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Manto Tshabalala-Msimang

Manto Tshabalala-Msimang

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Dr. Mantombazana 'Manto' Edmie Tshabalala-Msimang (née Mali) (9 October 1940–16 December 2009) was a South African politician. She was Deputy Minister of Justice from 1996 to 1999 and controversially served as Minister of Health from 1999 to 2008 under President Thabo Mbeki
Thabo Mbeki
Thabo Mvuyelwa Mbeki is a South African politician who served two terms as the second post-apartheid President of South Africa from 14 June 1999 to 24 September 2008. He is also the brother of Moeletsi Mbeki...

. She also served as Minister in the Presidency under President Kgalema Motlanthe from September 2008 to May 2009.

Her emphasis on treating South Africa's AIDS epidemic with vegetables such as garlic
Garlic
Allium sativum, commonly known as garlic, is a species in the onion genus, Allium. Its close relatives include the onion, shallot, leek, chive, and rakkyo. Dating back over 6,000 years, garlic is native to central Asia, and has long been a staple in the Mediterranean region, as well as a frequent...

 and beetroot
Beetroot
The beetroot, also known as the table beet, garden beet, red beet or informally simply as beet, is one of the many cultivated varieties of beets and arguably the most commonly encountered variety in North America, Central America and Britain.-Consumption:The usually deep-red roots of beetroot are...

, rather than with antiretroviral medicines, was the subject of international criticism.

Education


Born in Durban
Durban
Durban is the largest city in the South African province of KwaZulu-Natal and the third largest city in South Africa. It forms part of the eThekwini metropolitan municipality. Durban is famous for being the busiest port in South Africa. It is also seen as one of the major centres of tourism...

, Tshabalala-Msimang graduated from Fort Hare University
University of Fort Hare
The University of Fort Hare is a public university in Alice, Eastern Cape, South Africa. It was a key institution in higher education for black Africans from 1916 to 1959. It offered a Western-style, academically excellent education to students from across sub-Saharan Africa, creating a black...

 in 1961. As one of a number of young African National Congress
African National Congress
The African National Congress is South Africa's governing Africanist political party, supported by its tripartite alliance with the Congress of South African Trade Unions and the South African Communist Party , since the establishment of non-racial democracy in April 1994. It defines itself as a...

 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
Obstetrics is the medical specialty dealing with the care of all women's reproductive tracts and their children during pregnancy , childbirth and the postnatal period...

 and gynecology in Tanzania
Tanzania
The United Republic of Tanzania is a country in East Africa bordered by Kenya and Uganda to the north, Rwanda, Burundi, and the Democratic Republic of the Congo to the west, and Zambia, Malawi, and Mozambique to the south. The country's eastern borders lie on the Indian Ocean.Tanzania is a state...

, finishing there in 1972. In 1980 she received a master's in public health
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" . It is concerned with threats to health based on population health...

 from the University of Antwerp
University of Antwerp
The University of Antwerp is one of the major Belgian universities located in the city of Antwerp. The name is sometimes abbreviated as UA.-History:...

 in Belgium.

She was an official within the exiled ANC leadership in Tanzania and Zambia
Zambia
Zambia , officially the Republic of Zambia, is a landlocked country in Southern Africa. The neighbouring countries are the Democratic Republic of the Congo to the north, Tanzania to the north-east, Malawi to the east, Mozambique, Zimbabwe, Botswana and Namibia to the south, and Angola to the west....

 during the latter decade of apartheid, 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
AIDS
Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

 with anti-retroviral medicines (ARVs). She was called Dr Beetroot for promoting the benefits of beet
Beet
The beet is a plant in the Chenopodiaceae family which is now included in Amaranthaceae family. It is best known in its numerous cultivated varieties, the most well known of which is the purple root vegetable known as the beetroot or garden beet...

root, garlic
Garlic
Allium sativum, commonly known as garlic, is a species in the onion genus, Allium. Its close relatives include the onion, shallot, leek, chive, and rakkyo. Dating back over 6,000 years, garlic is native to central Asia, and has long been a staple in the Mediterranean region, as well as a frequent...

, lemons, and African potatoes as well as good general nutrition
Nutrition
Nutrition is the provision, to cells and organisms, of the materials necessary to support life. Many common health problems can be prevented or alleviated with a healthy diet....

, while referring to 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
Treatment Action Campaign
The Treatment Action Campaign is a South African AIDS activist organization which was founded by the HIV-positive activist Zackie Achmat in 1998. TAC is rooted in the experiences, direct action tactics and anti-apartheid background of its founder...

