Mantombazana "Manto" Edmie Tshabalala-Msimang OMSS (née Mali; 9 October 1940 – 16 December 2009) was a South African politician. She was Deputy Minister of Justice from 1996 to 1999 and served as Minister of Health from 1999 to 2008 under President

Thabo Mbeki Thabo Mvuyelwa Mbeki (; born 18 June 1942) is a South African politician who served as the 2nd democratic president of South Africa from 14 June 1999 to 24 September 2008, when he resigned at the request of his party, the African National Cong ...

. She also served as Minister in the Presidency under President

Kgalema Motlanthe Kgalema Petrus Motlanthe (; born 19 July 1949) is a South African politician who served as the 3rd president of South Africa from 25 September 2008 to 9 May 2009, following the resignation of Thabo Mbeki. Thereafter, he was deputy president und ...

from September 2008 to May 2009. Her emphasis on treating South Africa's

AIDS epidemic The global pandemic of HIV/AIDS (human immunodeficiency virus infection and acquired immunodeficiency syndrome) began in 1981, and is an ongoing worldwide public health issue. According to the World Health Organization (WHO), by 2023, HIV/AIDS ...

with easily accessible vegetables such as African potato, garlic and

beetroot The beetroot (British English) or beet (North American English) is the taproot portion of a ''Beta vulgaris'' subsp. ''vulgaris'' plant in the Conditiva Group. The plant is a root vegetable also known as the table beet, garden beet, dinner bee ...

, rather than with antiretroviral medicines, was the subject of local and international criticism. These policies led to the deaths of over 300,000 infected South Africans.

Education

Born as Mantombazana Edmie Mali in

Durban Durban ( ; , from meaning "bay, lagoon") is the third-most populous city in South Africa, after Johannesburg and Cape Town, and the largest city in the Provinces of South Africa, province of KwaZulu-Natal. Situated on the east coast of South ...

, Tshabalala-Msimang graduated from Fort Hare University in 1961. As one of a number of young

African National Congress The African National Congress (ANC) is a political party in South Africa. It originated as a liberation movement known for its opposition to apartheid and has governed the country since 1994, when the 1994 South African general election, fir ...

cadres sent into exile for education, she received medical training at the First Leningrad Medical Institute in the Soviet Union from 1962 to 1969. She then trained as a registrar in

obstetrics Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a su ...

and

gynaecology Gynaecology or gynecology (see American and British English spelling differences) is the area of medicine concerned with conditions affecting the female reproductive system. It is often paired with the field of obstetrics, which focuses on pre ...

in Tanzania, finishing there in 1972. In 1980 she received a master's in

public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...

from the

University of Antwerp The University of Antwerp () is a major Belgian university located in the city of Antwerp. The official abbreviation is ''UAntwerp''. The University of Antwerp has about 20,000 students, which makes it the third-largest university in Flanders. ...

in Belgium. She was an official within the exiled ANC leadership in Tanzania and

Zambia Zambia, officially the Republic of Zambia, is a landlocked country at the crossroads of Central Africa, Central, Southern Africa, Southern and East Africa. It is typically referred to being in South-Central Africa or Southern Africa. It is bor ...

during the latter decade of

apartheid Apartheid ( , especially South African English: , ; , ) was a system of institutionalised racial segregation that existed in South Africa and South West Africa (now Namibia) from 1948 to the early 1990s. It was characterised by an ...

, with job responsibilities focused on the health and well-being of ANC militants there.

AIDS policies

Tshabalala-Msimang's administration as Minister of Health was controversial, because of her reluctance to adopt a public sector plan for treating AIDS with

anti-retroviral The management of HIV/AIDS normally includes the use of multiple antiretroviral drugs as a strategy to control HIV infection. There are several classes of antiretroviral agents that act on different stages of the HIV life-cycle. The use of mu ...

medicines (ARVs). When interviewed by

Radio 702 702 or (Talk Radio 702) is a commercial FM radio station based in Johannesburg, South Africa, broadcasting on FM 92.7 and FM 106 to the greater Gauteng province. The station is also webcast via its website. It claims to be Johannesburg's numb ...

presenter John Robbie in 2000, Tshabalala-Msimang refused to say whether she believed HIV caused AIDS. She was called ''Dr. Beetroot'' for promoting the benefits of

beet The beetroot (British English) or beet (North American English) is the taproot portion of a '' Beta vulgaris'' subsp. ''vulgaris'' plant in the Conditiva Group. The plant is a root vegetable also known as the table beet, garden beet, dinner ...

