Unsurprisingly, I'm not the only one celebrating the axing of Health Minister Manto Tshabalala-Msimang. Fellow South African skeptical bloggers Irreverence and subtle shift in emphasis are also overjoyed, as is the local media. Perhaps a tad surprisingly, the international media has also reacted: CNN, The Scotsman, BBC News, the Associated Press and several others carried the happy news of Manto's ouster.
Again, however, the news is not all good... I found out via Nature News that parliament quietly passed the "Medicines and Related Substances Amendment Bill" (pdf) two days before Mbeki's retirement. While there are positives to the bill, overall it is an enormous blow to the scientific regulation of medicines in South Africa. The principal reason for this is that it replaces the fairly independent and internationally respected Medicines Control Council (don't judge an organization by its website) with the "South African Health Products Regulatory Authority" that, crucially, is "accountable to and reports to the Minister" (p. 3 of the above pdf). The Authority, in other words, is not independent of political interference. Specifically, while the Authority can "certify" a medical product (i.e. declare that it is safe, effective and so on [see p. 5]), the minister decides whether it is "in the public interest" to "register" it. Amazingly, the minister is to make this decision in terms of, amongst other things, "public health interests including national epidemiological trends", "economic interests in relation to health policies" and "whether the product is supportive of national health policy and goals in the long term" (p. 6). In other words, the minister can do as she damn well pleases. And, it seems, not only can a product be sold only if it is both certified and registered, the minister can authorize the sale of products which have not been certified or registered (p. 10 - 11). So, on the one hand, the Minister of Health can, by law, block access to treatments that are safe and effective, and, on the other, allow the sale of untested and possibly unsafe medical products. Again, the minister does what she wilt and South African patients will thus have to suffer what they must. (Sorry Thucydides). No wonder the Democratic Alliance and the AIDS Law Project together with the Treatment Action Campaign (pdf) opposed the legislation. (The TAC and AIDS Law Project's proposed amendments (pdf) were excellent but, alas, the bill's text actually became worse after their submission: compare the September 3rd text (pdf) to the official act's).
All of this means that we should be more happy than ever that Manto has been ousted. Imagine, if you can stomach it, the damage she could have done with this kind of authority. Imagine the quack remedies she would have authorized, contemplate the effective products she would have banned. While I certainly don't think any Minister of Health should have as much power as this amendment bill gives her, it's far better for Barbara Hogan to wield it than Manto. I really do hope Hogan turns out to be as good as advertized because, otherwise, we're in real trouble.
(More information on the new health minister, by the way, has become available. Wikipedians, bless their hearts, have already created a biography, and News24 has interviewed Hogan [mp3 here, via Irreverence].)
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