By Stephen Bevan
Deputy Health Minister Nozizwe Madlala-Routledge has criticised the government's shortcomings in tackling HIV and Aids, saying both President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang must bear some responsibility for confusion over the correct treatment for the virus.
Interviewed for a British newspaper, Madlala-Routledge criticised those who promoted traditional medicines as an alternative to conventional drug treatment.
"What has happened in South Africa, which is sad and tragic... people are confused about treatment... and this has come about because of the confusing messages coming from the very top.
"If I use the example of traditional medicine, I think it was irresponsible of leaders to say people have a choice... because how do those people choose when they don't have the knowledge that is backed up by science?
"It is absolutely irresponsible to say to people who are desperate, who want to live, 'Oh, go to your traditional healer if you want', because what traditional healers do we know of who know how to treat Aids? I don't know of any in my country."
Asked if she included the president and the health minister in her comments, Madlala-Routledge replied "yes".
Expressing concern that high-level decisions were generating confusion, she noted that Mbeki's recent appointment of Professor Herbert Vilakazi as chairperson of a "task team" on traditional medicine might contribute to this, if its role was not clearly defined.
"You see, in relation to the president himself, he has recently announced a task team on traditional medicine and for me there's nothing wrong with that, as long the task team understands its duty is to research or to assist in research on traditional medicine.
"But if there is a (misunderstanding)... that the task team is saying people can use traditional medicine, that is a problem, because what brings about that concern for me is that Vilakazi is chairperson of the task team on traditional medicine and... Vilakazi... is marketing an untested product, Ubhejane, so that's a concern because once people see 'Oh, Professor Vilakazi has now been appointed by the president to be chairperson of this task team and Professor Vilakazi is saying take Ubhejane to cure Aids' - you know what I mean, it's very confusing to ordinary people."
Pressed on whether she was saying it had been a mistake to appoint him, she replied, "Yes, I think so."
The comments are potentially embarrassing for the president, although Madlala-Routledge has a reputation for being outspoken.
The 55-year-old mother of two has become something of a hero to critics of the government's Aids policy and a symbol of the government's new willingness to accept criticism and work with former enemies such as the Treatment Action Campaign through the newly restructured South African National Aids Council.
Along with her old friend, deputy president Phumzile Mlambo-Ngcuka, she has been at the forefront of what has been hailed as the most important shift in the government's approach to tackling the disease in 12 years, with a five-year strategy being drawn up in consultation with civil society organisations, and bold new targets such as the halving of new infections by 2011.
Significantly, it was she, not her boss, who stood alongside the deputy president when the new strategy was unveiled on World Aids Day.
Referring to South Africa's exhibition stand at the Toronto Aids conference in August which featured garlic, lemon, beetroot and African potatoes, but no anti-retroviral drugs - until journalists pointed out the omission - Madlala-Routledge said it had left the government "very, very embarrassed" and did not reflect official policy.
Until very recently she was gagged from speaking on HIV and Aids at all - something she confirmed for the first time in the interview.
"Now I've not been gagged formally. It's not like there's a letter telling me not to talk about HIV and Aids, but I've been sanctioned because I've spoken in parliament and been told I may lose my job.
"I must only say what she says and this is official. For me that is gagging but I've not observed the gag. I've just said what I think ought to be said and nobody has told me to shut up. So I think, I've taken this to mean, what the government has wanted done from the point of view... that there have to be clear and consistent messages. This is what I'm doing, contributing to that."
Madlala-Routledge also commented for the first time on Tshabalala-Msimang's recent outburst on the ANC website, in which she attacked those who portrayed her recent illness as "an opportunity to turn others into champions of a campaign to rid our government of the so-called HIV and Aids denial (sic) at the highest level".
Madlala-Routledge said, "Of course, the minister has indicated her displeasure by writing... a veiled criticism of me, but I haven't had anybody else supporting her from the top."
She said she had not discussed the issue with her boss.
"As you know after her admission to hospital she's been recovering and I've wanted her to concentrate on that. I've not had any discussion with her about it but (I) also felt (I've) not really needed to although I know what I said and I stand by it."