root, garlic, lemons, and African potatoes as well as good general nutrition, while referring to the possible toxicities of AIDS medicines. She was widely seen as following an AIDS policy in line with the ideas of South African President Thabo Mbeki, who for a time publicly expressed doubts about whether HIV caused AIDS. In 2002, the South African Cabinet affirmed the policy that "HIV causes AIDS" which as an official statement silenced any further speculation on this topic by Cabinet members, including the President. In August 2003, the cabinet also voted to make anti-retrovirals available in the public sector, and instructed Tshabalala-Msimang to carry out the policy. The Treatment Action Campaign (TAC) and its founder Zackie Achmat often targeted the minister for criticism, accusing the government and the Ministry of Health in particular of an inadequate response to the AIDS epidemic. The TAC led a campaign calling for her resignation or dismissal. The TAC accused Tshabalala-Msimang of being aligned with Matthias Rath, a German physician and vitamin entrepreneur, who had charges laid against him for discouraging the use of ARVs. Tshabalala-Msimang placed her emphasis on broad public health goals, seeing AIDS as only one aspect of that effort and one which, because of the incurable nature of HIV and financial costs of HIV treatment, might impede broader efforts to improve public health. A report making the case that AIDS is such a burden on the public health system that treating it would actually free up costs was sent back for clarification and not released in the summer of 2003, until it was obtained and leaked by TAC. After the cabinet vote to accept the findings of this report, Tshabalala-Msimang was in charge of the ARV roll-out, but continued to emphasise the importance of nutrition in AIDS and to urge others to see AIDS as only one problem among many in South African health. A case that attracted much public attention was Nozipho Bhengu, daughter of an

legislator, who rejected anti-retroviral treatments for AIDS in favour of Tshabalala-Msimang's garlic and lemon diet. The minister declined to attend her funeral, and her stand-in was booed off the podium. In February 2005, the Congress of South African Trade Unions (COSATU) criticised the health department for their failure to ensure that most of the 30 million rand used to establish the government's AIDS trust in 2002 had been spent. They said only R520,000 of this money was used and of this a large portion had been squandered on unoccupied offices for the SANAC secretariat, something that drew criticism from the auditor-general. In August 2006, at the International AIDS Conference in Toronto,

Stephen Lewis Stephen Henry Lewis (born November 11, 1937) is a Canadian politician, public speaker, broadcaster, and diplomat. He was the Canadian ambassador to the United Nations in the 1980s and was the leader of the social democratic Ontario New Democr ...

, the United Nations special envoy for AIDS in Africa, closed the conference with a sharp critique of South Africa's government. He said South Africa promoted a "lunatic fringe" attitude toward HIV and AIDS, describing the government as "obtuse, dilatory, and negligent about rolling out treatment". After the conference, sixty-five of the world's leading HIV/AIDS scientists (most of them were attending the conference) asked in a letter that

dismiss Tshabalala-Msimang.

Traditional medicines

At a meeting with traditional healers to discuss future legislation in February 2008, Tshabalala-Msimang argued that traditional remedies should not become "bogged down" in clinical trials, also saying, "We cannot use Western models of protocols for research and development". In September 2008, Tshabalala-Msimang called for greater protection of the intellectual rights of Africa's traditional medicines. Speaking at the 6th commemoration of The African

Traditional Medicine Traditional medicine (also known as indigenous medicine or folk medicine) refers to the knowledge, skills, and practices rooted in the cultural beliefs of various societies, especially Indigenous groups, used for maintaining health and treatin ...

Day in

Cameroon Cameroon, officially the Republic of Cameroon, is a country in Central Africa. It shares boundaries with Nigeria to the west and north, Chad to the northeast, the Central African Republic to the east, and Equatorial Guinea, Gabon, and the R ...

's capital of

Yaoundé Yaoundé (; , ) is the Capital city, capital city of Cameroon. It has a population of more than 2.8 million which makes it the second-largest city in the country after the port city Douala. It lies in the Centre Region (Cameroon), Centre Region o ...

, she said that the continent should benefit more from its ancient traditional knowledge.

Personal

Tshabalala-Msimang married her first husband, Mandla Tshabalala, while both were in exile in the Soviet Union. Later she married Mendi Msimang, the treasurer of the African National Congress. Concern over Tshabalala-Msimang's health came to the fore in late 2006. She was admitted to the Johannesburg Hospital on 20 February 2007, suffering from

anaemia Anemia (also spelt anaemia in British English) is a blood disorder in which the blood has a reduced ability to carry oxygen. This can be due to a lower than normal number of red blood cells, a reduction in the amount of hemoglobin availab ...

and

pleural effusion A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung. Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilog ...

(an abnormal accumulation of fluid around the lungs). The Department of Health approached President Thabo Mbeki, and asked him to appoint an acting minister, and on 26 February Jeff Radebe was appointed acting health minister. On 14 March 2007, Tshabalala-Msimang underwent a

liver transplant Liver transplantation or hepatic transplantation is the replacement of a Liver disease, diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for Cirrhosis, end-stage liver disease and ...

. The stated cause was

autoimmune hepatitis Autoimmune hepatitis, formerly known as lupoid hepatitis, plasma cell hepatitis, or autoimmune chronic active hepatitis, is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells, causing the liv ...

with

portal hypertension Portal hypertension is defined as increased portal venous pressure, with a hepatic venous pressure gradient greater than 5 mmHg. Normal portal pressure is 1–4 mmHg; clinically insignificant portal hypertension is present at portal pressures 5� ...