 (TAC) and its founder Zackie Achmat
Zackie Achmat
Zackie Achmat is a South African activist, most widely known as founder and chairman of the Treatment Action Campaign and for his work on the behalf of people living with HIV and AIDS in South Africa.-Early life:...

 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
Matthias Rath
Matthias Rath is a doctor, businessman, and vitamin entrepreneur. He earned his MD degree in Germany. Rath claims that a program of nutritional supplements , including formulations that he sells, can treat or cure diabetes, cardiovascular disease, cancer, and HIV/AIDS...

, 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 financial costs of treatment, might impede broader efforts. 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 emphasize 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
Nozipho Bhengu
Nozipho Bhengu was a South African woman whose death from an AIDS-related illness intensified the controversy about how AIDS is treated in South Africa...

, daughter of an African National Congress
African National Congress
The African National Congress is South Africa's governing Africanist political party, supported by its tripartite alliance with the Congress of South African Trade Unions and the South African Communist Party , since the establishment of non-racial democracy in April 1994. It defines itself as a...

 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
Congress of South African Trade Unions
The Congress of South African Trade Unions is a trade union federation in South Africa. It was founded in 1985 and is the biggest of the country’s three main trade union federations, with 21 affiliated trade unions, altogether organising 1.8 million workers.-Establishment:COSATU was established in...

 (COSATU) criticized 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
XVI International AIDS Conference, 2006
The XVI International AIDS Conference was held in Toronto, Ontario, during the week of August 13-18 2006. This was the third time that Canada has hosted the International AIDS Conference, after Montreal in 1989 and Vancouver in 1996. The main venue for the conference was the Metro Toronto...

 in Toronto, Stephen Lewis
Stephen Lewis
Stephen Henry Lewis, is a Canadian politician, broadcaster and diplomat. He was the leader of the social democratic Ontario New Democratic Party for most of the 1970s. During many of the those years as leader, his father David Lewis was simultaneously the leader of the Federal New Democratic Party...

, the United Nations
United Nations
The United Nations is an international organization whose stated aims are facilitating cooperation in international law, international security, economic development, social progress, human rights, and achievement of world peace...

 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 Thabo Mbeki
Thabo Mbeki
Thabo Mvuyelwa Mbeki is a South African politician who served two terms as the second post-apartheid President of South Africa from 14 June 1999 to 24 September 2008. He is also the brother of Moeletsi Mbeki...

 dismiss Tshabalala-Msimang.

Radio interview


In a controversial 2000 interview by Radio 702
Radio 702
Radio 702, currently known as 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 number one news and talk station,...

 presenter John Robbie
John Robbie
John Cameron Robbie is a former international rugby union player. He went to The High School in Dublin, Ireland. He toured South Africa in 1980 with the British and Irish Lions and at the time played club rugby for Greystones RFC. He was later picked twice for the South African rugby team but...

, Tshabalala-Msimang refused to say whether she believed HIV caused AIDS.

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, 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 Day in Cameroon
Cameroon
Cameroon, officially the Republic of Cameroon , is a country in west Central Africa. It is bordered by Nigeria to the west; Chad to the northeast; the Central African Republic to the east; and Equatorial Guinea, Gabon, and the Republic of the Congo to the south. Cameroon's coastline lies on the...

's capital of Yaounde
Yaoundé
-Transportation:Yaoundé Nsimalen International Airport is a major civilian hub, while nearby Yaoundé Airport is used by the military. Railway lines run west to the port city of Douala and north to N'Gaoundéré. Many bus companies operate from the city; particularly in the Nsam and Mvan neighborhoods...

, 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
Mendi Msimang
Mendi Msimang has been treasurer of the African National Congress since 1997. From 1994 until that time, he served as High Commissioner in London, England. He was married to former Minister of Health, Manto Tshabalala-Msimang, until her death in 2009. Msimang had been a member of the ANC Youth...

, 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 and pleural effusion
Pleural effusion
Pleural effusion is excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during ventilation.-Pathophysiology:...

 (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
Jeff Radebe
Jeffrey Thamsanqa "Jeff" Radebe , is currently South Africa's Minister of Justice and Constitutional Development. He was born in Cato Manor, and lived there until 1958 when his family was forcibly removed to KwaMashu....

 was appointed acting health minister. On 14 March 2007, Tshabalala-Msimang underwent a liver transplant. The stated cause was autoimmune hepatitis
Autoimmune hepatitis
Autoimmune Hepatitis is a disease of the liver that occurs when the body's immune system attacks cells of the liver. Anomalous presentation of human leukocyte antigen class II on the surface of hepatocytes, possibly due to genetic predisposition or acute liver infection, causes a cell-mediated...

 with portal hypertension
Portal hypertension
In medicine, portal hypertension is hypertension in the portal vein and its tributaries.It is often defined as a portal pressure gradient of 10 mmHg or greater.-Causes:Causes can be divided into prehepatic, intrahepatic, and posthepatic...

