Aaron Motsoaledi

Minister of Health
2013 Grade: B
2012 Grade: C

It is ironic and anomalous that someone considered to be an upstanding character and a competent state official by a majority of diverse players in South Africa`s health sector presided over the further breakdown of its public healthcare system in 2012.

This year, the health departments of the Eastern Cape and Limpopo were placed under national and provincial administration for reasons including massive overspending that was incongruously accompanied by complete dysfunction, non-payment of suppliers resulting in drug stock-outs and equipment shortages, and staff not receiving salaries for months on end.

Health activists and policymakers, even those opposed to some of his plans and policies, continue to praise Motsoaledi`s undoubted determination to repair South Africa`s broken public health system. But they are concerned that his vision is undermined and ultimately paralysed by supremely incompetent administrators and MECs who he cannot fire because of their political value (read: vote-pulling clout) to the ruling party in certain provinces.

But the septic tsunami has not yet drowned some of Motsoaledi`s major achievements in 2012: he maintained South Africa`s – and indeed the world`s – largest antiretroviral treatment programme. In the midst of considerable obstacles, he advanced a male-circumcision programme that will significantly slow the spread of HIV. He pushed strongly for sex education and the availability of condoms in primary schools. He launched 11 National Health Insurance (NHI) pilot sites. He made R48-million available to triple the number of doctors trained in South Africa from 1200 to 3600 annually.

Motsoaledi also plans to send hospital managers back to school. Current and future hospital chief executives will have to be trained in how to run public facilities at the health minister`s newly established Academy for Leadership and Management in Healthcare.

He is praised as industrious, dedicated and extremely accessible by health sector players, but criticised by the same people for apparently failing to consider how certain policies will be implemented before announcing them.

Rural doctors, for example, are confused about how the minister`s new “one team per district” health groups will operate next year. And his exclusive breastfeeding policy has led to problems in the supply of free formula milk for HIV-infected mothers who are unable to exclusively breastfeed their babies.

Some in the private healthcare industry brand Motsoaledi`s disapproval of rising private healthcare costs as “superficial criticism” that bluntly disregards the factors that influence price and ignores research from outside his department.

Also, many policymakers are critical about the long-awaited NHI white paper remaining unreleased more than year after the green paper was published.

The halo is fading.

Grade Key

Take a bow. You are doing an excellent job.
Good, but room for improvement.
You're okay.
Get your act together.
Do yourself and the country a favour - resign.
You're fired.