Health budget: R1.7 billion for new staff and millions granted by Gates foundation

The department of health plans to spend billions on recruiting new professionals and infrastructure development over the coming financial year.

Health Minister Aaron Motsoaledi announced the coming years’ objectives during his budget speech in parliament on Tuesday.

The minister added that international organisations will plug the gap left in South Africa’s HIV/ Aids programmes by the Pepfar decision.

He conceded that the department did not have “all the money” needed to achieve these objectives, but was in discussions with international and local funders.

R64 billion budget

Motsoaledi announced that the department had been allocated an overall budget of R64 billion for the 2025/26 financial year.

The budget will be used by the department to achieve three main objectives; number one being a laying of the foundations for the National Health Insurance (NHI).

“There are people who believe that we have no plans nor inclination to do that. We want them to listen very attentively,” assured Motsoaledi.

Ensuring adequate facilities and sufficient staff would be the backbone of NHI, the minister has earmarked R1.7 billion for the hiring 1 200 doctors and 450 nurses and support staff.

A further R1.4 billion will be spent on absorbing 27 000 community health workers who had previously been employed by non-governmental organisations.

To “make public hospitals hospitable”, R1.3 billion will be spent on beds, linen, towels, basin and other similar items.  

Infrastructure upgrade

During the last financial year, Motsoaledi boasted that 47 existing clinics and 45 hospitals had been “substantially” refurbished, while 403 public health facilities had been upgraded.

Additionally, five new facilities were completed during the last financial year, and six are currently under construction, and 17 are in the design and development stage.

“These facilities and their placement are not a thumbs-up. We are using a digital system called the Health Infrastructure Portfolio System,” explained the minister.

“This digital system has a geographic information system, district information system and other data tools that help us understand and plan the health system,” he added.

The department will also spend R3.75 billion paying accruals — expenses recorded but not paid in earlier financial years — for equipment and pharmaceuticals.

The second of Motsoaledi’s objectives is to implement “serious reforms” in the private healthcare system — a goal he did not elaborate on.

“Please ignore those who want us to believe that there is nothing to fix in that sector,” he said.

Pepfar replacement

Third on Motsoaledi’s list is the elimination of diseases such as HIV/ Aids, tuberculosis, malaria and some cancers.

“The time has now arrived to start dreaming about a future with a certain disease gone from our country,”

Speaking on the impact of the Pepfar withdrawals, he stated the department would not allow South Africa’s HIV programmes to collapse.

He said negotiations with treasury had resulted in the allocation of R753 million for provincial and national HIV/ Aids-related support.

This will be boosted by R100 million research contributions by both The Bill and Melinda Gates Foundation and London-based researchers the Wellcome Trust.

The grants are conditional based on Treasury’s commitment to double it, meaning the R200 million from the international funders will be backed by R400 million from Treasury, which is to be released more than three years for HIV/ Aids treatment.

Part of this treatment will include the piloting of HIV/ Aids wonderdrug Lenacapavir, a twice-annually injection that claims to have a 100% success rate in preventing HIV/ Aids in women.

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