In late September Barbara Hogan was appointed as South Africa's new health minister by interim President Kgalema Motlanthe, ousting her controversial predecessor Manto Tshabalala-Msimang. AIDS activists and many South Africans are hopeful that this move will signal a shift in the government's HIV/AIDS policies.

Hogan, a veteran anti-apartheid activist and a long-term ANC (African National Congress) member, was previously the chair of the finance portfolio committee. Since becoming health minister, she has broken from the former government's stance on HIV/AIDS and has
vowed to make AIDS a top priority. This has caused excitement for many South Africans, who are hopeful that Hogan can strengthen the country's fight against HIV/AIDS by taking a more science-based approach to policymaking. In this video AIDS activists celebrate Hogan's appointment.

In the past Hogan publicly criticized former President Thabo Mbeki's stance and policies on HIV/AIDS. Roughly 5.7 million people in South Africa are living with HIV and 350,000 people died of the disease last year (almost 1,000 deaths a day). Tshabalala-Msimang has also been blamed for inadequately responding to South Africa's HIV/AIDS problem. The former health minister promoted beetroot, garlic, and other foods as treatment for HIV/AIDS, resulting in the nickname “Dr. Beetroot,” and has been accused of creating confusion about anti-retroviral drugs.

Stephen, posting on irreverence, calls Tshabalala-Msimang a national embarrassment and Hogan a glimmer of hope. Ciaran Parker, blogging on Ciaran’s Peculier [sic] Blog, elaborates on Tshabalala-Msimang's unorthodox views:

“Kgalema Motlanthe, while stating a desire to pursue continuity, has got rid of some of Mbeki’s more controversial ministers. Chief among these is Health Minister Dr Manto Tshabalala-Msimang, the chief theoretician behind Mbeki’s AIDS denialist policies. Mbeki’s government refused to accept the role the HIV virus has in the spread of AIDS, and his health minister stated that anti-retroviral drugs, which have been shown to have some effect in fighting the disease, were too expensive…Medical professionals working in the South African health service who publicly disagreed with the minister’s bizarre theories have been victimised.”

Earlier this week, at the opening of the International AIDS Vaccine 2008 conference in Cape Town, Hogan publicly declared that HIV does cause AIDS and should be treated with conventional medicine. She also said the government was committed to scale-up mother-to-child prevention programs, therapies that prevent HIV-positive pregnant moms from passing on the disease, and that an effective HIV vaccine was desperately needed.

Scientists, activists, and many bloggers have expressed relief and excitement following Hogan's address. Haley, blogging on adventures as an ambassadorial scholar, says:

“So most people I talk to find it – surprising – that democratically elected government officials, in today's world, would deny such ideas as … say… that HIV causes AIDS. However, sadly in South Africa, that has been the case…. but no longer my friends, no longer.”

Ray Hartley, posting on The Times, South Africa, blog adds:

“‘We know that HIV causes AIDS.’

With these words, the Health Minister, Barbara Hogan, ended an ignominious decade of Aids denial that has cost South Africa countless lives and has forced those with the virus to live in the shadows.”

It's difficult to determine how many lives were impacted by previous HIV/AIDS policies, but the Treatment Action Campaign (TAC) says that over two million South Africans died of AIDS during Mbeki's presidency and at least 300,000 deaths could have been avoided if he had met basic constitutional requirements. Some bloggers say that both Mbeki and Tshabalala-Msimang have blood on their hands. Soneka Kamuhuza, blogging on Things That Make You Go Mmmh!, blames mostly Mbeki.

“Their [Mbeki and Tshabalala-Msimang] intellectual apathy, targeted myopia and general dis-ingenuousness played dangerously to help continue the pandemic. Pushing holistic approaches, which when used singularly, cannot be an effective treatment for the virus, they battered their nation with their fortified and unified ignorance. It is now estimated that South Africa has the world's highest numbers of people infected with HIV. Somehow, I see Mbeki's hand all over this…In a country rich with natural resources, he has cheated its most important resource, the people of an opportunity to make a critical head start in the fight against AIDS.”

Many hope that Hogan will reverse some of this damage. A post on peripheries points out that many people expect that the period of politically-supported AIDS denialism in South Africa is over. However, others remain cautious. BillyC, commenting on a blog post on The Times, South Africa, says:

“Barbara Hogan has a mountain to climb to reverse the almost terminal damage to health care on Manto’s watch. Staff competency, morale and levels as well as a slew of health policies and legislation all have to be addressed. In addition the promotion of voodoo medicine and demonisation of western science is now deeply embedded in the national psyche. It will take years of hard, courageous and diligent work to get us back to a health system that’s respected and effective. We can only wish Barbara Hogan god speed. She’s gonna need it.”

Photo of South African AIDS Ribbons by mvcorks on Flickr.