Her emphasis on treating South Africa's AIDS epidemic with easily accessible vegetables such as African potato, garlic and beetroot, rather than with antiretroviral medicines, was the subject of local and international criticism.

Tshabalala-Msimang's administration as Minister of Health was controversial, because of her reluctance to adopt a public sector plan for treating AIDS with anti-retroviral medicines (ARVs).

The Treatment Action Campaign (TAC) and its founder Zackie Achmat 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 accused Tshabalala-Msimang of being aligned with Matthias Rath, a German physician and vitamin entrepreneur, who had charges laid against him for discouraging the use of ARVs.

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.

A case that attracted much public attention was Nozipho Bhengu, daughter of an African National Congress legislator, who rejected anti-retroviral treatments for AIDS in favour of Tshabalala-Msimang's garlic and lemon diet.

[8] In February 2005, the Congress of South African Trade Unions (COSATU) criticised 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.

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".

[21] 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, cirrhosis.

[22] With the endorsement of Jacob Zuma's supporters, Tshabalala-Msimang was re-elected to the ANC's 80-member National Executive Committee in December 2007 in 55th place, with 1,591 votes.