there is a lesson to learn. The core function of a government is to care for the welfare of its people, and of the environment upon which the wellbeing of humanity depends. With a leader known for prickliness, his intellectual remoteness and his insistence on getting his own way, the Mbeki administration put its political aspirations ahead of the people’s needs. As the Western Cape example illustrates, different leadership yielded different consequences. The nation needs leaders who are accessible and open-minded, willing to be guided by validated expert opinion and big enough to concede that their own thinking could be flawed. The quality of leadership can literally be a matter of life and death.

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