, 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
Nozizwe Madlala-Routledge
Nozizwe Madlala-Routledge is a South African politician who was South Africa's Deputy Minister of Defence from 1999 to April 2004 and Deputy Minister of Health from April 2004 to August 2007...

, the Sunday Times
The Sunday Times (South Africa)
The Sunday Times is a popular South African Sunday newspaper. It has an audited circulation of 504,000 and a weekly readership of 3.2 million, making it the largest weekly newspaper in South Africa. Recently it was involved in exposing a corruption scandal involving the South African government's...

ran an article titled "Manto's hospital booze binge" about a previous hospital stay in 2005 for a shoulder operation. The article alleged that she sent hospital workers out to fetch wine
Wine
Wine is an alcoholic beverage, made of fermented fruit juice, usually from grapes. The natural chemical balance of grapes lets them ferment without the addition of sugars, acids, enzymes, or other nutrients. Grape wine is produced by fermenting crushed grapes using various types of yeast. Yeast...

, whisky
Whisky
Whisky or whiskey is a type of distilled alcoholic beverage made from fermented grain mash. Different grains are used for different varieties, including barley, malted barley, rye, malted rye, wheat, and corn...

 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
Alcoholic liver disease
Alcoholic liver disease is a term that encompasses the hepatic manifestations of alcohol overconsumption, including fatty liver, alcoholic hepatitis, and chronic hepatitis with hepatic fibrosis or cirrhosis. It is the major cause of liver disease in Western countries...

, cirrhosis
Cirrhosis
Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules , leading to loss of liver function...

.

According to a Sunday Times
The Sunday Times (South Africa)
The Sunday Times is a popular South African Sunday newspaper. It has an audited circulation of 504,000 and a weekly readership of 3.2 million, making it the largest weekly newspaper in South Africa. Recently it was involved in exposing a corruption scandal involving the South African government's...

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.

ANC politics and replacement as Health Minister


With the endorsement of Jacob Zuma
Jacob Zuma
Jacob Gedleyihlekisa Zuma is the President of South Africa, elected by parliament following his party's victory in the 2009 general election....

's supporters, Tshabalala-Msimang was re-elected to the ANC's 80-member National Executive Committee
National Executive Committee (African National Congress)
The ANC National Executive Committee is the chief executive organ of the South African political party, the African National Congress. It is elected at every National Conference; the executive committee, in turn, elects a National Working Committee for day-to-day decision-making responsibilities.On...

 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
Barbara Hogan
Barbara Hogan is the former Minister of Public Enterprises in the Cabinet of South Africa.-Early life:Hogan attended St Dominic's Catholic School for Girls, Boksburg and gained a degree at the University of the Witwatersrand....

 to replace her as Minister of Health.

Tshabalala-Msimang was not included in the first Cabinet of President Jacob Zuma
Jacob Zuma
Jacob Gedleyihlekisa Zuma is the President of South Africa, elected by parliament following his party's victory in the 2009 general election....

, 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 from complications related to her liver transplant in 2007.

Reaction


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
    Helen Zille
    Helen Zille is the Premier of the Western Cape, a member of the Western Cape Provincial Parliament, leader of South Africa's opposition Democratic Alliance political party, and a former Mayor of Cape Town.Zille is a former journalist and anti-apartheid activist, and famously exposed the truth...

    , 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
    African National Congress
    The African National Congress is South Africa's governing Africanist political party, supported by its tripartite alliance with the Congress of South African Trade Unions and the South African Communist Party , since the establishment of non-racial democracy in April 1994. It defines itself as a...

    .

See also

  • HIV/AIDS in Africa
    HIV/AIDS in Africa
    HIV/AIDS is a major public health concern and cause of death in Africa. Although Africa is home to about 14.5% of the world's population, it is estimated to be home to 67% of all people living with HIV and to 72% of all AIDS deaths in 2009.-Overview:...

  • Nozizwe Madlala-Routledge
    Nozizwe Madlala-Routledge
    Nozizwe Madlala-Routledge is a South African politician who was South Africa's Deputy Minister of Defence from 1999 to April 2004 and Deputy Minister of Health from April 2004 to August 2007...

  • South African Department of Health
    South African Department of Health
    The Department of Health is the executive department of the South African government which is assigned to health matters....


External links



In her own words: