FORMER colleagues describe Molefi Sefularo as an agent for change and the tonic South Africa's beleaguered health system needs.

FORMER colleagues describe Molefi Sefularo as an agent for change and the tonic South Africa's beleaguered health system needs.

The former North West MEC for health was last year appointed Deputy Health Minister and was recently handed a list of critical responsibilities not traditionally reserved for deputies.

A document signed by Health Minister Aaron Motsoaledi and Sefularo lays out each ones responsibilities in detail.

Sefularo has been given maternal, child and women's health; communicable disease control; 2010 Fifa World Cup; internal communication; information and communication technology; health technology; office of standards compliance and quality; health information evaluation and research; governance and accountability; district health, primary health care and systems strengthening; aspects of international relations specifically with donors and the technical assistance programmes of the WHO.

Sefularo believes that constitutional and legislative provisions on concurrent powers has left too much leeway for provinces, institutions and units to hide problems and that the national Health Department has the right to know everything about the state of health.

The ministry has called for a relook at the Constitution, which he believes has a weakness that needs to be corrected, giving clearer and greater legis-lative and executive authority to the national ministry.

Turning to the nitty gritty of his new responsibilities, Sefularo warns that the department's information and communication technology systems are nonexistent.

"We are extremely vulnerable, with our surveillance systems virtually nonexistent," Sefularo says.

He reveals that in Gauteng the absence of a cold chain manager and the collapse of the cold chain itself could have led to the measles outbreak.

Sefularo frowns when he addresses infection control, another key responsibility.

"We know that with drug-resistant TB a lot of the infections have been nosocomial (hospital acquired) and we have failed to measure the extent of that problem," he says.

Possibly Sefularo's most pressing responsibility is taking care of maternal, child and women's health, key indicators of the looming Millennium Development Goals that South Africa is set to miss.

Sefularo believes a first step would be to revive the volunteer system. But he cautions that these volunteers would have to be better supported, with an increase in the training of first level workers such as maternity and staff nurses.

He also believes that a human rights approach needs to be returned as an integral part of healthcare delivery.

Time will tell whether this struggle doctor has his finger on the pulse and whether he has the remedy to help cure our ailing health system. - Health-e News