Dr Thembisile Xulu was recently appointed as the new CEO of the South African National AIDS Council (Sanac). Biénne Huisman spoke to Xulu on October 2 (her second day in office), about her new role, her love for medicine, and growing up in a family of strong women.
Dr Thembisile Xulu, the newly appointed CEO of the South African National AIDS Council (Sanac), describes herself as an empath and very ambitious.
She stems from a line of formidable women. When Xulu was seven years old, her mother, Sisana, a single parent, joined the armed struggle in Swaziland. Xulu was raised by her great grandmothers Gogo Victoria, a nurse, and Gogo Ruby, a seamstress - both also managed a trading store in the Durban township of Inanda, where Xulu learnt to count change and treat people with respect – skills that may come in handy in her new position.
“From a very young age I was part of stock-taking and able to count change. There were older people working with me in that shop; there were things that they could learn from me. But they could only learn from me if I was a child that they felt comfortable sitting with and listening to. So I learnt back then, in order to be respected, you need to show respect first. It’s something I’ve carried with me for the longest time. It’s probably biblical as well. I treat other people, no matter who they are, how I want to be treated,” she said.
Over Zoom, Xulu’s speech is spiced with eye-rolling exclamations, like “goodness!” More than once she refers to herself in the third person as “Dr T”, describing herself as a “tamed KwaZulu-Natal migrant labour, in Joburg searching for gold”.
“To inspire and drive the bus”
Apart from great ambition to rise to the top, the interview reveals her humility.
“When I sit in a room, I don’t necessarily regard myself as the smartest. In fact, mostly I’m not. I thrive when I manage people who are smarter than me. My job is to inspire and to drive the bus. But I need team members holding the GPS to say ‘driver, this thing is not going the right way, we need to go there or there’,” she said.
The role of Sanac
Sanac is a forum through which, among others, South Africa’s National Strategic Plan (NSP) for HIV, TB, and STIs are developed. Currently, the 2017-2022 plan, which maps the measurable goals set for the country’s fight against HIV, TB, and STIs, is in effect. Xulu will oversee the development of a new plan starting later this year.
She inherited the position from Dr Sandile Buthelezi, who on becoming director-general of the Health Department in May, admitted to Daily Maverick that he only partially stabilised “disruption and infighting” at Sanac.
Going forward, how does Xulu see Sanac’s role and relevance?
“Sanac is mainly meant to coordinate the national response to HIV, TB, and to STIs. There are multiple players that are key from donors, civil society, to the private sector. Sanac is the body that makes sure that, even though we might all be doing different things, the direction is towards one common objective, as stipulated in the NSP,” she said.
She added that even though Sanac has established capacity in securing international funding – it hosts South Africa’s Global Fund Country Coordinating Mechanism (CCM). This is a growth area which she hopes to strengthen through better donor coordination.
“When resources come in, Sanac must advise how these resources are used. We must then track the performance and be able to report back to donors and government and other entities that are interested. We need to identify where are the shortfalls, where we are going wrong. And we need to put together plans to implement corrective action. While we course-correct, there are budget implications that need to be discussed and approved.”
Asked how Sanac can be improved, Xulu said she needed more time to assess the organisation. “It’s only been a day. I haven’t even met the stakeholders. I haven’t sat with the board since my appointment. I would hate to say anything that is not founded. I haven’t had a chance to engage with civil society. I will do that soon. There will come a time when I’m bold enough to give an honest assessment,” she said.
Making a difference
Xulu takes over the reins on the back of 16 years at HIV treatment non-profit organisation, Right To Care. Before that, she did perinatal HIV research at the Chris Hani Baragwanath Academic Hospital in Johannesburg.
