President’s choice for acting health minister baffling

A few minutes before I was wheeled into the operating theatre earlier this month, my doctor came to do his final briefing. “Good luck,” I said, as he turned to leave. The maxillofacial surgeon looked at me with a slight puzzle on his face. Then he put his hand on my shoulder and said this: “Don’t worry. It’s what I do.”

If I had any nerves, they were now settled.

My nerves were thoroughly rattled this week when the President Cyril Ramaphosa appointed minister of tourism Mmamoloko Kubayi-Ngubane as the acting health minister to replace the scandal-ridden Dr Zweli Mkhize. Before the announcement, a politically astute colleague at another university had warned me: “the problem is not getting rid of Mkhize; it’s who replaces him that worries me.”

We have reason to worry.

Whatever Mkhize might have done wrong to be placed on special leave, at least he was a medical doctor by profession. When he appeared alongside his friend, the infectious diseases expert Prof Salim Karim, in those early briefings on the pandemic, we felt reassured as a nation. These two men had studied medicine together at the University of Natal, as it was then called. Healing people is what they do.

Kubayi-Ngubane knows nothing about health. A young and inexperienced politician, she has already been moved all over the cabinet from energy to communications, science and technology and, since 2019, tourism.

When I first met the minister, she was clearly insecure among the senior scientists and academics around the table, spending the entire hour looking down at the papers in front of her while surrounded by overconfident young ideologues who knew nothing about science but all things about race.

In her professional and political life, the minister has dabbled in everything from banking and artificial intelligence to community development and skills facilitation. None of this is her fault. If anyone cared among the senior politicians, they would provide any young minister with mentorship and capacity in one thing in which s/he would, over time, excel rather than play musical chairs across cabinet portfolios.

But here we are, in the middle of a pandemic and facing down a third wave of coronavirus infections, and the tourism minister takes over the health portfolio. We are in deadly serious trouble. More than 57,000 souls have expired because of the Covid-19 disease.

North of 1.7 million positive cases have been identified. There is a serious logistical and supply problem in the rollout of vaccines. Just around me friends are dropping dead. On Wednesday we said goodbye to Prof Michael Cross from the University of Johannesburg, a victim of Covid who apparently contracted the virus while training senior students.

Michael’s expertise in higher education is irreplaceable. Another friend, a senior academic leader with rare expertise in one of the sciences, lies on a ventilator in a Pretoria hospital. With all this stress and concern around you, imagine waking up to find that the minister of tourism is now in charge of public health.

Of course, a cabinet minister is a political head with access to specialised expertise in the form of advisors, deputy ministers, directors and deputy-director generals, and any number of specialist panels or committees. There are, however, major problems with this kind of reasoning in the midst of a life-threatening pandemic. It is the problem of public confidence.

Regardless of the political credentials of the person in charge of a specialist portfolio, citizens want to know that the appointee knows what s/he is talking about. Across the world, health (as opposed to, say, tourism) is one of the portfolios in which governments tend to appoint people with expertise in that field to reassure the public. In our neighbourhood, the ministers of health include Dr Kalumb iShangula in Namibia, Dr Edwin Dikoloti in Botswana, and until recently, Dr Obadiah Moyo in Zimbabwe — before the latter was ejected because of a corruption scandal involving medical equipment.

You can have all the specialists around you but as the head of an organisation you must be able to ask the right questions and that can only come from expertise. An incoming minister of health who does not have a starting knowledge of epidemiology or a basic vocabulary on the coronavirus (positivity rates, for example) will not know “who to ask what and when” in a crisis of pandemic proportions. Knowledge matters, and expertise can literally be the difference between life and death. The jokes abound (vaccine tourism?) but this is no laughing matter.

The president did the right thing to place Mkhize on special leave. He did a reckless thing by bringing in the tourism minister to replace him. He can fix this with a cabinet reshuffle that places a knowledgeable person with the requisite health expertise that can guide us through a still raging pandemic.