{"id":437750,"date":"2026-05-12T10:58:13","date_gmt":"2026-05-12T10:58:13","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/437750\/"},"modified":"2026-05-12T10:58:13","modified_gmt":"2026-05-12T10:58:13","slug":"somebody-call-hasina-2","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/437750\/","title":{"rendered":"Somebody call Hasina"},"content":{"rendered":"

Amid the mostly depressing HIV headlines of recent times, concerned as they mainly are with the deadly impacts of donor defunding<\/a>, South Africa\u2019s imminent roll-out of a twice-yearly HIV prevention injection called lenacapavir (LEN)<\/a> has been a spot of bright light. <\/p>\n

Staff in 360 healthcare facilities<\/a> spread across the country stand trained and ready to receive and administer the drug, which has been found to be near perfectly successful<\/a> in preventing HIV when administered twice yearly, attracting cliches like \u201cgame-changer\u201d, \u201cground-breaking\u201d and \u201cnew dawn\u201d, though contrarian voices warn<\/a> that the public benefit of rapid LEN roll-outs in African contexts is far from clear.<\/p>\n

Now is not the time to drop the ball, to use another cliche, but many in the HIV space take comfort in the knowledge that the person responsible is Hasina Subedar, the health department\u2019s senior technical adviser in HIV prevention.<\/p>\n

Getting Subedar to give an interview took some convincing (she eschews the limelight), but she ultimately took a call on a Saturday afternoon in late April, with LEN all but ready to launch. <\/p>\n

After some connectivity issues \u2014 \u201cIs this better? Hang on, I\u2019ll move closer to the modem. Hello, Hello, He-LO-HO\u2026 \u201d \u2014 Subedar tries to minimise the achievement.<\/p>\n

\u201cIt\u2019s not my first, um \u2026 \u201d <\/p>\n

\u201cRodeo?\u201d I interject, with too much enthusiasm.<\/p>\n

\u201cRoll-out!\u201d<\/p>\n

Before LEN, Subedar oversaw the roll-out of a once-a-day HIV prevention pill (a form of pre-exposure prophylaxis or PrEP medication) for HIV-negative South Africans wanting to protect themselves against infection, becoming, former health department director-general Yogan Pillay<\/a> told me, \u201cone of the most experienced people in understanding PrEP provision, and one of its leading advocates\u201d.<\/p>\n

With the drugs now in the country, the next step is getting LEN to those most likely to benefit from it, a challenge made markedly trickier by the Trump administration\u2019s HIV funding cuts. (Jay Caboz) <\/p>\n

When I exclaim about the responsibility she must have to shoulder, Subedar chuckles and says, \u201cI don\u2019t get stressed easily. I am on a high all the time. I just have to keep moving, and things have to run like clockwork.\u201d<\/p>\n

She works from 6am to 11pm every day, and typically only takes off from the day of reconciliation each year until January 3. Last year, however, she worked through.<\/p>\n

\u201cI had to sit and finish all the training materials [for clinic staff to be able to administer LEN], while worrying over consignments of drugs that still needed to come into the country,\u201d says Subedar, who for the past nine months has met weekly with all of the organisations involved in supplying the drug, a process she describes as \u201cimmensely complex and at times quite fraught\u201d. <\/p>\n

\u201cRelax your grip, and there\u2019s a chance the drugs will simply not make it into the country. I have had to become a very hard taskmaster for people who don\u2019t do the things they\u2019re supposed to be doing,\u201d she says.<\/p>\n

Grit, grace and humour<\/p>\n

With the drugs now in the country, the next step is getting LEN to those most likely to benefit from it, a challenge made markedly trickier by the Trump administration\u2019s funding cuts<\/a> to South Africa, which, according to a report released by Physicians for Human Rights<\/a> and partners in April, have undermined much of the infrastructure \u2014 such as community-based testing and field recruitment for HIV prevention services \u2014 needed to create demand for LEN. How will such yawning gaps be bridged?<\/p>\n

In answering, Subedar focuses on the opportunity inherent in decreased donor funding.<\/p>\n

\u201cPreviously, with the oral PrEP roll-out, we had donors telling us, \u2018This is where you must implement. These are the populations you must implement for\u2019. It was initially led by them [donors], and this often resulted in fragmented service delivery. With LEN, I was determined that it would be government-led, and not rolled out by partner-funded projects but instead integrated within public primary healthcare from the outset.\u201d<\/p>\n

