Dr. Manto Tshabalala-Msimang, the former South African Minister of Health, has died. She also served as a cabinet minister within the presidency under Kgalema Motlanthe.
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She posed difficult questions, challenged sloppy formulations and refused to accept "fact" simply because it was being billed as such by all and sundry.
So now that Sis'Manto is gone, we will go to the normal template and find the standard words to describe how her departure was all too sudden and unexpected. Many who hated her guts ratcheted up all kinds of incidents to justify an antipathy that had turned pathological. Thus the real Sis'Manto disappeared under the pile of words, sounds and images that reduced complex phenomena into superficial and impressionistic representations.
All this will come to pass. And the living would have asserted their authority over the dead.
But tragic as her departure was, would Sis'Manto agree with us that it was all too sudden and unexpected? "We-Joel", former Minister Manto Tshabalala-Msimang was fond of saying in jest as she struggled with her health after the liver-transplant, "lesi sibindi ngathi asingithandi" (Joel, it seems this liver does not like me). Then, she was struggling with walking; her eyes watering from time to time; and sometimes with a persistent cough that made it difficult for her to speak.
The competent team of doctors who managed the transplant and her tentative recovery can explain the physiology and biochemistry that conspired to rob Sis'Manto of her life.
What many of us will never fully appreciate is the courage with which she bore her condition and accepted that the complications may not be resolved. Even when her health was failing, she endeavoured to attend all meetings of Cabinet as well as the NEC and Gauteng Executive Committee of the ANC, and to all the tasks that the ANC had deployed her to like the Support for Caster Semenya Task Team.
During the recent election campaign, she would call late in the evenings about inspiring experiences she had gone through that day, interacting with the Afrikaner community in her area, with the youth, with people with disability and women from all walks of life. And more than in any other period, one came to understand what made Sis'Manto tick: intellectual debate and a search for the truth; and reassurance that her efforts were making a difference particularly on the quality of life of South Africans and people of the continent, to whom she selflessly dedicated her life. It is this, and this mainly, that finally consumed her life.
What many of us will never fully understand is the intelligent and inquiring mind that Sis'Manto possessed. Quite often, even those of us who knew her had to be woken from the slumber of assumptions that we had swallowed hook, line and sinker from media discourse: as she posed difficult questions, challenged sloppy formulations in drafts, and refused to accept "fact" simply because it was being billed as such by all and sundry.
This, some of us came to appreciate even more when she became Minister in The Presidency after the recall of President Thabo Mbeki in September 2008. What is the core responsibility of the GDCY (gender, disability, children and youth) function, she would ask to our irritation because we thought we knew it all. And it would be in her elaboration that we realised she was onto something significant: should they confine themselves merely to advocacy; shouldn't there be specific projects that they initiate and supervise; to what extent are they monitoring practical implementation by departments and the other spheres of government!
It became clearer in those brief seven months of her tenure in The Presidency that Sis'Manto was and will always be more than just about matters of health, let alone HIV and AIDS. She was a committed gender activist, within and outside of the ANC Women's League and she brought this quality into the Justice Ministry when she joined the Executive as Deputy Minister.
There is something in how Sis'Manto revelled in a good intellectual spat, and in how under difficult conditions she never lost sight of the big picture, which speaks of attributes of a generation that had indescribable courage to defy the odds.
She was a member of the Luthuli Detachment, those ‘daredevils' who in the darkest days of repression took the courageous step to seek all-round skills in far-away lands, never losing confidence in the certainty of victory; and she was in Angola during the most dangerous period. Their discipline of focussing on essence always shines through – under current circumstances, exposing the gap they leave behind as one by one they bid us farewell.
It is this steadfastness to principle, sometimes to a fault, that pitted Sis'Manto against many, in the debates on HIV and AIDS - and she insisted on separating the two because she argued quite logically that infection was not the onset of the syndrome: people can and should lead normal healthy lives even if they have the virus. Precisely because it attacks the immune system and because there is no cure, the HI virus needed to be confronted first and foremost in prevention, secondly in strengthening the immune system through a healthy diet and lifestyle, and thirdly through a combination of these elements and treatment of secondary infections and anti-retroviral medication. This was and remains government policy
Tomes have been written on these debates, the evolution of government policy and the consequences thereof. And more will still be penned.
In the process the truth will sometimes be turned on its head as oversimplification and sometimes downright distortion and populism take the place of rational reflection. And so we are persuaded to forget the titanic battles for the reduction of anti-retroviral drug prices, without which we would not have been able to afford the drugs and achieve any significant coverage. We are persuaded to ignore the real challenge of side-effects of anti-retroviral medication that patients have to be aware of and commit to bear.
We are called upon to ignore the fact that Sis'Manto's insistence on completing the Nevirapine trials on mother-to-child transmission has in fact now been borne out by science (with proof of resistance and the migration to combination therapy), the 2001 Constitutional Court decision notwithstanding. In the words of an ANC statement then, the formulation of which Sis'Manto insisted on:
"[W]e should fully understand the long-term effects of using the drug, both for the baby and the mother. Thus, those who have gone through the programme are continually monitored. At the end of [this] period…, the evidence will become clearer. This will then inform a decision on universal access".
Did Sis'Manto at times overstate some approaches to the pandemic? Perhaps. My own sense is that this had to do with her penchant for a good intellectual spat as she sought, in her own logic, to balance out what was in turn an overstatement of other approaches.
In reality, the balance was there in formal policy such as the rolling comprehensive strategies - including the current one, which she led in crafting.
The vagaries of fate have dictated that Sis'Manto should depart on Reconciliation Day. Was this her last symbolic gesture that we should accept the synthesis of different ideas that has made our approach to the pandemic the richer and more effective? This we shall never know. But as with any genuine reconciliation, this can only be long-lasting if it is based on fact rather than fiction.
--This is an edited extract of a tribute by Joel Netshitenzhe to the former Minister of Health and NEC Member, Cde Manto Tshabalala-Msimang. Joel Netshitenzhe is a member of the ANC NEC and former Head of the Policy Unit in The Presidency.
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