KHOPOTSO: Perhaps the saying ‘€œwhen the cat is gone, the mice come out to play’€ holds true. Look what has happened in the Health Department since the big boss, Dr Manto Tshabalala-Msimang, took ill more than a month ago. Her deputy, Nozizwe Madlala-Routledge and the country’€™s Deputy President Phumzile Mlambo-Ngcuka, are positively influencing the attitude of government in relation to HIV and AIDS. Dr Clarence Mini, a former member of the National AIDS Council of South Africa (NACOSA) ‘€“ predecessor of the current South African National AIDS Council (SANAC), observes.

Dr CLARENCE MINI: I’€™m very optimistic’€¦ It does look like – even though, regrettably, it’€™s after so many deaths down the line – that the Deputy President is going to get it right’€¦ Everybody’€™s feeling positive about it and everybody wants to support her. As much as we are not going to forget what has happened ‘€“ the people who couldn’€™t get support ‘€“ we want to look forward. We want to make sure that the people that are sick now do not die.      

KHOPOTSO: Unlike what mice do when the cat is gone, though, this is not damaging play. It’€™s trying to undo the damage caused by the current Health Minister over years. Her shenanigans at the recent International AIDS Conference in Toronto, Canada, came as the final straw. Continued efforts to undermine the role of antiretrovirals and to promote nutrition, vitamins and traditional medicines in the treatment of AIDS, resulted in a stinging attack from the United Nation’€™s chief envoy on AIDS in Africa, Stephen Lewis. Lewis accused the government of espousing ‘€œtheories more worthy of a lunatic fringe than of a concerned and compassionate state’€. Shortly after the conference, in an apparent reference to Tshabalala-Msimang, the country’€™s Deputy President called for an end to mixed messages and the conflict around AIDS. Activist group Treatment Action Campaign and others called for the resignation of the Health Minister.

MARK HEYWOOD: What is missing is unity between the country as a whole and our government in the way that it combats the epidemic. I made a speech that called for the Minister of Health to resign. But I did that with enormous reluctance because I believe that partnership is critical, but sometimes you cross over a line and you reach a decision that partnership with this particular individual is going to be impossible because she has spurned collaboration on these types of issues, so that is why I made those comments.

KHOPOTSO: Mark Heywood of the Treatment Action Campaign and AIDS Law Project. But during the annual briefing of government’€™s social cluster departments, Tshabalala-Msimang dug in her heels.

Dr MANTO TSHABALALA-MSIMANG: I really can’€™t compromise on that one. I think if I trained as a medical doctor, I know what I’€™m talking about. And that is where we emphasise the use of a number of fruit and vegetables that provide particular vitamins and other micro-nutrients in dealing with conditions associated with HIV and AIDS’€¦ For people who might not want to listen to this one – I have been in the villages – people who have thrush’€¦ if you give them garlic’€¦ in two days’€™ time that thrush is gone and they can eat properly’€¦ even in the presence of HIV and AIDS’€¦ All of you say we are sending confusing messages. And I don’€™t know what are these confusing messages.                    

KHOPOTSO: The value of a good diet, micro-nutrients and traditional medicines in keeping immuno-compromised individuals healthy or even in helping alleviate certain opportunistic infections is undisputed. However, there is concern that Tshabalala-Msimang promotes these as alternative treatment for AIDS. Yet people who have AIDS need a comprehensive treatment based on antiretroviral medication as well as the treatment of opportunistic infections such as thrush.    

It’€™s encouraging that Deputy Health Minister Nozizwe Madlala-Routledge, is speaking out to clarify matters. She has been quoted as saying that it is ‘€œirresponsible of leaders to say people (with AIDS) have a choice’€ of what treatment to take. Deputy President Phumzile Mlambo-Ngcuka, who chairs the South African National AIDS Council, has managed to bring a wide group of organisations together to draw up a new plan to tackle AIDS until 2011.

South Africa can hope that this force of positive change is never silenced. But Madlala-Routledge has fingered both President Thabo Mbeki and his Health Minister for misleading South Africans on the treatment of AIDS.  

Writing in the ANC Today on-line newsletter, recently, sick Health Minister Tshabalala-Msimang criticised her deputy for speaking her mind on the AIDS issue. Will President Thabo Mbeki do the same? Will the Deputy Health Minister be charged with bringing the government into disrepute and be fired? But whether this happens, South Africans can be proud to have finally had someone in government tell the truth about HIV and AIDS. It’€™s the way things should be.