, but the transplant was surrounded by accusations of heavy drinking. She subsequently recovered her health and returned to her Ministerial duties until her replacement as health minister in 2008. On 16 December 2009, she died due to complications related to her liver transplant.

Scandal

On 12 August 2007, four days after the controversial dismissal of her deputy minister, Nozizwe Madlala-Routledge, the ''

Sunday Times ''The Sunday Times'' is a British Sunday newspaper whose circulation makes it the largest in Britain's quality press market category. It was founded in 1821 as ''The New Observer''. It is published by Times Newspapers Ltd, a subsidiary of N ...

'' ran an article titled "Manto's hospital booze binge" about a previous hospital stay in 2005 for a shoulder operation.Manto’s hospital booze binge
, ''Sunday Times'' (South Africa). Published 12 August 2007. Retrieved 15 August 2007. The article alleged that she sent hospital workers out to fetch wine,

whisky Whisky or whiskey is a type of liquor made from Fermentation in food processing, fermented grain mashing, mash. Various grains (which may be Malting, malted) are used for different varieties, including barley, Maize, corn, rye, and wheat. Whisky ...

and food items, in one case at 1:30 am. Tshabalala-Msimang threatened legal action against the newspaper on the grounds that they were in possession of her medical records. The paper defended its statements, stating that "a retraction was not under consideration". The article also reported speculation among "many top medical experts at state and private institutions, who refused to be named as they feared retribution from the health ministry" that her liver condition was alcohol-induced

cirrhosis Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, chronic liver failure or chronic hepatic failure and end-stage liver disease, is a chronic condition of the liver in which the normal functioning tissue, or parenchyma, is replaced ...

. According to a ''

'' article titled "Manto: A Drunk and a Thief" published on 19 August 2007, the minister was a convicted thief who had stolen patient items at a hospital in Botswana, and had been deported from Botswana and declared a prohibited immigrant.MANTO: A DRUNK AND A THIEF
, Sunday Times article. Published 19 August 2007. Retrieved 19 August 2007.

ANC politics and replacement as Health Minister

With the endorsement of

Jacob Zuma Jacob Gedleyihlekisa Zuma (; born 12 April 1942) is a South African politician who served as the fourth president of South Africa from 2009 to 2018. He is also referred to by his initials JZ and clan names Nxamalala and Msholozi. Zuma was a for ...

's supporters, Tshabalala-Msimang was re-elected to the ANC's 80-member National Executive Committee in December 2007 in 55th place, with 1,591 votes. Mbeki was forced to resign by the ANC in September 2008. When his successor, Kgalema Motlanthe, took office on 25 September 2008, he moved Tshabalala-Msimang to the post of Minister in the Presidency, appointing Barbara Hogan to replace her as Minister of Health. Tshabalala-Msimang was not included in the first Cabinet of President

, announced on 10 May 2009.

Death

Tshabalala-Msimang died on 16 December 2009 at the Wits University Donald Gordon Medical Centre and Medi-Clinic ICU. Her doctor, Professor Jeff Wing, announced that she died due to complications arising from a liver transplant."Manto Tshabalala-Msimang has died"
''Sunday Times (Johannesburg)'', 16 December 2009. Political opponents and friends alike expressed shock at the announcement of her death: * The Treatment Action Campaign (TAC) – "We don't wish ill on any human being even though we had a very difficult time with her as minister of health. We are sending our condolences to her family and children." *

Helen Zille Otta Helene Maree (''née'' Zille ; born 9 March 1951), known as Helen Zille, is a South African politician. She has served as the Chairperson of the Federal Council of the Democratic Alliance since 20 October 2019. From 2009 until 2019, she w ...

, leader of the Democratic Alliance – "We extend our sincere regrets to her family and loved ones. It is sad when anyone dies. Like many politicians she was controversial. However, that doesn't detract from the sadness of her death". * COSATU president Sidumo Dlamini – "This is shocking news. Somebody asked me yesterday what message we were going to send her in hospital and I said we hoped and wished her a speedy recovery. She made some mistakes by driving those policies but she was a human being. Her loss is a great loss. South Africa is losing a great leader of the ANC."

References

External links

Manto replaced by Barbara Hogan

Tshabalala-Msimang's CV

Democratic Alliance website detailing Tshabalala-Msimang's failures and gaffes

Sack Manto
a South African initiative to oust the incumbent minister

Aids experts condemn South African minister

Transcript of radio interview with Tshabalala-Msimang, asking her whether HIV causes AIDS
In her own words:

{{DEFAULTSORT:Tshabalala-Msimang 1940 births 2009 deaths Ministers of health of South Africa Members of the National Assembly of South Africa 1994–1999 Members of the National Assembly of South Africa 1999–2004 Members of the National Assembly of South Africa 2004–2009 Members of the National Assembly of South Africa 2009–2014 Politicians from Durban South African politicians convicted of crimes University of Antwerp alumni HIV/AIDS denialists African National Congress politicians Women government ministers of South Africa 20th-century South African women politicians Liver transplant recipients Women members of the National Assembly of South Africa