The decision to appoint Precious Matsoso as the new Director General of Health is deeply problematic and, we believe, to the detriment of the Department of Health's administration and the people it serves in turn. Under Matsoso, who previously served as the head of the Medicines Control Council (at the appointment of former Health Minister Manto Tshabalala-Msimang), its standing as a world class regulatory body was systematically undermined. There is little in her public record to recommend her to a position of this importance.

The position of Director General is a crucial to that department's proper administration: a DG is required to manage a staff of more than 1 300, to oversee a large budget that includes transfers of billions of Rands to the provinces and to guide policy and legislative reform. Matsoso's record in this regard suggests she is not the ideal candidate, and that it would have been possible to appoint someone better suited to the position.

That said, there are a number of critical challenges now facing Matsoso. These include:

End the legacy of qualified audit reports the department has received over the last decade;
Getting the provinces to submit their various reports on time and to the required standard;
Getting the ARV tender sorted out so that the cost of the ARV programme is reduced;
Re-opening nursing training colleges; and
Expanding training opportunities for doctors.

There are many more important challenges, but these are such some of the key ones. The degree to which Matsoso is able to impact on them, will be the real measure of her success. Many before her have failed but, should she succeed, she will have climbed a mountain. We will support her in this undertaking.