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21 June 2022 | Story Prof Pearl Sithole | Photo Sonia Small
Prof Pearl Sithole
Prof Pearl Sithole is Vice-Principal: Academic and Research at the Qwaqwa Campus, University of the Free State

Opinion article by Prof Pearl Sithole, Vice-Principal: Academic and Research, Qwaqwa Campus, University of the Free State.
Public service is the heart of the strategic and operational compass of any country. Whereas politics is in the space of driving the national vision, socio-economic positioning of a country and consolidating the symbolic essence of a nation; public service is the heartbeat of monitoring strategy against present coalface realities.  Political leadership can successfully focus on visioning if its relationship with public administration is healthy. This means there must be professionals who can, on the one hand, advise on strategic scenarios to achieve a political vision, and on the other, fine-tune professionalism for the everyday service experience of the citizen as they tap into government products to assist living and livelihoods. A healthy relationship is one that has sufficient thresholds of expertise, operational agility, ethics and visioning for both political office-bearers and public servants. It is that mutual respect for vision and professional lines that influence each other that makes or breaks the functionality of public administration in any country. It has to be a tango of political and professional strategising that happens best when the country has a fair degree of patriotism amongst its important stakeholders, including business.

Sadly, in recent times there is very little good news regarding the performance of the public service in South Africa. Of course, some within a largely failing system are trying very hard to do their best. Yet public service and public administration in South Africa is deteriorating from a culture, structure and agency perspective. The issues are as follows:

• Inability to balance routine maintenance, new projects and growth for real places: ‘Service’ and ‘delivery’ are not seen as two missions that can benefit from quality execution. Since their conflation into ‘service delivery’ the phrase is more of a political statement exemplifying point scoring. Basically, whether it is at municipal level or provincial level, routine maintenance of roads, robots, servicing drainage systems is a difficult task for the South African public service. Tasks that were once done directly by government departments for reasons to do with regular service routine are now thrown into the outsourcing culture.

• Medium- to long-term planning is good on paper rather than afforded champions and structures to see these through: In South Africa we do not need to be reminded about the aging infrastructure in most municipalities – it is a reality seen in the quality of tap water in some municipalities. There should have been professionals doing projections for growing capacity demands on energy and water. Clearly this was not to be – despite the existence of technical units within local and provincial government, and huge national departments and Commissions existing to support these specialisations. South Africa is seen aspiring and punting 4IR aligned ways of doing things, including acquiring health equipment that cannot be sustained locally. Even innovation and advancement is not planned from the point of view of sustainability and carefully funding national capability.

• Professionalism is not receiving continuous attention within institutions and in monitoring and evaluation approaches: South Africa is wrestling with a huge human resource bill with many sitting in positions where they lament capacity. Studies are yet to be done to ascertain the lag between capacity and capability – given the changing world of work and the need for dynamic systems to respond to issues. Many academic institutions share amazing potential solutions to everyday problems – solutions for which public administration is not ready because of its unchanging formats. In fact, academic institutions, which are sometimes blamed for not preparing students for the (changing) world of work, have reason to suspect that public administration wants to tame the critical innovative thinkers they produce into imbibing the archaic formatted processes that are not changing with the times.

• Data-driven, evidence-based approaches have purged all qualitative, context-driven service: Communities are suffering from an impersonality of service and systems that refuse to offer human service. Tele-systems with voice prompts and generic emails are supposedly ‘servicing’ people with nuanced problems, and there is no way to follow-up on issues. Things may be reported to human professionals in certain locations but they ultimately find themselves as data in impersonal systems. Recent talk of special relief social grant applicants accessing the internet to supply or change their details, as well as connect with banks – is an amazing case of middle-class consciousness imposed on poor people, most of whom are in rural areas and informal settlements. Clearly South Africa has blunted its capability to respond to real people in real time through its devaluing of qualitative experience. ‘Service’ has removed ‘the person’ on either end of the need-and-service spectrum. This exacerbates alienation and bitterness towards public service establishments.
 
• Cycles of planning away poverty are an end in themselves: No country speaks of planning and reporting more than South Africa. The only problem is that the physical impact does not match the planning and reporting. Instead it does seem that the plans have certain descriptors that have lost ‘feeling’ and ‘lost entitlement for change’. One of them is reference to ‘the poor’. No descriptor legitimises planning, conferencing and reporting, than the concept of ‘the poor’; but the static nature of numbers and criteria forcing people to remain poor in order to access help is an inbuilt conundrum of South African planning. 

A question has to be asked as to whether a typical South African public service manager would be scared for their job if they woke up to ‘no poor people’. The point is: If public service mainly exists to ‘solve poverty’ then developing countries actually do not want to be developed. I am making this point because it seems there is no aspiration for ‘quality of service’, ‘solving poverty’, ‘creating a service blend suitable for circumstance’, or ‘growing development precincts in real spaces’ in South Africa. public servants are working on reducing people to data and generating overlays of faceless needs.  

This speaks to the ethos, ethics and culture of public service locally and the public administration system internationally. Let me be blunt about this point: there has never been freedom from colonial formats of public administration because it is in the interest of certain global bodies to find docile public service in African countries. Their ‘poor’ is the less dynamic systems in developing countries. This is what I call the qualitative colonial dividend.