If questions remain about the viability of the plan (one prominent HIV researcher told me that Subedar \u201cis constantly having to make things work in a sea of mediocrity\u201d), her competency is widely acknowledged. <\/p>\n

Francois Venter, executive director of Ezintsha at the University of the Witwatersrand, recognised Subedar\u2019s work ethic and \u201cabsolute integrity\u201d. Desmond Tutu Foundation CEO Professor Linda-Gail Bekker praised her ability to work well with a spectrum of role-players, \u201cdoing so with grit, grace and humour\u201d. <\/p>\n

These are not innate abilities. How, I wonder aloud, were they forged?<\/p>\n

Hasina (second from right), with her mother and sisters. (Supplied) <\/p>\n

\u201cI\u2019m from Pietermaritzburg,\u201d Subedar begins, as if this on its own answers the question.<\/p>\n

\u201cI was born there, in Edendale Hospital. My father was a tailor who wanted a boy, but instead my mother had five girls, so I was often dressed like a boy from the time I was little,\u201d she says.<\/p>\n

Subedar\u2019s parents \u2014 Hajira and Goolam Subedar \u2014 were both largely self-taught people, denied education by family circumstances.<\/p>\n

\u201cIt was important to them that we should receive the education they were denied. My father always said, \u2018The one thing you must always do is educate yourself, because nobody can ever take away your education,\u2019 which is so true.\u201d<\/p>\n

The Subedar family lived towards the bottom end of East Street (renamed Masukwana in 2014), near the mosque. For junior school the girls attended the Nizamia School, 200 metres from their home, but had to walk much farther for senior school, to Pietermaritzburg Indian Girls High School, on Berg Street. <\/p>\n

Subedar says she was \u201cnonconformist\u201d and found the compulsory afternoon sport \u201cquite challenging\u201d. <\/p>\n

\u201cYou had to find a way of ducking out somehow or other,\u201d she says.<\/p>\n

As the middle child, she was often left to fend for herself, never quite included in the alliances of her two older and two younger sisters. This would prove consequential. The Subedars were a political family who often shared what little they had with the families of Robben Island detainees like Harry Gwala<\/a>. Subedar\u2019s father decided that one of his daughters should go and live in the home of another detainee, Abdool Kader Hassim<\/a>, to support his wife Nina and two young sons. <\/p>\n

\u201cMy older sisters flat out refused, and since my younger sisters were too young, it pointed at me,\u201d says Subedar, admitting that she resented the imposition initially, but came to appreciate the experience. <\/p>\n

\u201cOur own home was a tiny little place, with the bathroom and toilet separate outside, and for hot water you had to make a fire below a copper geyser, but when I went to live with Nina and her boys I had my own room, and I learned a lot. I became more politicised around this time, which wasn\u2019t unique to me. It was a common experience in the areas and communities we lived in, but it shaped my thinking. There wasn\u2019t this thing of we are Indian and they are African. We were very integrated in lots of ways.\u201d<\/p>\n

Hasina (back row, last on right) found her high school years ‘interesting, not least because the staff were a mix of races, and one struggled to relate to some of them’. (Supplied) <\/p>\n

The other force shaping Subedar\u2019s outlook was money, or lack thereof.<\/p>\n

\u201cMy father\u2019s work completely dried up when I was at high school, so I had to work to support myself,\u201d says Subedar, who dropped out of a social work degree after just one year due to a lack of funds.<\/p>\n

Her choice to study nursing was born mainly out of need \u2014 she would be able to study and earn, enabling her to support the family \u2014 but there was something else.<\/p>\n

\u201cWhen I was 18 years old I was attacked by a man who tried to kill me. I was left badly injured: two of my fingers were completely severed, and a third was left non-functional,\u201d she recalls.<\/p>\n

Amid the chaos of that emergency, the nurses who attended to Subedar in hospital provided a refuge of calmness and kindness.<\/p>\n

\u201cMy hair had lots of glass and sand in it, and one of the nurses said, \u2018Let me wash your hair for you.\u2019 And that meant so much to me,\u201d she says, confirming that these experiences of care strongly factored in her decision to study nursing.<\/p>\n

