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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 response to the pandemic.