PRESIDENT MBEKI FIRES DEPUTY HEALTH MINISTER

C O N F I D E N T I A L PRETORIA 002817

SIPDIS

SIPDIS

PLEASE PASS TO USAID AFR/GH

E.O. 12958: DECL: 08/10/2017
TAGS: PGOV PREL KHIV EAID SF
SUBJECT: PRESIDENT MBEKI FIRES DEPUTY HEALTH MINISTER

REF: A. 06 PRETORIA 4320


B. PRETORIA 589

C. PRETORIA 1021

Classified By: Deputy Chief of Mission Donald Teitelbaum. Reasons 1.4(
b) and (d).


1. (SBU) President Mbeki on 8 August issued a terse press
statement informing the public that he had, "acting in terms
of the Constitution of the Republic of South
Africa....relieved the Deputy Minister of Health, Ms. Nozizwe
Madlala-Routledge, of her duties with effect today."
President Mbeki's firing of the outspoken Deputy Health
Minister is being widely criticized by ANC alliance partners
Congress of South African Trade Unions (COSATU) and the South
African Communist Party (SACP) as well as civil society
groups. South Africa's most prominent NGO, Treatment Action
Campaign, has called it "a dreadful error in judgment that
will harm public health care, especially the response to the
HIV epidemic." COSATU believes her dismissal "raises fears
that the National Strategic Plan Against HIV/AIDS will come
to nothing," and the SACP has said the "circumstances under
which she was dismissed goes against the spirit of the ANC
and SACP." Madlala-Routledge had been credited with
providing strong leadership on HIV/AIDS by acknowledging the
government's uneven response, encouraging testing and
treatment, and establishing close working relations with
civil society. Her performance was in sharp contrast to
Health Minister Dr. Tshabalala-Msimang's combative style,
mixed messages on treatment, and strained relationships with
civil society and international organizations (reftels).


2. (U) On 10 August, Madlala-Routledge told a press
conference that she was dismissed for two reasons. First,
she traveled to Madrid to address the International Aids
Vaccine Initiative without Mbeki's permission, a fact that
has been widely reported within the media over the past week
following a leak from the Presidency. Madlala-Routledge said
she returned to South Africa on the first flight back as soon
as she found out that her trip was not approved. Second, she
paid a surprise visit to a hospital last month that had been
the subject of an undercover investigation by a local
newspaper for its high death rate among infants. After her
visit, Madlala-Routledge publicly condemned the quality of
care, saying it reflected a national emergency in health
care. (NOTE: Immediately after, Dr. Tshabalala-Msimang sent
an investigative team to the hospital, which issued a
contradictory written report claiming the infant death rate
was comparable to other hospitals. END NOTE)


3. (C) COMMENT: Madlala-Routledge's dismissal is
disappointing, but not surprising. The Deputy Health
Minister may have provided great leadership in the eyes of
civil society and the international community, but often
highlighted the government's failures in addressing the
epidemic. In fact, her public criticisms of the President
and Health Minister made it appear at times as if she wanted
to be fired. Moreover, Health Minister Tshabalala-Msimang,
who is very close to Mbeki, has never had a good relationship
with her deputy. Madlala-Routledge is likely to remain
involved in the struggle against HIV/AIDS as a Member of
Parliament and as an HIV/AIDS activist.


4. (C) COMMENT CONT'D: During the Health Minister's prolonged
absence leading up to and after her liver transplant, the
health community, including the US Government, was able to
foster better relations with the National Department of
Health. Madlala-Routledge spearheaded a more collaborative
effort among partners which resulted in the development of
the SAG's National Strategic Plan for HIV/AIDS for 2007-2011,
which has been embraced by US Government stakeholders and
civil society. If and how her dismissal will affect the
implementation of the new National Strategic Plan is unknown,
but her dismissal may make relations between USG agencies
working on HIV and broader health issues and the National
Department of Health more difficult. END COMMENT.
Bost