Subedar says she emerged from the experience a more compassionate person, \u201cespecially towards those experiencing rupture in their lives\u201d, and strongly resolved to move forward \u201cwithout any self-pity \u2014 without ever talking about it, in fact \u2014 while finding ways to compensate for the considerable loss of functionality in my left hand.\u201d<\/p>\n

The black section and the white section<\/p>\n

Within a month of applying to train as a nurse, Subedar was on her way to Cape Town, to learn and work in Groote Schuur Hospital, where \u201cthere was a black section and a white section, and you stayed on your side!\u201d (Ever the non-conformist, Subedar found ways of undermining workplace apartheid, playing squash late at night \u201cat the white residence where we were not allowed to be\u201d.<\/p>\n

In Pietermaritzburg, Subedar had been well aware of the inequality in the education system. Now she saw it up close in the health system.<\/p>\n

\u201cOne of the things I did as a student was go into Langa to train people in first aid. Ambulances weren\u2019t going into Langa at night, and in many instances people died at the police station for want of basic care.\u201d<\/p>\n

Subedar qualified as a professional nurse and spent some time working in intensive care units, until her son was born, at which point she returned to Pietermaritzburg to be closer to her family, taking a position as a mental healthcare nurse at Fort Napier, the psychiatric hospital, and later as part of an outreach team in Durban communities like Chatsworth, Phoenix and Merebank. <\/p>\n

\u201cIt was a refreshing change, more humane in many respects, because I could spend time with people who were dealing with life in all of its complexity,\u201d she says.<\/p>\n

When she was granted long leave in 1989, Subedar used it to further her studies at the University of KwaZulu-Natal, where she was ultimately offered a post providing clinical training to student nurses in both psychiatry and midwifery.<\/p>\n

Having left Cape Town with a diploma in nursing, Subedar managed, by 1993, to complete a basic degree, a qualification in nursing education, an honours in psychology and a master\u2019s in mental health nursing, all while working and raising a son as a single parent.<\/p>\n

\u201cShame, I moved around and this poor child moved everywhere with me. At one point he said to me, \u2018Mom, you are very lucky you have me as a son\u2019, and that is so true because he never complained, he just adjusted every time.\u201d<\/p>\n

Hasina, her mother Hajira, and son Mikael. (Supplied) <\/p>\n

After South Africa\u2019s first democratic elections in 1994, Subedar, who had participated in some of the strategic teams that had been set up in advance to look at the transformation of healthcare, decided to move back to the Western Cape, feeling that of all the provinces, its mental health services were the most in need of transformation, concentrated as they were in psychiatric hospitals like Valkenberg, Lentegeur, Stikland and Alexandra.<\/p>\n

\u201cOne of the reasons I left academia to go back into the [public health] system was to contribute to the realisation of the idea that basic services should be taken out of hospitals and made available in communities,\u201d says Subedar, who spent three hopeful years \u2014 1997-2000 \u2014 working on the establishment of community mental health services in the Western Cape, only to become frustrated with the province\u2019s see-saw politics.<\/p>\n

\u201cWe had three health MECs in that period with different political affiliations, and I think this influenced the direction in which we went, which was not what I had envisaged,\u201d she says. <\/p>\n

In 2000, Subedar was headhunted to work at the South African Nursing Council <\/a>as its registrar, opening a new and distinct chapter in her life. <\/p>\n

\u201cI was the first female registrar, and the first person of colour to hold that position,\u201d says Subedar, recalling that the discourse on transformation when she entered the council, \u201cwas at the level of worrying about what new pictures to put on the walls, and which building names should change, not about the profession and what needed to happen to transform it!\u201d <\/p>\n

\u201cWe had this changing health system, which is also needing to respond to new challenges like the HIV\/Aids pandemic. For me, one of the priorities was making sure that our professionals are able to work in such a system,\u201d says Subedar, who instigated a review of the scope of practice of nurses, with appropriate adjustment to their education. <\/p>\n

South Africa\u2019s Nursing Act of 2005<\/a> was largely based on the new frameworks Subedar developed, and she believes it \u201cquite clearly defines what nurses should be doing, and what the regulations are, and making sure that those regulations enable the nurses to do what they have to do.\u201d <\/p>\n