In conclusion 

Of course, no one wants to over-emphasise bad news but a deterioration of public service is one of the notable trends of post-independence in many African countries. Why is it that a professional layer of government is not able to salvage its country, and we all blame the politicians? The reasons are both structural and related to devaluing professionalism. An over-arching culture of formats importation that structure the relationship between the globe and former colonies speaks to structural colonial dividends to be gained from dysfunctional public administration regimes. The colonial dividends strategy seems to be: ‘Beyond making countries beg for foreign investment, tame their tools and call that “a request for a permitting environment” – then excessively format the way they work’.   

Let me end by specifying the real sore points that must to be sorted if we are to resuscitate the South African public service:
We need to sort human resource systems and practices: Currently HR recruitment systems are not versatile and they discourage agility in their recruitment criteria. There are no mechanisms to assess the capable “butterflies” that have been bravely hopping between related sectors. The people who hold the answer to the responsive leadership and discretion are often punished for not being stagnant.

A need to resolve the capacity vs capability debacle: Responsive capability is curtailed by valorising already existing ways of doing things in spite of a technology mix that may be afforded, a possibility of designing new cross-sector policies that allow different specialists to work together, of retraining needed to respond to new situations.

Speaking truth to powers of vigilance – that should be supporting core business: No matter how versatile public service can be in response to developmentalism, if the disciplines that see their role as vigilance over resources are only operating from the stance of distrust, there shall be no responsiveness. These disciplines are Planning, Monitoring and Evaluation, as well as Finance and Auditing. In South Africa they are famous for stating ‘why things cannot be done’ rather than ‘how they can be done’. If this will change, they will need to see sector partners as equal partners with essential expertise for advancing the development mission. These ‘disciplines of vigilance’ may even create accountable discretionary points closer to the coalface instead of only recognising a priori planning-based expenditure even for unforeseen situations.

Finally, someone needs to whisper to all future presidents, especially for their State of the Nation Addresses (SONA), that: “it is OK to prioritise and pinpoint focal areas when it comes to designing an annual strategic direction”. SONAs actually endorse silos. In South Africa even cameras will point to a specific minister as the President jumps from one sector to the next. Being issue-based and resolving major developmental conundrums that have a spiralling effect on other issues is the way to go. SONAs are short, but they can garner determination towards a well-considered mission.

News Archive

Cardiology Unit involved in evaluation of drug for rare genetic disease
2013-01-04

Front from the left, are: Marinda Karsten (study coordinator and registered nurse),
Laumarie de Wet (clinical technologist), Charmaine Krahenbuhl (study coordinator and radiographer),
Lorinda de Meyer (administrator), Andonia Page (study coordinator and enrolled nurse);
back Dr Gideon Visagie (sub investigator), Dr Derick Aucamp (sub investigagtor),
Prof. Hennie Theron, (principal investigator) and Dr Wilhelm Herbst (sub investigator).
Photo: Supplied
09 January 2013


The Cardiology Research Unit at the University of the Free State (UFS) contributed largely to the evaluation of the drug Juxtapid (lomitapide), which was developed by the Aegerion pharmaceutical company and approved by the FDA (Federal Drug Administration). Together with countries such as die USA, Canada and Italy, the UFS’ Unit recruited and evaluated the most patients (5 of 29) for the study since 2008.  

The drug was evaluated in persons with so-called familial homozygous hypercholesterolemia (HoFH).  

Following its approval by the FDA, Juxtapid is now a new treatment option for patients suffering from HoFH. The drug operates in a unique way which brings about dramatic improvements in cholesterol counts.  

According to Prof. Hennie Theron, Associate Professor in the Department of Cardiology at the UFS and Head of the Cardiology Contract Research Unit, HoFH is a serious, rare genetic disease which affects the function of the receptor responsible for the removal of low-density lipoprotein cholesterol (LDL-C) (“bad” cholesterol) from the body. Damage to the LDL receptor function leads to extremely high levels of blood cholesterol. HoFH patients often develop premature and progressive atherosclerosis, which is a narrowing or blockage of the arteries.  

“HoFH is a genetically transmitted disease and the most severe form of hypercholesterolemia. Patients often need a coronary artery bypass or/and aortic valve replacement before the age of 20. Mortality is extremely high and death often occurs before the third decade of life. Existing conventional cholesterol-lowering medication is unsuccessful in achieving normal target cholesterol values in this group of patients.  

“The only modality for treatment is plasmapheresis (similar to dialysis in patients with renal failure). Even with this type of therapy the results are relatively unsatisfactory because it is very expensive and the plasmapheresis has to be performed on a regular basis.  

“The drug Juxtapid, as currently evaluated, has led to a dramatic reduction in cholesterol values and normal values were achieved in several people. No existing drug is nearly as effective.  

“The drug represents a breakthrough in the treatment of familial homozygous hypercholesterolemia. The fact that it has been approved by the FDA, gives further impetus to the findings,” says Prof. Theron.  

In future further evaluation will be performed in other forms of hypocholesterolemia.  

According to Prof. Theron, the findings of the study, as well as the recent successful FDA evaluation, once again confirms the fact that the UFS’ Cardiology Contract Research Unit is doing outstanding work.  

Since its inception in 1992, the Unit has already been involved in more than 60 multi-centre, international phase 2 and 3 drug studies. Several of these studies, including the abovementioned study, really affected the way in which cardiology functions.  

The UFS’ Cardiology Contract Research Unit is being recognised nationally and internationally for its high quality of work and is constantly approached for their involvement in new studies.  

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