From mugs to mouse pads, freebies emblazoned with med logos were flying out of exhibition booths at last August’s International AIDS Conference in Toronto. South Africa’s national booth, however, offered visitors baskets brimming with lemons, beetroot, garlic and potatoes. The foods lacked logos, but South African Health Minister Manto Tshabala-Msimang, MD, insists that they are better than those Big Pharma drugs. Since 2000, she and her government have pushed natural remedies as lifesaving alternatives to anti-retrovirals for the country’s 5 million positive people. But in Toronto, treatment activists, who had long denounced the minister’s deadly fiction, finally took extraordinary measures to silence her.

After the conference, 81 internationally renowned scientists, including HIV codiscoverer Robert Gallo, petitioned South Africa’s President Thabo Mbeki for Tshabala-Msimang’s resignation. Meanwhile, politicians such as UNAIDS envoy to Africa Stephen Lewis and U.S. Sen. Barack Obama (D-Ill.), denounced her, and Mbeki soon curbed his support.

In the summer of 2000, with Tshabala-Msimang at his side, Mbeki proclaimed that poverty, not HIV, causes AIDS. However, in 2003 he announced a plan to quickly treat 380,000 HIV positive people with anti-retrovirals. Only 200,000 have received treatment thus far, and Tshabala-Msimang, continuing to tout her natural remedies, has repeatedly thwarted the rollout.

Toronto conference cochair Mark Wainberg says politicians and diplomats rarely speak out against governments, leaving outspokenly critical comments to academics and activists, but says that Tshabala-Msimang’s “scientific nonsense” sparked the unusual outcry. “It’s Mbeki who’s really at fault here,” he adds. “He chose her.” Mbeki has never publicly reprimanded his minister, but on September 7 he appointed a committee to oversee her national HIV policy.

Nathan Geffen of Treatment Action Campaign (TAC), South Africa’s largest and most outspoken HIV activist group, says his organization demands her dismissal. “I have numerous reports of people who’ve died be-cause they’ve used alternatives to anti-retrovirals promoted either explicitly or implicitly by Tshabala-Msimang,” he says. As for the recently distributed meds, he says, “She can take zero credit. It happened despite her.” Indeed, at press time, she was still standing by her lemon-scented pledge.