Comment & Analysis | Healthcare Policy

Ramaphosa announces the appointment of a not-so-new Minister of Health

2 July 2024.15:30
 

In a move that caught many by surprise, President Cyril Ramaphosa has re-appointed Aaron Motsoaledi as Minister of Health, with former Minister Joe Phaala stepping aside to resume his previous role as Deputy Minister. 

Minister Motsoaledi is one of Parliament's longest-serving ministers. He originally joined the National Assembly after the 2009 general election and was appointed Minister of Health in President Jacob Zuma's cabinet. He held this position throughout Zuma's presidency, overseeing significant developments, including the formulation of the National Health Insurance (NHI) policy and framework. In 2019, he was moved to the Department of Home Affairs, where he had a somewhat bumpy and unpopular tenure. Six years later, he picks up where he left off, taking up the position in what many acknowledge to be a tumultuous time as we look to herald in the biggest transformation in South Africa's healthcare history.

Reaction to the re-appointment has been mixed. Whilst the South African Medical Trade Union has warmly welcomed the announcement, citing Motsoaledi's proven track record of reform, the South African Medical Association's chairperson Dr Mvuyisi Mzukwa indicated that he was less concerned about the individuals than the bloated cabinet under the Government of National Unity (GNU). He highlighted that the increased cabinet size represents a missed opportunity to reallocate funds to the struggling healthcare system. Nonetheless, he reiterated that SAMA remains committed to working with the Ministry. 

Perhaps the Minister's biggest achievement in his previous tenure was his impact on HIV and TB healthcare initiatives. Dr Yogan Pillay, Director for HIV and TB delivery at the Bill & Melinda Gates Foundation, has welcomed Mostoaledi's appointment, noting the significant improvements in life expectancy, reductions in child mortality, and the expansion of HIV treatment during Motsoaledi's previous tenure, which saw South Africa's antiretroviral therapy program become the largest in the world.

Not everyone has been complimentary though. Professor Francois Venter, an HIV clinician and health researcher at the University of Witwatersrand, was less impressed with Motsoaledi's track record. He pointed out that despite many promises and a much vaunted 10-point plan, none of the plan's points were implemented under the Minister's tenure. He went further, saying that the portfolio was left in a weaker state than it had been when the Minister originally took office. 

The Democratic Nursing Organisation of South Africa (DENOSA) welcomed the appointment but emphasized the need for a better working relationship, one which would help to address the profession's challenges. Motsoaledi introduced a new nursing curriculum under his previous tenure, which DENOSA has criticized for significantly impacting the quality of nursing care, affecting the ability to meet community healthcare needs, and limiting career growth. These changes are considered by many to have been nothing short of disastrous for the profession.

As for Joe Phaala, he is no stranger to the health portfolio. Known as a steady hand, he served as Deputy Minister of Health from 2014 to August 2021, when in a midnight cabinet reshuffle, he replaced disgraced former Minister Zweli Mkhizeas as Minister of Health. We would do well to remember that it was Deputy Minister Phaala at the helm when the NHI passed into law.

The Department of Health has congratulated both Motsoaledi and Phala on their return, emphasizing the continuity and stability they bring to the Ministry and stating that their leadership will be crucial in addressing key healthcare priorities, especially the implementation of the NHI.

It remains to be seen how effective Motsoaledi will be in his renewed role. His ability to navigate the complex healthcare landscape and foster cooperation among various stakeholders will be critical in improving South Africa's national health outcomes. 

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