Belonging to the Pattali Makkal Katchi (PMK), the same party as his predecessor, Dalit Ezhilmalai, Shanmugam is a two-time MP from Vellore parliamentary constituency in Tamil Nadu.

The similarity does not end there. Like his predecessor Shanmugam has been given independent charge of a portfolio about which he knows precious little. Trying vainly to explain the reason for his appointment, Shanmugam says, "This Ministry was given to my party, PMK, last time too. Which is why this time also PMK was given this portfolio."

But for Ministry insiders, Shanmugam's appointment and his ignorance about the issues confronting the Health Ministry comes as no surprise. Officials have got so used to running the various departments with scant interference from the politically appointed Minister, who in any event is more occupied with partypolitics and his constituency back home, that many of them confess that it really doesn't make a difference.

"It's years since we've had a hands-on Minister. In any case, even a Minister who knows his stuff doesn't last too long, so it's back to us if you want any kind of continuity," said a senior official.

The lack of direction and benign neglect of the health sector over the years has resulted in the resurrection of a number of major diseases, the patchy record of family welfare programmes and the overall decline in the quality of health services, abysmally so in the rural areas. Despite different national programmes for the prevention of tuberculosis, leprosy, blindness, HIV/AIDS, there has been no notable dent in battling these diseases. TB is making a come back. Smallpox has been eradicated but chicken pox and measles, both preventable diseases, continue to claim lives. After years of denial about the spread of HIV/AIDS, the government has finally woken up to the near epidemic status of the fataldisease in some parts of the country. Enormous efforts would be required by the government to keep the disease in control.

On the population front, a National Population Policy has been on the slow track. It has finally reached the Cabinet, where a group of ministers has scrutinised the draft policy, but it's anybody's guess when it will be adopted. Expectations about the latest incumbent in the Ministry are mixed. Shanmugam has proved to be a quick learner. Within hours of taking charge, he had his sound bytes ready for the media: Improvement in the quality of rural healthcare, stabilisation of population and eradication of infectious diseases would be his primary priorities.

But if Ezhilmalai's example is anything to go by, Shanmugam too will be spending more time in Tamil Nadu, than in the Capital. The PMK, with five MPs, has been rewarded with two ministerships, the other being the Minister of State for Petroleum, E Ponnuswami.

The exigencies of state politics being what they are, every weekendShanmugam will be winging back to his home state and the affairs of the Health Ministry will be in the hands of the bureaucracy.