POISONED CHALICE FOR KHANYA?

As we begin to witness changes taking place in the problematic Ministry of Health, where Principal Secretary (PS)  Dr Simon Zwane has been transferred and an award-winning Director of NERCHA, Khanya Mabuza, has been brought in to replace him, one is reminded of the proverb, ‘success has a thousand fathers and failure is an orphan’.

Dr Zwane may feel like the scapegoat, but he understands deep down that things can’t stay the same in the face of massive public discontent about healthcare service delivery. Something has to give, and accountability begins at the top, and we appreciate His Majesty for making the call for the much needed reforms in this ministry. It could easily have been the Health minister who was reshuffled, but Cabinet is all but gone with the dissolution of Parliament on July 11, 2023.

In other countries, one fatality caused by negligence or inefficiency is enough to cost leaders their jobs. Take nothing away from Zwane and the minister, they have played their part but it’s the results that speak on their behalf. The reforms come as we begin to see some relief for approximately 400 orthopaedic patients who are finally having their day on the operating table, thanks to Prime Minister (PM) Cleopas Dlamini’s intervention, who established a Cabinet task team to address the health crisis. We wonder why the public has had to wait so long for this and other similar difficulties that have caused immense agony.

Mabuza will find a heap of tasks placed in his in-tray, top of which is the drugs shortage coupled with the need to provide relief for dozens of cancer patients said to be idling in South Africa (SA)  needing treatment, which won’t come unless government settles long-standing bills that run into the multi-millions of Emalangeni. He has numerous relationships to rebuild and new ones to foster, not least with institutions, like The Luke Commission, that have taken up the responsibility of providing a high standard of public health services that many emaSwati (including the Health Ministry when desperate) are running to for life’s sake.

We believe his leadership played a large part in coordinating a national campaign towards achieving good results and we can count on his understanding of health systems to get our sector more efficient. Can he transfer this charm to achieving buy-in from members of the Swaziland Democratic Nurses Union (SWADNU), who do not hesitate to protest at any given opportunity? This is not unfamiliar territory for him, as these are the same foot soldiers he has used to turn the HIV/AIDS tide in our favour. He was at the helm of the National Emergency Response Council on HIV and AIDS (NERCHA) as Eswatini turned from being one of the countries with the highest HIV infection rates in the world to becoming one of the top five countries, globally, to have achieved the 95-95-95 targets of curbing the disease as a public health threat, well ahead of the set 2025 deadline.

The 95-95-95 are part of the United Nations Programme on HIV/AIDS (UNAIDS) targets for testing and treatment to have 95 per cent of people living with HIV knowing their status, 95 per cent of people who know their status being put on treatment and 95 per cent of people on treatment with suppressed viral loads. This has earned Eswatini accolades for this achievement, and His Majesty the King recently received two of the US President’s Emergency Plan for AIDS Relief (PEPFAR) awards for coming close to reaching the set targets.

Mabuza has been to NERCHA what the late Simon Kunene was to malaria, which earned him the nickname ‘Mbuzulwane’. The country earned global recognition in the fight against malaria, back in 2017, when it received the African Leaders Malaria Alliance (ALMA) Awards for Excellence at the 28th  African Union Summit for its impact on malaria incidence and mortality. Eswatini was the first country in Africa to produce a malaria elimination scorecard to enhance tracking and accountability under Kunene’s watch.

These are important developments as they demonstrate the capabilities that the country has to become the best in the world in healthcare service delivery. We have got the brains and the know-how, but somehow we choose to play ignorant and make life difficult for ourselves, albeit at the expense of other people’s lives. However, we are well aware that Mabuza now takes on a much broader mandate, and a lot of what he can achieve will depend on the Health minister he gets in the next Cabinet as well as the level of political will to address the ongoing challenges. His comments in reaction to his appointment are encouraging about his approach to the job.

He stated that pointing fingers would be futile while people were dying on the other side. All he wants, he said, is to ensure that all problems identified, whether by the forensic audit or otherwise, are addressed since he believed that if the problems were created by humans, they could also be remedied by humans. A good starting point, for he knows well that while his success at NERCHA has earned him a thousand fathers and placed him in the vanguard of a health service transformation, there are plenty of lessons to be learned from his predecessors, which, if not cautious about, can easily render him an orphan when things fall apart. Best of luck Mshengu!

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