South Africa Replaces Health Minister

Manto Tshabalala-Msimang for years advocated dietary remedies for AIDS, not antiretroviral drugs. She has had her own health problems recently.
Manto Tshabalala-Msimang for years advocated dietary remedies for AIDS, not antiretroviral drugs. She has had her own health problems recently. (By Mark Wessels -- Associated Press)

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By Craig Timberg
Washington Post Foreign Service
Wednesday, February 28, 2007

KAMPALA, Uganda, Feb. 27 -- South African President Thabo Mbeki on Monday named an interim health minister, replacing the ailing Manto Tshabalala-Msimang, whose reluctance to embrace lifesaving AIDS drugs provoked international rebuke and the derisive nickname Dr. No.

Transport Minister Jeff Radebe was appointed interim health minister, but South African officials would not say whether Tshabalala-Msimang would return to her job.

AIDS activists said they believed that her tenure as health minister -- which dates to the beginning of Mbeki's first administration in 1999 -- had ended.

"I hope that we're in a position to have a more scientifically focused HIV policy going forward," said Francois Venter, president of the Southern African HIV Clinicians Society, speaking from Los Angeles, where he was attending a conference.

Mbeki has steadily decreased Tshabalala-Msimang's authority over AIDS policy since a disastrous appearance at the International AIDS Conference in Toronto in August, when a booth she sponsored initially included elements of her widely criticized dietary remedies -- including garlic, beets and lemon -- but no antiretroviral drugs. After the conference, dozens of scientists signed an open letter calling for her removal.

Deputy President Phumzile Mlambo-Ngcuka took control of national AIDS policy in September, at about the same time Tshabalala-Msimang was hospitalized for what officials described as a lung infection.

She was discharged after several weeks, but the South African press has chronicled the continued decline in her health. At a press briefing in Cape Town this month, she appeared confused and had lost substantial weight. She reentered the hospital soon after, and there is little public hint that a recovery is likely to come soon. The government announced her removal quietly in a statement Monday evening.

Joel Netshitenzhe, Mbeki's top policy adviser, declined to comment on whether discussions have begun on a permanent replacement for Tshabalala-Msimang.

"I don't want to speculate on that at all," Netshitenzhe said from Cape Town.

The early years of Mbeki's presidency were marked by frequent controversy over AIDS, and though he has largely withdrawn from public debate on the issue, Tshabalala-Msimang has remained a focus of anger among activists and a favorite target of editorial cartoonists. Her criticisms of antiretroviral drugs, which alone relieve the debilitating and generally fatal symptoms of AIDS, made her a pariah among international health leaders.

She was the subject of frequent lawsuits by activists demanding more aggressive expansion of the nation's AIDS treatment program. In a population of 46 million, an estimated 5.5 million South Africans have HIV, the virus that causes AIDS, one of the highest rates of infection in the world.

Radebe is widely seen as a caretaker in the job. Under South Africa's constitution, only a current minister can serve as an interim replacement for another minister.

The Treatment Action Campaign, South Africa's most prominent AIDS activist group, which has repeatedly called for Tshabalala-Msimang's firing, issued a statement Tuesday welcoming the move and wishing her well. But it urged that Radebe, who has little record in public health, quickly be replaced by a permanent health minister.

"The public health system is in crisis and requires dedicated leadership," said the group's general secretary, Sipho Mthathi.

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