Barbara Hogan and the NSP: Women’s Lives in Men’s Hands

female condom
Wednesday, 29 October, 2008 - 09:08

While Barbara Hogan’s leadership of the health portfolio is welcome, her silence on access to female condoms remains is a concern.

As with the rest of the HIV sector, we were relieved and delighted when Barbara Hogan assumed the health portfolio just over a month ago. In her address to the International HIV Vaccine Research Conference in Cape Town on 13 October 2008, she officially marked the end of the genocidal denialism that has characterised our country’s management of the pandemic to date. 

Hogan declared that the disease was unquestionably caused by HIV and must be treated with conventional medicine. 

"It was imperative to get ahead of the curve of this epidemic 10 years ago," she said. "We all have lost ground. It’s even more imperative now that we make HIV prevention work….” 

Unlike Tshabalala-Msimang, Hogan was frank about the cost of the epidemic which kills nearly 1 000 South Africans a day and infects about the same number. We have the world’s highest number of people with HIV, counting some 5.4 million people as infected with the virus that causes AIDS. 

With more than half of all South African public hospital admissions being AIDS-related, more than one-quarter of the national health budget goes to fighting the disease.

We know that although South Africa now boasts the world’s largest anti-retroviral programme - with 550 000 people on treatment - much more needs to be done to prevent new infections. 

"I want to emphasise that we will scale up mother-to-child prevention programmes", Hogan said, referring to therapy to keep HIV-positive pregnant woman from passing on the disease. Tshabalala-Msimang only agreed to roll out UN recommended therapy for pregnant women earlier this year. 

However, despite the fact that the ‘face of AIDS’ is predominantly female, Hogan was disappointingly silent on access to female condoms. This silence assumes even greater significance if we consider the much-lauded National Strategic Plan (NSP) which provides for the distribution 425 million male condoms but only three million female condoms! 

In a country where life expectancy has fallen to 52 years we desperately need a concerted effort to address the discriminatory content and patterns of the NSP. As it stands, I argue, the approach effectively sentences millions of women to an untimely death. 

Since its introduction in 1992 (the current form) the female condom has been and remains the only female initiated and controlled method of birth control and HIV prevention. Despite this, NGOs that have historically been associated with speaking out for the health rights of people living with HIV earlier this year declared male circumcision as the ‘new issue’ that they (and SANAC) will be taking up! 

At the recent 2008 TVEP National Female Condom Dialogues, the South African Human Rights Commission confirmed that the lack of adequate access to female condoms is a human rights violation, but the silence from leading elements of South African civil society remains deafening. 

Too many perhaps uncomfortable questions arise. The silence of the women’s sector in SANAC… where were they when the condom procurement and distribution was being planned and adopted? TAC’s women’s sector - where are you? The TAC’s National Women’s Coordinator used the female condom dialogue to share the challenges of the TAC’s Womens Sector in getting the leadership of TAC to listen to their needs. Patriarchy has no boundaries it seems. 

So Minister Hogan, while we welcome the sanity you have bought to the sector, it is imperative that you put an end to this discrimination, and enable women to take control of their own protection. We ask you to turn your attention to those girls and mothers who are needlessly contracting HIV because the only tool that they can use to protect themselves is currently in the hands of men only. The old argument that ‘women don’t like them’ has been repeatedly disproved by credible research. Besides, if this is the criteria used, how many men ‘like’ the male condom? Yes, the cost of female condoms is high, but would reduce substantially if larger quantities were ordered. Afterall, what is the social cost of losing our nation’s mothers? 

Nearly two years after its adoption, significant progress has yet to be made in implementing the NSP which has betrayed the women of South Africa even before meeting its already discriminatory targets. At a recent roundtable meeting on the NSP, held in Limpopo, it transpired that the majority of CBO’s had no idea of what was contained in the plan, let alone how they could assist in its implementation. Once again those that need this information most, who are hardest hit, are left out of a process that essentially decides whether they and their families live or die. 

Fifteen years after the female condom was first introduced, very few people even know of its existence. One would think that the silent genocide being perpetrated by holding back of this life saving option would have received the attention that it so deserves. 

The heroes of our struggle for health rights are failing us. Perhaps that’s not such a bad thing, perhaps we will be the new heroes that take up this struggle, on behalf our mothers, sisters and daughters who die needlessly from a preventable disease but are denied the tools to protect themselves.

We should be ashamed, shouldn’t we?

Tian Johnson is the Advocacy Officer of the Thohoyandou Victim Empowerment Programme. For more information he can be reached at or visit the dialogue blog at

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