Sunday Times (Johannesburg) - August 12, 2007
Claire Keeton

This week she paid the price for being an HIV champion and exposing the failure of Manto Tshabalala-Msimang, and indirectly President Thabo Mbeki, to provide leadership against the epidemic.

"I never aimed to embarrass or defy [the government] or to be a rebel, but I grew up in an ANC of mutual respect where even my seniors would listen to me," Madlala-Routledge told the Sunday Times on Friday.

"I did try to raise issues internally and had no sense they were appreciated or that my concerns were given a chance. What was I meant to I do in that situation?" she asked, responding to criticism that she had been out of order.

The former deputy and her former boss were never a team; their conflicting views and opposing styles of leadership were evident since day one.

# While Madlala-Routledge spoke out about the proven benefits of antiretroviral drugs for Aids patients, Tshabalala- Msimang took every opportunity to promote nutrition as an alternative, especially garlic, beetroot and lemon, earning her the title "Dr Beetroot".

# As far back as March 2005 Madlala-Routledge publicly acknowledged the deadly impact of HIV/Aids, the time lost in tackling it and the benefits of treatment.

On that occasion she expressed a willingness to work with all partners and affirmed the Treatment Action Campaign (TAC) as an ally - an organisation that her minister was in conflict with.

# While the fired deputy went out of her way to build bridges with civil society, especially the TAC, the minister more often met their leaders in court.

Madlala-Routledge was also willing to meet and listen to health professionals, winning her the respect of the medical community.

Tshabalala-Msimang has a track record of clashing with health professionals who are outside of her trusted circle of advisers. Even the ANC's health committee meetings effectively petered out in the last few years.

# Madlala-Routledge, on the other hand, has a consultative and down-to-earth manner, which she demonstrated during her service as the deputy Health minister.

Her dismissal this week has sparked outrage and dismay from HIV, medical and political organisations.

"Madlala-Routledge was a key player in the past two years in the creation of a more united and better environment vis-a-vis HIV and Aids, culminating in the launch of the National Strategic Plan 2007-2011 and the re-launch of the South African National Aids Council," said chairman of the South African Medical Association, Dr Kgosi Letlape.

The HIV/Aids plan was unveiled in Boksburg while Tshabalala-Msimang was on sick leave after a liver transplant in March.

The same week she resumed office in June, the minister ignited tensions by refusing to address the Third South African Aids conference in Durban because she had not been afforded a prominent speaking slot.

Deputy President Phumzile Mlambo-Ngcuka announced at the opening plenary that the minister would not attend since she had not been invited to speak at the opening ceremony. Tshabalala-Msimang had been scheduled to speak during a morning plenary session. However, the organisers said they had repeatedly invited the minister to be one of the speakers during the opening ceremony.

At virtually every major Aids conference, whether in Durban, Bangkok in Thailand or Toronto in Canada, Tshabalala-Msimang has provoked controversy.

In July 2004 in Bangkok, the minister was out of step with international scientists and doctors. She attacked the UN special envoy on HIV/Aids in Africa, Stephen Lewis, and was once again quick to raise the alarm about antiretroviral drugs without reference to their efficacy.

In August last year in Toronto, the minister again emphasised nutrition and traditional medicines as alternatives to antiretroviral medication. Lemons, beetroot, garlic and African potatoes were displayed prominently at South Africa's exhibition stall at the Canadian conference.

Madlala-Routledge stepped into the fray when she described the uproar over South Africa at the conference as an embarrassment.

Three months later the former deputy took a public HIV test to support the Sunday Times in its campaign to promote HIV testing and Aids awareness.

Her public and independent role did not go down well in official party circles and the same month Tshabalala-Msimang hit out at her deputy, though not by name, in the weekly ANC Today newsletter.

"The incident of my illness was portrayed as an opportunity to turn others into champions of a campaign to rid our government of the so-called "HIV and Aids denial at the highest level," Tshabalala-Msimang wrote.

Madlala-Routledge's dismissal on Wednesday was preceded by another attack in ANC Today last Friday.

These written attacks were only the latest round in the battles between Madlala-Routledge and her former colleagues.

From day one in her post she was marginalised and isolated, with almost no authority and few resources.

In a frank press conference on Friday, Madlala-Routledge told journalists that she had difficulty simply getting information from departmental officials.

"Senior management in my department were told not to liaise directly with me but with the director-general [Thami Mseleku]."

She said that Transport Minister Jeff Radebe, who was Acting Health minister while Tshabalala-Msimang was off sick, had signed papers delegating authority to her.

"He realised my designation was meaningless without authority," she said. "Just before I was dismissed, this authority was withdrawn."

Madlala-Routledge said before her dismissal her staff had received anonymous SMSs and threatening phone calls saying they would no longer have jobs.

She also said the minister threatened to "fix" her two years ago, after she spoke at the Council of Provinces.

Madlala-Routledge said she was sacked for an unauthorised trip to attend a conference hosted by the International Aids Vaccine Initiative in Spain and her unannounced visit to Frere Hospital, where she described the infant death rate as a "national emergency".

Asked if she was fired for doing her job, the former deputy replied: "I agree I was doing my job."

Mbeki's office yesterday confirmed that he sacked her over this trip and because she refused to work as part of a "collective".

Idasa analyst Richard Calland condemned Madlala-Routledge's dismissal as "a shameful error of judgment".

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