The Congress of South African Trade Unions (COSATU) notes the National Assembly’s passing of the Special Appropriation Bill. The Bill provides an additional R754 million to the National Department of Health in response to R4 billion in funding cuts from the United States Agency for International Development (USAID) for HIV/AIDs and other public healthcare programmes.
The United States President’s Emergency Plan for HIV/AIDS (PEPFAR)’s funding through USAID and the National Institute for Health (NIH) and the Centre for Disease Control (CDC) has played an invaluable role in the African continent and in particular in South Africa as an epicentre of the global pandemic of HIV/AIDS. These programmes have helped prolong and save the lives of millions, in particular the poor, across South Africa and Africa over the past 22 years. This has enabled recipients of these healthcare programmes to continue working and leading active lives.
COSATU was extremely distressed by the impact of the sudden cut in funding through USAID to more than 500 000 South Africans living with HIV/AIDS in February 2025. We have been equally concerned about the loss of funding for the jobs of 20 000 university, community health and NGO workers.
We had engaged the South African government then to cover the funding shortfall equivalent initially to R4 billion dispensed through USAID. We have been pleased that an equivalent R4 billion funding through the NIH has continued and that the CDC subsequently authorised the release of R2 billion to minimise the impact of the funding cuts on lives for the remainder of the financial year.
Whilst welcoming the R754 million supplementary allocation by the Bill for the Department of Health, we remain disappointed that it does not cover the full funding shortfall and in essence there remains a gap of R1.25 billion. This was largely for university and NGO community health clinics. These losses remain.
We are equally disappointed that it took so long for government to provide additional funding. The consequences are that those university, community and NGO health workers remain unemployed and the invaluable lifesaving work they did, has ended.
It is fundamental that government and Parliament ensure that the 2026/27 Budget and the Medium-Term Expenditure Framework provides the Department of Health the resources it requires to fulfill its constitutional mandate to provide accessible and quality public healthcare for all South Africans and that the journey to rolling out the National Health Insurance as the foundation for universal healthcare is expedited.
Whilst welcoming financial and other support from the US, Europe, China and any other nations, any such resources should be utilised to build clinics and hospitals, invest in infrastructure capacity and purchase ambulances and other physical assets. This will help minimise disruptions when such funding inevitably comes to an end.
Issued by COSATU
Matthew Parks (COSATU Parliamentary Coordinator)
Mobile: 082 785 0687
Email: matthew@cosatu.org.za
