South African AIDS activists are protesting the firing of Deputy Health Minister Nozizwe Madlala-Routledge, calling the move a major setback for anti-HIV efforts, which had been much more agressive in the past year under Madlala-Routledge’s guidance, after years of government inaction.

President Thabo Mbeki has given no reason for firing Madlala-Routledge, but it may be tied to recent allegations of an unauthorized trip she took to Spain at the government’s expense as well as her role in a controversy surrounding allegations of poor health care at a hospital.

South Africa has one of the world’s highest HIV prevalence rates, at nearly 30 percent.