- Governments have the power to decide whether people live or die when it comes to health — and your vote will determine which type of government we get.
- In South Africa this kind of influence became especially apparent in the late 1990s and early 2000s when the Mbeki government denied South Africans free HIV treatment, resulting in over 330 000 unnecessary deaths.
- In 2004, our government’s policy changed resulting in the country now having the largest antiretroviral treatment in the world and people with HIV living almost as long as HIV-negative people.
- Today, we’re launching a series of analyses to break down what parties say they will do to fix the country’s health system.
In today’s newsletter, our team tallies up how different parties address health issues in their manifestos. Sign up.
Governments have the power to decide whether people live or die when it comes to health — and your vote will determine which type of government we get.
In South Africa, this kind of influence became especially apparent in the late 1990s and early 2000s when the Mbeki government denied South Africans free HIV treatment, resulting in over 330 000 unnecessary deaths.
In 2004, our government’s policy changed resulting in the country now having the largest antiretroviral treatment in the world and people with HIV living almost as long as HIV-negative people.
On 29 May — just four weeks away — your vote will determine how well South Africa’s post-election government will look after your health. That’s why it’s crucial that you know what your party says it will do about health matters.
But comparing what different parties say about an issue can be tricky to figure out — which is why we’ll be bringing you a series of analyses of 16 parties’ health plans and promises from their manifestos over the next month, in the run-up to the election.
For easy comparison, we’ve broken it down to nine categories — from rolling out universal healthcare and dealing with the effects of climate change to rooting out corruption in health services and tackling HIV, tuberculosis and gender-based violence. All of this is wrapped into the context of what health looks like in South Africa at the moment, so that you can make an informed decision about where to put your cross on election day.
You’ll be able to decide how much depth you want: bite-sized summaries of what each party says on a specific issue for a quick overview or a fuller unpacking of the detail within a category to help you understand the jargon of manifesto speak — the choice is yours. In a few days, we’ll be adding a handy comparison tool as well, so watch this space.
We kick off the series by analysing the manifestos of the four biggest movers and shakers.
Results from an Ipsos poll released on Friday, showed that voter support for the African National Congress (ANC), who’s held the majority vote over the past 30 years, is hovering around 40%. The Democratic Alliance’s (DA) percentage of support sits in the low 20s, while the Economic Freedom Fighters’ (EFF) share has almost halved from 19.6% in February to 11.5% at the end of April. The newcomer uMKhonto weSizwe Party (MKP) has rallied 8.4% of support among voters in four months since its launch.
Here’s how they’ll keep South Africa healthy.
If you want to read the full, original party manifestos, click here for the ANC, DA, EFF and MKP.
If you want to read our easy breakdown, click the tabs with the party names.
| Universal access to healthcare (UHC) UHC is a 2030 sustainable development goal. It gives everyone access to the same basic health services regardless of whether they can pay for it. | The ANC’s plan for universal health coverage is National Health Insurance (NHI). It will make the NHI Bill law and roll it out over the next five years. On plans for health services and facilities, the party says: – its government will create electronic health records for patients – expand the Ideal Clinic programme, used to systematically upgrade primary healthcare facilities in preparation for the NHI – work with other countries on research around traditional medicines and the development of products – put tighter measures in place to curb corruption with health tenders and contracts. The ANC doesn’t say how much implementing these plans will cost or where the money will come from. Want to know more about the ANC’s plans for UHC, health services and facilities over the next five years, should it be voted into power, click here. |
| Climate change The effects of climate change — a hotter Earth and more droughts and storms — will increase lung diseases, make HIV and TB spread faster, and allow diseases transmitted by insect hosts, such as malaria, to spread to countries where they’ve never been experienced before. | An ANC government will work with other countries and recommit South Africa “to take forward its responsibilities in the fight against climate change, global poverty and inequality in line with applicable international resolutions”. However, the party doesn’t mention the Paris Agreement, which South Africa has signed up for, in its manifesto. According to this agreement, signatories have to work towards the world achieving net zero carbon emissions by 2050. To make South Africa a climate-friendly place, the ANC says it will, for instance, invest in producing electric cars and green hydrogen and “promote cheaper and subsidised solar power”. By how much, and for whom, isn’t specified in the manifesto. The ANC will ensure a just energy transition (meaning switching to climate-friendly energy sources to power our lives will not cause workers in the current energy system to lose their jobs unfairly). The manifesto doesn’t say how much a just transition would cost. Want to know more about the ANC’s promises for tackling climate change, click here. |
