South African deputy health minister, Nozizwe Madlala-Routledge, told a media briefing in Cape Town on Friday that President Thabo Mbeki sacked her for "just doing my job."

Madlala-Routledge was appointed deputy minister in 2004, but it soon became apparent that her views on HIV/AIDS were at odds with both Mbeki and his health minister, Manto Tshabalala-Msimang, who promotes garlic and lemon juice as a panacea for symptoms of the disease, which according to the latest government survey has infected 5.41 million South Africans.

During her tenure as deputy minister Madlala-Routledge sought to mend fences between the government and AIDS activists, shepherding through a comprehensive five-year HIV/AIDS plan that was seen as instrumental in changing perceptions about South Africa's controversial reponse to the pandemic.

Former UN secretary-general's special envoy for AIDS in Africa, Stephen Lewis, told the South African financial newspaper, Business Day, that Madlala-Routledge's firing "was a dreadful setback in the struggle against the pandemic, a blow to those fighting it internally and a blow to those outside watching developments in South Africa. The government of South Africa seems determined to discredit itself in the eyes of the world.

"Everyone will be shocked by what has happened. We assumed that the turnaround experienced in 2006 signified a real change in heart but obviously with the reemergence of the health minister [Tshabalala-Msimang] it means we are going in reverse again."

In February this year, Tshabalala-Msimang took a medical leave of absence to undergo a liver transplant, but rather than appoint Madlala-Routledge to the post of acting health minister, transport minister Jeff Radebe was asked to oversee the health ministry.

Tshabalala-Msimang returned to her post shortly before the third South African AIDS Conference in June, and then withdrew from the conference because she believed her deputy was given a more prominent role, an allegation disputed by the organisers who said they had invited the minister to speak at the conference's opening session.

Reasons for sacking

Although the presidency has refused to disclose the reasons for Madlala-Routledge's sacking, the former deputy health minister told the media briefing she was "fired for paying an unannounced visit to Frere Hospital [in East London] on the 13th of July 2007 and for my response to the shocking situation I found in the maternity ward."

Madlala-Routledge's visit to the hospital was prompted by an investigation by the local paper, the Daily Dispatch, that found an alarmingly high infant mortality rate, with at least 2,000 still births in the past 14 years. Following her visit to the hospital the deputy health minister declared the overburdened maternity ward a "national emergency". Within days there was a fierce rebuttal from first Tshabalala-Msimang, who said her deputy was not speaking the truth, and then from Mbeki in his weekly newsletter published on the ANC website.

"My comments that the situation constituted a national emergency were informed by the shocking realisation that some of the deaths were avoidable, and that the situation I observed was not unique to Frere Hospital," Madlala-Routledge told the press briefing.

Another reason given by Madlala-Routledge for her dismissal was "the much publicised trip I undertook to Madrid to address a conference hosted by... the International AIDS Vaccine Initiative."

"What is at issue here is that I went to Madrid without permission from the president," Madlala-Routledge told the press briefing. "When I realised the trip had not been approved by the president, I had a huge dilemma because besides the huge cost to the department, I could not be seen to defy the president by attending the meeting. So I did not attend... I took the first available flight back home."

Uproar over Madlala-Routledge's firing

Her dismissal, on the eve of Women's Day, has led to an uproar in South Africa and the belief that the real reason behind her sacking, was her views on HIV/AIDS were out of sync with Mbeki and Tshabalala-Msimang's.

The Treatment Action Campaign (TAC), which has spearheaded the fight for universal access to antiretroviral treatment in South Africa, said in a statement: "This [the sacking of Madlala-Routledge] is a dreadful error of judgment that will harm public health-care and especially the response to the HIV epidemic. It indicates that the president still remains opposed to the science of HIV and to appropriately responding to the epidemic. We call on him to reverse his decision."

TAC chairman, Zackie Achmat, told Business Day, "There is no question the minister of health and her director general [Thami Mseleku] are the strongest movers behind this sacking."

The general secretary of the Congress of South African Trade Unions, Zwelinzima Vavi, told the weekly newspaper, the Mail & Guardian, "In the absence of any other convincing explanation, we then conclude that she was fired because of her views on HIV/AIDS, which were not shared by the president and Minister Tshabalala-Msimang. It is very sad because this means the sheep mentality of following the leader will persist. It will deepen the culture of sycophancy among government ministers and officials."

IRIN/PlusNews was unable to get any official comment. Mbeki has yet to name a successor to Madlala-Routledge.