13 JANUARY 2026, CAPE TOWN

LIVES TURNED UPSIDE DOWN: OUTLINING IMPENDING HEALTH CRISIS BORNE PRIMARILY BY POOR HOUSEHOLDS AND COMMUNITIES VULNERABLE TO HIV/AIDS AND TB DUE TO THE PEPFAR FUNDING CUTS

HONOURABLE MEMBERS 

LADIES AND GENTLEMEN 

FELLOW SOUTH AFRICANS WATCHING AT HOME

GREETINGS TO YOU ALL!

HOUSE CHAIRPERSON,

This Bill is tabled before this August House at a time when the lives of key populations have been placed in sudden uncertainty, not because of HIV/AIDS and TB incidences, but because of the abrupt withdrawal of PEPFAR funding that supported 17% of South Africa’s HIV/AIDS and TB response.

HONOURABLE MEMBERS,

South Africa remains at the epicentre of the global HIV/AIDS epidemic and TB incidences among people living with HIV/AIDS. That reality is not accidental. It is rooted in Apartheid’s “structural violence” that reproduces poverty, inequality, and unemployment. When the Trump Administration withdrew PEPFAR funding without regard for these South African realities, it did not engage in diplomacy; rather, it imposed suffering.

The abrupt withdrawal of PEPFAR funding was not an administrative oversight, but a deliberate political decision taken by the Trump Administration and amplified by anti-revolutionary forces within our own country, especially  AfriForum. The Trump Administration is not only hostile towards the progressive ANC-led government, but it has also demonstrated through actions rather than rhetoric that it is willing to weaponize crucial funding that supports South Africa’s massive HIV/AIDS response and TB programmes, to punish the ANC-led government for refusing to submit to the United States of America’s ideological and geopolitical agenda.

Therefore, it is our view that this Bill is a pivotal instrument of not only of the ANC-led government’s strategy of ensuring palpable inroads against HIV/AIDS and TB infections but also for socioeconomic growth, as our people’s health is the cornerstone of any development.

HONOURABLE MEMBERS,

Although South Africa’s HIV response has been resilient through the 7% Global Fund and 76% domestic funding the  effects of the abrupt withdrawal of PEPFAR funding jeopardised critical programs that serve key populations from poor and working-class backgrounds that already carry the heaviest burden of HIV/AIDS and TB infections because of poverty, inequality, unemployment, spatial exclusion and historic economic exclusion. It placed frontline health workers in limbo. It endangered treatment continuity. It risked reversing ostensible gains in the fight against HIV/AIDS and TB infections that were won through decades of struggle, activism, and decisive ANC-led government intervention.

As part of an immediate plan to defend the gains of HIV/AIDS response and TB programmes, the ANC-led government felt an enormous need to introduce the Special Appropriation Bill to ensure continuity of access to quality healthcare services for key populations from poor and working-class backgrounds to boost their well-being and development.

HONOURABLE CHAIRPERSON,

What should alarm this August House is that while the Trump Administration’s decision to withdraw PEPFAR funding undermined our health system, certain local actors like the AfriForum, the Freedom Front Plus, and the Democratic Alliance (DA) which claim to speak for the civil society showed no concern when this funding withdrawal threatened HIV/AIDS and TB treatment programmes, jobs, and lives. They offered no solutions, no solidarity, and no defence of vulnerable key populations – they only showed opposition to transformation and hostility to the ANC-led government’s democratic developmental state project. Instead, these actors function as ideological conveyor belts that are more comfortable supporting, amplifying, and legitimising the Trump Administration’s effort to attack our progressive healthcare system. Importantly, these actors are anti-revolutionary agents who have no interest in whether key populations from poor and working-class backgrounds receive HIV/AIDS and TB treatment. Their interest lies in outsourcing South Africa’s future to the USA.

It is therefore important to stress that this Bill is neither an administrative nor an accounting exercise which adjusts the government’s budget. Rather, this Bill is a declaration of South Africa’s sovereignty and self-determination. It affirms that the ANC-led government will not allow its key populations from poor and working-class backgrounds to become collateral damage in foreign political battles. It reasserts that access to HIV/AIDS and TB treatment is a constitutional right, not a bargaining chip.

The provincial allocations in this Bill are a true testament to this as they are targeted precisely at 27 HIV/AIDS high-burden Districts, which are areas selected on the basis of need, vulnerability, and service pressure. This is what the ANC-led government’s developmental state does in practice – it intervenes where the crisis is deepest, not where political noise is loudest. In other words, this Bill is underpinned by the ANC’s Manifesto commitment to building a capable, ethical, and developmental state that places people’s lives, health, and dignity at the centre of public policy; it advances the National Development Plan’s (NDP) goal of reducing HIV/AIDS and TB incidences whilst strengthening the health system; and it aligns with the Medium-Term Development Plan (MTDP) priority of improving service delivery and rebuilding state capacity.

HONOURABLE CHAIRPERSON,

The ANC-led government is invariably lambasted for its key stated objectives of stabilising the debt-to-GDP ratio and achieving a primary budget surplus through public spending and investment cuts. Ironically, this Bill is not symptomatic of these objectives. Instead, this Bill demonstrates that when lives are threatened, the ANC-led government does not hide behind debt stabilisation and primary surplus objectives. The ANC is firmly convinced that these objectives cannot be used as a reason for the government to fold its arms while HIV/AIDS and TB prevention treatment fails. Hence, this Bill affirms that people come before process, and life comes before balance sheets.

HONOURABLE MEMBERS,

Through this Bill, South Africa will minimize its dependence on USA aid whose commitments shift with electoral cycles and ideological fashions. We will mobilise domestic resources to strengthen our public healthcare system to respond to HIV/AIDS and TB infections. And we will ensure that external geopolitical dynamics do not dictate who receives HIV/AIDS and TB treatment and who does not.

More importantly, the ANC-led government will not be lectured about accountability by anti-revolutionary forces that have consistently opposed transformation, undermined public institutions, and aligned themselves with reactionary global forces like the Trump Administration. Our accountability is to the people of South Africa, especially key populations from poor and working-class backgrounds living with HIV/AIDS and TB.

For these reasons, the ANC supports this Bill without hesitation. We support it because it protects lives. We support it because it defends hard-won gains. And we support it because it affirms a simple but powerful principle: South Africa’s sovereignty, and the lives of its people, are not negotiable.

I thank you.