BBC News - September 21, 2007
Justin Pearce, Johannesburg

In recent weeks, however, the minister dubbed "Dr No" and "Dr Beetroot" has been in the spotlight more than ever before, amid the controversial sacking of her deputy minister, and reports of theft and heavy drinking.

The affair prompted an opposition MP to storm out of parliament after the speaker refused to admit a question on the allegations.

There have also been sharp exchanges of words between the state-run South African Broadcasting Corporation and the rest of the media over the way in which the controversy has been reported.

Exile

Mantombaza Tshabalala was born in Durban in 1940. She graduated with a BA from Fort Hare University in 1961, at a time of growing confrontation between the apartheid government in South Africa and its opponents in the African National Congress.

For many of Manto Tshabalala's generation, exile was the only option. At a time when the Soviet Union was starting to take an interest in liberation movements in Africa, Ms Tshabalala attended the First Lenin Medical Institute in Moscow, graduating as a medical doctor in 1969.

Her knowledge of the Russian language has stayed with her - earlier this year she was reported to throw in a Russian phrase during a cabinet briefing at which one journalist described her as seeming "disorientated" and "in poor health".

She returned to Africa and throughout the 1970s and 1980s, she remained in centres where the ANC had a presence, studying in Dar es Salaam before taking up a post as medical superintendent at a hospital in Lobatse in Botswana in 1973.

Some of the most serious accusations made against her in the press date from this period.

The South African Sunday Times reported that she had been convicted of theft in Botswana in 1976, and claimed that the charges related to the theft of possessions from hospital patients. The court documents relating to the case appear to have gone missing.

Parliament

In 1982 she married a fellow South African exile, Mendi Msimang, who subsequently became one of the most prominent members of South Africa's post-apartheid black business elite.

Dr Tshabalala-Msimang entered parliament on the ANC ticket with the first democratic elections in 1994.

The next election, five years later, saw Thabo Mbeki elected president and Dr Tshabalala-Msimang appointed as health minister.

Not long after that, she found herself at the centre of the most enduring controversy of Mr Mbeki's presidency: the president's scepticism about the links between HIV and Aids, and his support for remedies that defied established scientific opinion.

In a country where the HIV infection rate hovers around 12%, this difference of medical opinion became a serious political issue.

Campaign

The government's position prompted the formation of the Treatment Action Campaign - the most prominent activist group to have emerged in South Africa since the end of apartheid.

At one time, there was speculation that the minister had no choice but to parrot views and implement policies that were really the president's own.

But more recently it has been suggested that the close relationship between Mr Mbeki and Dr Tshabalala-Msimang - seen in his refusal to heed calls for her resignation - in fact lies in their shared and deeply held convictions on the subject of Aids.

Either way, it is the minister who has borne the brunt of the criticism for government Aids policy, and this has endured in recent years as Mr Mbeki has become less forthright about his views on Aids.

Vegetables

The "Dr Beetroot" nickname appeared after Dr Tshabalala-Msimang began recommending olive oil, lemon, beetroot and the African potato as elements of a healthy diet that could treat the symptoms associated with Aids.

While no one has ever denied that Aids patients need to eat healthily, the minister's vegetable menu was ridiculed in the light of the government's refusal to endorse the anti-retroviral (ARV) drugs that were being developed at the same time.

In the months before the 2004 election, with several provincial health departments already rebelling against national policy on ARVs, the government shifted its position, allowing government clinics to prescribe the drugs.

A further hint of change came with the appointment as deputy health minister of Nozizwe Madlala-Routledge, a politician who had a cordial relationship with Aids activists and who embraced more orthodox views on how to deal with the epidemic.

Dr Tshabalala-Msimang, however, continued to attract criticism for never wholeheartedly endorsing ARV treatment.

When, last month, President Mbeki dismissed the deputy minister on the grounds that she had flown to Spain for an international Aids conference without proper authorisation, Aids activists and the media interpreted the move as the latest shot in the long battle between Aids denialists and conventional scientific opinion.

Accusations

The move was followed by a series of damning accusations against the minister - including the report about the incident of thieving in Botswana.

It was claimed not only that she had received privileged access to a liver transplant, but also that the operation had been necessitated by excessive drinking.

Dr Tshabalala-Msimang has dismissed the allegations, and her supporters say she is the victim of a media conspiracy.

It is true that complex debates are easier to put into headlines when they can be painted as a clash between two individuals, one portrayed as a monster and the other as a hero.

Much of the coverage of the sacking of Ms Madlala-Routledge was along these lines, with the minister demonised while her deputy's own shortcomings were played down.

One cartoon showed President Mbeki as a surgeon conducting an organ transplant and choosing to remove the "good heart" (the deputy minister) rather than the "bad liver" (the minister) from the sick patient.

But even if the reporting has verged on the sensationalist, the controversy goes to the heart of genuine anger around the government's stance on Aids.

Style

The minister's unpopularity with the media has a lot to do with her personal as well as her political style. Her response to criticism is invariably to go on the attack rather than to try to engage in debate with her critics.

One common characterisation of the ANC's - and South Africa's - current leaders classifies them into two camps: those who learnt their politics in the secretive and authoritarian world of the ANC in exile, and those who were schooled in the grassroots struggle against apartheid that emerged in the 1980s.

This formula may be simplistic. Still, it is hard not to notice how the former deputy minister's common touch reflects her background as a community activist, while the minister takes her instructions from above, and expects her underlings to do as they are told.

The battle between "Manto" and "Nozizwe" - the headlines seldom stretch to accommodate their lengthy surnames - has captured the imagination of South Africans who are eager to know in what direction a still-young democracy is going to develop.

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