The next step was to have been the transformation of the nursing education system.<\/p>\n

\u201cThat\u2019s the part that \u2026\u201d she starts to say, but her voice peters out. She doesn\u2019t need to describe the crisis in nursing education in South Africa currently, which has been well publicised. Instead of necessary transformation, nursing education has been compressed by the closure of several nursing colleges, and choked by changing qualification requirements, contributing to a situation in which nearly half of all nurses registered with the nursing council are over the age of 50<\/a>.<\/p>\n

Subedar\u2019s time at the council ended badly. In 2008, controversially, her contract was not renewed, leading her to take legal action. She was reinstated for a short time but departed in 2009. <\/p>\n

\u201cI didn\u2019t know what to do at that point, but an opportunity arose to come back into the department to assist with the healthcare re-engineering process. It was this question of \u2018how do we restructure primary healthcare, and make it more functional in the current system?\u2019\u201d<\/p>\n

Learning from scratch<\/p>\n

So began her time \u201cof sort of developing stuff for the department and delivering for them\u201d.<\/p>\n

When she was asked to roll out HPV vaccination in 2012, it was a one-line instruction: \u201cYou will roll out the HPV vaccination, it will be in March 2013, and a treasury allocation will be made available, but only in April 2013,\u201d Subedar recalls mirthfully.<\/p>\n

\u201cThere was no pilot, yet we had to reach every public school within 20 days, campaign style. I learned a few valuable lessons in all of that. You need to know how many people are required for the work, and to understand who is going to do what. Your people need to be competent, and they need to be supported. Do they understand their role? Do they have job aids [tools such as checklists, algorithms and explanatory posters]? Those campaigns were scripted to the T,\u201d she says, adding, \u201cthe beauty of all of this is that people, once they have direction and know what they need to do, they get it done, especially at the province level.\u201d<\/p>\n

Typically, whenever she has taken on a new project for the department, Subedar has started in complete unfamiliarity.<\/p>\n

Hasina believes that collaboration is key to ending the HIV epidemic. \u201cThis, and affordable medicines.\u201d (Supplied) <\/p>\n

\u201cOn the day I was approached about HPV vaccination, I did not know what it was. I did not know how it needed to be administered. I knew nothing, but this was a strength because I needed to systematically grasp the subject. I learned from scratch on PrEP, too,\u201d says Subedar, who advocates, \u201cseeking out the experts and literature on the clinical trials and studies, and getting them to provide you with all the technical information that is required for the direction that you need to go, and then just shaping it, so that it will work in the real world in which you want to implement.\u201d This consultative approach has not been without its challenges.<\/p>\n

\u201cWith oral PrEP, I sat in the very first meeting with these incredibly forceful HIV researchers, and everybody was doing their own study and had their own ideas about what should be done and which population we should be focusing on, be it men who have sex with men, adolescent girls, sex workers or transgender people. Disappointment was guaranteed,\u201d says Subedar, insisting her personal motto remains \u201ccollaboration\u201d.<\/p>\n

\u201cI might not agree with you, but I will listen. All stakeholders should have a space to give their view, including civil society. It [collaboration] doesn\u2019t come naturally to the department of health, but if anybody tries to create animosity, or start excluding people, I would intervene,\u201d she says before politely ending the conversation. A difficult problem has arisen, and for once it has nothing to do with her work.<\/p>\n

\u201cI am renovating, and the contractor failed to cover my room, so everything \u2014 my clothes, my linen, my floors \u2014 is coated in a fine layer of dust.\u201d<\/p>\n

Bhekisisa (supplied) <\/p>\n

This story was produced by the Bhekisisa Centre for Health Journalism<\/a>. Sign up for the newsletter<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"Amid the mostly depressing HIV headlines of recent times, concerned as they mainly are with the deadly impacts…\n","protected":false},"author":2,"featured_media":437659,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[205280,163,521,12815,85,46,29152,29154,205279,205281],"class_list":["post-437750","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-hasina-subedar","tag-health","tag-healthcare","tag-hiv","tag-il","tag-israel","tag-lenacapavir","tag-prep","tag-sean-christie","tag-yogan-pillay"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/437750","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=437750"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/437750\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/437659"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=437750"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=437750"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=437750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}