| Food security | Over the next five years, food prices will be lowered by exempting more foods from VAT, helping communities to grow food in their own gardens and speeding up the redistribution of land in South Africa so that more people have land on which they can grow food. The party doesn’t specify how many more foods, and which ones, the party plans on exempting from VAT. |
| Social grants | In addition to already existing grants such as the child support grant (currently R530 per month per child) and state pension (from 1 April: R2 180 or R2 200 per month, depending on someone’s age), the party will phase in a basic income support grant (within the next five years) for unemployed people. See more below. |
| Basic income grant | A basic income support grant for unemployed people will be phased in within the next five years. Almost a third (32.1%) of SA is unemployed. No one will be allowed to pay workers less than the national minimum wage (currently R27.58 per hour) and this payment will increase in line with inflation. The party doesn’t specify how much a basic income grant would be or what the budget implications will be, but it does say it would use the social relief of distress grant “as a mechanism towards phasing in a basic income support grant”. A social relief of distress grant is currently R370 per month. |
| Tuberculosis (TB) | The ANC doesn’t specifically address tuberculosis in its manifesto. TB kills more people than any other illness in South Africa. |
| HIV | The ANC says it will address things like bullying, discrimination against people’s choice of sexuality, teenage pregnancy, HIV and other sexually transmitted infections, but it doesn’t say how. |
| Corruption | Over the next five years, the ANC will “eradicate corruption”, improve governance and public service, work with communities “to deliver quality and reliable basic services … and maintain and build new infrastructure”. |
| Gender-based violence | To end gender-based violence (GBV), the ANC will implement the country’s National Strategic Plan on Gender-Based Violence and Femicide, expand victim support services, like the Thuthuzela Care Centres and GBV desks at police stations, and run public campaigns against toxic masculinity, sexism and homophobia. |
| Universal access to healthcare (UHC) UHC is a 2030 sustainable development goal. It gives everyone access to the same basic health services regardless of whether they can pay for it. | The proposed National Health Insurance (NHI) scheme should be dropped in favour of the DA’s health plan, which the party says it will implement over five years of being elected into power to achieve universal health coverage. The party doesn’t provide a budget for the plan in its manifesto. Want to know more about the DA’s model for UHC, along with its plans for fixing and maintaining health facilities and addressing skill shortages and service delivery issues in the health system, click here. |
Climate change The effects of climate change — a hotter Earth and more droughts and storms — will increase lung diseases, make HIV and TB spread faster, and allow diseases transmitted by insect hosts, such as malaria, to spread to countries where they’ve never been experienced before. | The DA says it’s committed to getting the country to net zero carbon emissions by ensuring that South Africa can use a mix of energy sources to power our lives. Each country has individual targets that feed into the global target, depending on how much they contribute to climate change. Here are South Africa’s targets. The DA will make renewable energy (eg, wind and solar power) easier and cheaper to be used, so that its government will be less reliant on Eskom. To do this, the party will invest in setting up local factories for making solar panels and other equipment used to produce power from renewable energy, reward institutions who train people in this field, lower import taxes on green energy equipment and make it attractive for people to feed extra electricity generated from renewable energy such as solar power into the grid. Want to know more about the DA’s plans on tackling climate change, click here. |
| Food security | The DA will reduce hunger by exempting more foods from VAT and so make them more affordable. The food items listed include bone-in chicken, beef, tinned beans, wheat flour, margarine, peanut butter, baby food, tea, coffee and soup powder. |
| Social grants | A DA government will increase child support grants to South Africa’s official food poverty line, pushing the amount up from the current R530 to R760, to give people the money needed to buy enough healthy food for a month. The DA says if this is implemented in the next financial year, it will cost an additional R39.6-billion in funding per financial year for the existing 13.2-million recipients, which it believes the national treasury could find the money for if the government roots out corruption, cuts waste and generates savings. The DA will also give child support grants to pregnant mothers (and their unborn babies). The DA doesn’t specify at which stage of a pregnancy such a grant would be introduced, nor do they say when they will implement this or how much it would cost. A DA government will allow private doctors to assess people for disability grants, to shorten the waiting period for getting an assessment spot at a government doctor. |
