South Africa's former health minister, Dr Manto Tshabalala-Msimang, died on Wednesday from complications related to a liver transplant she received in 2007.
The news was greeted with a flood of tributes by her colleagues in the ruling African National Congress (ANC) for her devotion to the party and the struggle against apartheid. But members of South Africa's HIV/AIDS sector expressed mixed feelings about her controversial tenure as health minister from 1999 to 2008.
Tshabalala-Msimang played a key role in stalling the introduction of a government antiretroviral (ARV) programme, although she was widely believed to have the backing of then President Thabo Mbeki, who publicly expressed doubts about whether HIV caused AIDS.
After losing a protracted legal battle with the AIDS lobby group, Treatment Action Campaign (TAC), the health department finally started making ARVs available at public health facilities in 2004, several years after many other countries in the region had begun rolling out treatment.
A 2008 study published by the Harvard School of Public Health estimated that more than 330,000 HIV-positive South Africans had lost their lives between 2000 and 2005 as a direct result of government delays in setting up a treatment programme.
Even after ARVs became available, Tshabalala-Msimang continued to cast doubt on their safety and efficacy, regularly touting the benefits of good nutrition and traditional medicines for prolonging the lives of HIV-positive people.
Her approach to HIV/AIDS drew widespread international condemnation, which came to a head at the 2006 International AIDS Conference in Toronto, when she insisted that garlic, lemon and beetroot be displayed in South Africa's exhibition booth. After the conference, 65 HIV/AIDS scientists put their names to a letter to Mbeki requesting that she be dismissed.
She was finally replaced as health minister after Mbeki was forced to step down in 2008. Her departure saw the beginning of a new era in South Africa's HIV/AIDS policy, with both President Jacob Zuma and his health minister, Aaron Motsoaledi, publicly committing to scaling up government treatment and prevention efforts.
The Congress of South African Trade Unions (COSATU) said that while it "disagreed sharply with the [former] minister’s views on the causes of HIV/AIDS and the need to distribute antiretrovirals", it recognised her role in the liberation struggle.
“She made some mistakes by driving those policies, but she was a human being," COSATU president Sidumo Dlamini said in a statement.
Prof Francois Venter, President of the Southern African HIV Clinicians Society, requested in a statement that political leaders keep their eulogizing of Tshabalala-Msimang to a bare minimum, "to respect the large number of people who died unnecessarily of HIV, or who suffered at the hands of a decimated health system."
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