Finance Minister Enoch Godongwana did not announce a budget allocation to plug the gap created by the termination of USAid funding to HIV/Aids organisations (Photo by Luke Dray/Getty Images)
Finance Minister Enoch Godongwana did not announce any allocation to plug the gap created by the termination of United States funding for HIV/Aids and other health programmes in the country during his tabling of the budget in parliament on Wednesday.
In January, newly US President Donald Trump announced a 90-day global freeze on all funding for the United States Agency for International Development (USAid), which used to fund 44 health projects in South Africa. Last month, Trump said Washington was withdrawing support to South Africa, citing what he called racist policies against the white minority.
The US has supported HIV/Aids programmes in South Africa through the President’s Emergency Plan for Aids Relief (Pepfar). The health department drew 17% of the budget for its HIV programme from the plan.
On Wednesday, Godongwana told journalists prior to presenting the budget in parliament that, out of 275 000 people working on HIV, TB and sexually transmitted infections programmes, only 15 000 were reliant on Pepfar, adding that the department of health would be asked to assist with funding the shortfall. The treasury would only be able to provide more information at the end of the month.
In his budget speech to parliament later, he said health spending would grow from R277 billion in the 2024-25 financial year to R329 billion in 2027-28 to support the equitable provision of public health services, including free primary healthcare.
He said R28.9 billion had been added to the health budget, mainly to keep about 9 300 healthcare workers in hospitals and clinics, and would also be used to employ 800 post-community service doctors and to ensure pharmacies did not run out of medicines.
According to budget documents, the health function is allocated R941.5 billion over the mid-term economic framework period to support the equitable provision of public health services, including free primary healthcare.
Of this, about 44.7% is directed to funding district health services, particularly
primary healthcare facilities such as clinics and community health centres, which also
provide outreach services.
“This level of care is recognised as the most efficient and effective due to its focus on disease prevention and proximity to communities. Almost 98% of the budget for this function is allocated to provinces, amounting to about R922.7 billion,” the national treasury said in the budget review.
To strengthen the health system and prepare for the National Health Insurance (NHI) policy it said the department of health would fund the development of a patient information system, a centralised chronic medicine dispensing and distribution system, and a facility medicine stock surveillance system.
Over the mid-term economic framework period, the indirect and direct conditional grants for NHI were allocated R8.5 billion and R1.4 billion respectively.
The treasury said the total allocation for health infrastructure was R37.4 billion over the mid-term economic framework period, consisting of provisional allocations from the budget facility for infrastructure and new allocations for equipment for the Siloam District Hospital in Limpopo and Tygerberg Hospital in Cape Town through a public-private partnership in 2027-28.
“It remains important to improve efficiency in expenditure, including in the areas of commuted overtime, public procurement and price benchmarking,” the treasury said.
*This story has been updated throughout.