MAKE POSITION ON TLC FUTURE CLEAR

Sir,
When sharing the ‘Word of God’ during the official launch of the Cabinet Retreat, Reverend Dr JV Mazibuko rightly challenged all Cabinet ministers to make more of an impact. Speaking under the theme of ‘High Impact Teams’, Reverend Mazibuko took the opportunity to re-emphasise that the drive for excellence is never an easy journey and that success is not measured by just giving the impression of being industrious. Illusion and reality are two very different sides of the same coin.

While Cabinet was on retreat, the difficult decision was taken by The Luke Commission (TLC), the only real beacon of hope in Eswatini’s failing public health system, to pause some outpatient services for the elderly. In part due to the depletion of the E30 million relief fund. An absolute disaster for the nation on which I am able to comment from a position of authority, having been a Very Important Patient (VIP) at TLC on two occasions. Once facing my own possible demise during the 2nd wave of the COVID pandemic; only alive today due to the quality of medical care received and the ready availability of life-giving oxygen.

And the second time as a beneficiary under their joint replacement programme, when I once again received world class healthcare and a new left knee joint, which has given myself and a number of emaSwati a fresh lease of life. Government’s silence on the Funduzi Forensic Services Report’s recommendations is seen as an indictment of health sector corruption and mismanagement. This inaction fuels public frustration with the perceived lack of political will for meaningful change. Instead of supporting the highest authority’s directive to visibly support key health institutions, some appear resistant. Isn’t it time to identify those high-level politicians blocking crucial financial support for this vital health facility?

When delivering the Speech from the Throne during the State Opening of the Second Session of the 12th Parliament, His Majesty King Mswati III, again found it necessary to address the need for affordable healthcare for all. At the same time calling for a minimum standard for all hospitals in the provision of essential medical care fit for purpose. Respectfully, the prime minister now needs to be more aligned to Sibaya-driven priorities of the nation on health and to demonstrate a much greater commitment to the future long- term sustainability of TLC.

Compassionate

With both the deputy prime minister and the minister for health now having publicly acknowledged the compassionate medicine being practiced by TLC, through their recent attendance at the partnership celebration at Miracle Campus. Perhaps an opportune time for the prime minister (PM) to follow the example of his Cabinet colleagues and a number of Members of Parliament (MPs) over the last twelve months, by making his first official visit to TLC Miracle Campus. And in so doing, to demonstrate his own visible support to the ‘nkwe’ directive on health; by acknowledging the vital contribution TLC has made and continues to make to the accessing of free quality healthcare for all emaSwati; and if not, at least explain to the nation his reasons for not supporting TLC.

The government spokesperson’s January 23, 2025, statement contradicts the clear message delivered by the highest authority at TLC’s 2023 opening. The Finance minister reiterated that TLC welcomes the auditor general’s review of their finances. A faith-based organisation demonstrating transparency, accountability and integrity, this institution sets a valuable example for others. The hope remains that its 15-year partnership with USAID, which provided approximately E125 million in funding last year, can continue. The executive order suspending foreign aid poses a significant threat.

A workable Public-Private Partnership (PPP) between government and the organisation is now critically urgent, especially given the new US president’s apparent disinterest in Africa and some local ministers’ seeming disregard for the organisation’s financial stability. The impact of recent political decisions, including the US’ withdrawal from the World Health Organisation (WHO) and the proposed NGO funding freeze, cannot be ignored. These actions will negatively affect the nation’s health, particularly the 24.8 per cent adult HIV/AIDS rate. Government must urgently rethink its health strategy and mobilise resources, as the potential suspension of PEPFAR will destabilise the country’s HIV/AIDS response.

Seven PEPFAR-funded organisations have already closed, resulting in job losses. A renewed focus on critical healthcare demands greater Cabinet unity. Some observe a lack of shared agenda and supportive decision-making at the highest levels. The prime minister’s Programme of Action (POA) must include key healthcare institutions. Aligning the substantial national budget with the POA will be challenging, but the proposed bi-annual progress evaluation across ministries, including healthcare, is a positive step. These long-standing healthcare challenges have significant national implications.

After a year in office, some politicians haven’t demonstrated a results-oriented approach to health. Without collective Cabinet commitment to national health, progress on other directives will be difficult. Concerns about internal Cabinet divisions impacting key sectors are growing. The PM’s increased interest in the Central Medical Stores (CMS) mismanagement, coupled with his unclear stance on the future of key healthcare partners, may explain a perceived lack of inclusive leadership. This may also explain the lack of clarity with those ministers who have made their positions clear on the crucial role that some institutions play.

Influential

But poor service delivery and corruption plague our healthcare system, but the core issue is a lack of trust and a meaningful action plan for emaSwati. Influential politicians appear to undermine vital work. While the PM invited practical ideas at the retreat, the less-than-convincing response and reluctance to address specific individuals confirms a lack of political will. No amount of rhetoric will change the perception of inaction.

The PM, constitutionally responsible for government departments, should reflect on his relationship with key institutions. His oath of office emphasised the nation’s well-being. Transparency, accountability and a shared goal are crucial for public trust. Ministerial responsibility and a united Cabinet response are essential. Evidence suggests uneven commitment to the health directive, raising questions about needed changes.

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