On branching from HIV as a clinician into HIV as a public health issue, she said; “We were doing clinical trials on new drugs and didn’t know what the new drugs were going to do to anyone. One piece of advice I would give to young women partaking in the study was not to fall pregnant. We would give them access to contraceptives. But human beings are human beings, and lo-and-behold, there would be two or three females that are pregnant. As I said, I regard myself as an empath. It really got to me, because when somebody falls pregnant on a drug that you don’t know the effects of, it looks like you are not doing your job,” Xulu explains.
“So I decided at that point that, you know what, I love my job. I love HIV and TB. But I can’t do one-on-one medicine. I still wanted to make a difference, but it had to be on a policy level and management level. That’s when I got my supervisor to write a motivation for me to go to Wits [University], to do a master’s degree in public health. And I enrolled.”
Xulu started at Right to Care in 2004. Three years later, she became the director. “At Right to Care, I did everything. I could run grants, I could manage finance, NGOs and clinics. When Right to Care International started, I was made managing director, which meant I had the blessing of starting Right to Care Lesotho, Malawi, Ukraine, Myanmar, Haiti, Dominican Republic.”
Family and medicine
Xulu says it was her great grandmothers that instilled her passion for health care.
“They were quite sickly. One was hypertensive, the other was diabetic with a chronic ulcer on her left ankle. By the time I was in fourth grade, I used to take a day off school every month, going to King Edward Hospital to queue at the MOPD (Medical Outpatient Department) for them to see the doctor and the pharmacy for them to collect medication. When my mum left for Swaziland, she left the grannies her car, so they had a driver who would drive them and me to the hospital. They would wait in the car while I’d be sitting in the queue. When it was just about their turn the driver would go call them,” Xulu recalls.
“When Gogo’s feet were swollen, I was the one who would boil water and put her feet in it. The two of them lived together until they passed on. And I think that’s where my love for medicine started because I would say to them ‘Gogo when I grow up, I am going to fix your foot, or whatever’.”
At Inanda Seminary, Xulu excelled in maths, biology, and physics. She studied medicine at the University of KwaZulu-Natal, where her mum was a manager of student affairs, which helped subsidise her fees. “By the time I got into second year, I was working in hospitals, including Prince Mshiyeni Hospital in Umlazi for extra money. I was then funded by the [KZN] province from second year until final year,” she said.
Xulu recalls a time during her studies when they lived in a one-bedroom flat. Her mum and two young brothers sleeping on a double bed, and herself on a single bed. It wasn’t always easy, but she persevered, doing her community service at Prince Mshiyeni, then staying an additional year to complete a diploma in obstetrics.
“I’d run into a woman in the market, or at the Spar or Checkers and she would just pick up her shirt and say ‘doctor, look, your scar has healed’.” Xulu recalls the joy of handing mothers their babies and telling them their baby is well. “This is something I set my heart on.”
Today, Xulu is divorced with two daughters aged 12 and 18, who live with her in Ruimsig, Johannesburg. In keeping with their family tradition of matriarchy, Xulu’s mother (67) now lives with her and is helping to raise the girls.
“The 18-year-old is very artsy. A girly girl. She likes make-up and looking pretty. The 12-year-old is a bit like me, tomboyish, as people say, she’s a fighter,” said Xulu.
She recalled how her 12-year-old was almost expelled from school. “When she was in grade one, and I think her sister was in grade five, she punched a boy who was bullying her sister. I was called to a meeting, to discuss the fact that she needed to be expelled. But I had theatre or something that morning so I asked to come in the afternoon. By the time I came, I was lucky that two other parents had reported the same boy for bullying and the boy got expelled.”
Speaking from Sanac’s Pretoria office, Xulu said she likes to relax with a romantic novel, having just ordered the fourth novel by Zulu writer Dudu Busani Dube, called Iqunga. “Dudu writes about a taxi cartel. It’s three brothers, one falls in love with a doctor, the other one falls in love with a journalist. But the guys are so romantic.”
As the interview draws to an end Xulu’s day is filled with meetings – not to mention the considerable challenge of steering the ship at Sanac.
*This article was produced by Spotlight – health journalism in the public interest.