CALLS FOR HEALTH MINISTER'S DISMISSAL INTENSIFY

C O N F I D E N T I A L SECTION 01 OF 02 PRETORIA 002957

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E.O. 12958: DECL: 08/17/2017
TAGS: PGOV KHIV SF
SUBJECT: CALLS FOR HEALTH MINISTER'S DISMISSAL INTENSIFY

REF: A. PRETORIA 2817


B. PRETORIA 1021

C. PRETORIA 589

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Classified By: Charges d'Affaires Donald Teitelbaum. Reasons 1.4(b) an
d (d).


1. (C) SUMMARY. President Mbeki's August 8th dismissal of
Deputy Health Minister Nozizwe Madlala-Routledge (ref A) has
unleashed relentless domestic and international criticism of
the controversial lifestyle and tenure of current Health
Minister Manto Tshabalala-Msimang. Increasingly, media and
critics are shifting their focus to President Mbeki as well,
rehashing his doubts about the link between HIV and AIDS,
questioning his steadfast support of the Health Minister, and
criticizing his apparent intent to ensure that Routledge is
appropriately disciplined. END SUMMARY.

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THE ALLEGATIONS
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2. (U) The front page of the Sunday Times on 19 August reads:
"MANTO: A DRUNK AND A THIEF." The paper alleges that
Tshabalala-Msimang was convicted of theft when she was

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superintendent at the Athlone Hospital in Botswana in the
late 1970s. A retired nurse told a Botswana newspaper she
testified in court that Tshabalala-Msimang wore a watch to
work that was stolen off the arm of an anesthetized patient.
Tshabalala-Msimang also was reportedly found guilty of

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stealing hospital blankets, linens, and heaters and was
declared a "prohibited immigrant," meaning she was prohibited
reentry to Botswana for ten years. The newspaper's sidebar
includes a quote from an unnamed employee at the Athlone
Hospital which states that, "Everyone here thinks it's
hilarious that she is a health minister in South Africa."


3. (C) Even more controversial has been the Sunday Times
reporting on the Minister's condition of "alcoholic liver
cirrhosis," which is given as the real reason the Minister
needed a liver transplant in March (ref B) and not autoimmune
hepatitis, as reported by the Minister's medical team
immediately after the transplant. The paper also has
acquired copies of Tshabalala-Msimang's medical records from
a 2005 shoulder surgery, which indicate that the minister
abused alcohol and staff during her stay. Tshabalala-Msimang
filed a successful motion before the Johannesburg High Court
to have the copies of medical records returned to the court.



4. (C) Reports of alcohol abuse are also causing the public
to question the ethics of her liver transplant. The Sunday
Times alleges that doctors and staff knew she had been
drinking before the transplant, even though standard
procedure is that alcoholic patients stop drinking for six to
12 months before surgery, and permanently after surgery.
Unnamed medical experts claim that given Tshabalala-Msimang's
age and condition, she would not have qualified for the
transplant and died. The opposition party, Democratic
Alliance, has asked the Public Protector to investigate
allegations that President Mbeki personally intervened by
calling the Health Minister's doctors and insisting that they
approve the transplant. The Sunday Times also alleges that
Tshabalala-Msimang continues to drink, saying that she was

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seen drinking whiskey "as recently as last week." (COMMENT:
Numerous Embassy contacts over the past year have confirmed
that Tshabalala-Msimang drinks to excess (Ref C). END
COMMENT)


5. (C) Adding to these woes, a consensus report released on
August 22 from a 15-member panel of the Academy of Science of
South Africa on the impact of nutrition on the spread of
HIV/AIDS and TB, effectively discredited the Health
Minister's claims that garlic, beetroot, and lemon can stop
the progression from HIV to full-blown AIDS. The report
states that although good nutrition is a valuable supportive
measure, no food or food supplement has been identified in
any credible study as an effective alternative to appropriate
medications. The scientists conclude that recent public
debate on the value of certain foodstuffs and nutritional
supplements and claims of cure arising from unproven diets
have lead to confusion within communities and among health
care workers.

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THE OUTCRIES
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6. (C) Opposition parties Democratic Alliance (DA) and
Independent Democrats (ID) have criticized Mbeki for keeping
the health minister. DA Leader Helen Zille has argued that
Tshabalala-Msimang "is not only a political and moral

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liability, but now a legal one too." ID Leader Patricia de
Lille has publicly said that Mbeki's allegiance should be to
South Africans and not to the minister, and that "we can no
longer afford to carry her on our shoulders."

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MBEKI STANDING FIRM
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7. (C) Mbeki appears to be standing firm, both with his
decisions to fire Routledge and to keep Tshabalala-Msimang on
as Health Minister. For two weeks in a row, Mbeki
spokesperson has told the press that current allegations do
not warrant any action or investigation and that anyone with
evidence of any minister neglecting their duties is welcome
to bring it to the Presidency. On 17 August, Mbeki wrote in
his weekly newsletter that the recent criticism reflects
unease at South Africa's transition from white minority rule
to democratic rule. (COMMENT: Mbeki has used racism
accusations to deflect valid criticism of other issues as
well, including both crime and corruption. END COMMENT) He
also called on the ANC to deal with Routledge according to
ANC disciplinary procedures. The ANC's national working
committee met and decided on 20 August to ask ANC
secretary-general Kgalema Motlanthe to "investigate"

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Routledge's dismissal. Press reports note that though some
are saying the investigation will focus on what drove
Routledge to make derogatory statements against the
government, others believe that this is the beginning of a
probe that could lead to a disciplinary charge of putting the
organization into disrepute.

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COMMENT
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8. (C) ANC succession politics aside, the controversy's
overshadowing of other significant events, such as the
government's prosecution of former apartheid-era officials
and the SADC summit, illustrates just how relevant the
struggle against HIV/AIDS is to the majority of South
Africans. It is unclear, however, whether Mbeki will be
swayed. This is not the first time Mbeki has come under fire
for retaining the Health Minister. For Mbeki, it is probably
just as risky politically to fire Tshabalala-Msimang, who is
Zulu, whose husband is ANC Treasurer, and who has obviously
built a power base through her cabinet-level positions over
the past decade, as it is to keep her.
Teitelbaum