| Basic income grant | The DA will look at ways to better use South Africa’s tax income to address unemployment if voted into power and will fund a job seekers grant (which will replace the current social relief of distress grant). Recipients would need to provide proof that they’re making an effort to find a job (eg, that they’ve gone for interviews). The party says the grant will only be viable if the economy grows and there’s enough tax income to fund it. The party won’t increase any tax to fund the grant, but instead will identify how to save money and find better ways to spend tax income. |
| Tuberculosis (TB) | The DA doesn’t include a specific plan to address HIV or tuberculosis in its manifesto, but does refer to both diseases in its current online health policy document (a new document will be launched after the elections). TB is South Africa’s most deadly disease and 12.7% of adults in South Africa were infected with HIV by the end of 2022. |
| HIV | |
| Corruption | To reduce corruption, the DA will create an “independent watchdog for health entities” (also called supervisory structures), which will manage all regulators, big hospitals, health services and health districts. The watchdogs will have the powers to supervise procurement processes, oversee human resource matters and appoint and remove the chief executives (the chief executives will report to the watchdog of an entity). The party will establish “an independent National Health Appointments Authority to guarantee the autonomy” of watchdogs. This authority will handle supervisory structure members’ nomination, appointment, as well as removal processes, “moving these responsibilities away from the executive” (in other words, removing the health minister’s powers to influence such appointments or removals). |
| Gender-based violence | The DA will invest in training health workers and to treat victims of gender-based violence (GBV) with dignity. They will, for instance, be trained in how to use screening tools to spot GBV cases and how to report such cases to the police, and appoint people to attend court proceedings to see what hinders investigations, prosecution and court processes for crimes such as rape. No specific timeline or budget for this plan is given in the DA’s manifesto. |
| Universal access to healthcare (UHC) UHC is a 2030 sustainable development goal. It gives everyone access to the same basic health services regardless of whether they can pay for it. | The EFF says it’s committed to achieving universal health coverage and its government will expand maternal, child and teen health services, as well as sex education, lifesaving surgery and “undisrupted access to essential medicines”. The EFF will focus on groups such as the poor, women, people with disabilities, the elderly, sex workers, disabled and gender-diverse people, who often face discrimination at health facilities. The party’s manifesto doesn’t give details of how it will implement universal health coverage, but they did table a Private Members Bill in 2020, the National Health Amendment Bill, which said in order to give everyone the healthcare they need, all public health facilities need to operate 24 hours a day and seven days a week. The health department responded saying a detailed cost analysis would first need to be done, as the proposal holds massive financial implications. Want to know more about the EFF’s plans to build more healthcare facilities, improve infrastructure and make service delivery in the health system more efficient, click here. |
| Climate change The effects of climate change — a hotter Earth and more droughts and storms — will increase lung diseases, make HIV and TB spread faster, and allow diseases transmitted by insect hosts, such as malaria, to spread to countries where they’ve never been experienced before. | The EFF government will reduce carbon emissions by 10% by 2029. The Paris Agreement, for which South Africa signed up, requires countries to reduce carbon emissions by 45% by 2030 — the EFF says it will renegotiate South Africa’s portion of such targets. By 2050, the world needs to achieve “net zero”, which means the amount of greenhouse gases we emit (which mostly come from burning coal, oil and gas for producing electricity or fuelling vehicles), balances out with the amount the Earth’s ecosystems can naturally absorb, so that there’s no build-up of these gases in the atmosphere where they form a layer that traps heat and results in the Earth heating up. Each country has individual targets that feed into the global target, depending on how much they contribute to climate change. Here are South Africa’s targets. An EFF government will fine industrial carbon polluters (companies burning oil, gas and coal), introduce carbon taxes and reward businesses who use clean energy and recycle water with a special tax incentive. It will provide schools and communities with saplings (young trees) to plant (to capture carbon). The EFF will “immediately stop” the decommissioning of coal power stations and will invest at least R4-billion by 2026 in “carbon emission control technologies” to make emissions from coal-powered stations less harmful. The party will develop “clean coal and oil” by 2025 and, in the process, it says, create 2 000 jobs, of which half will go to women and young people. Want to know more about the party’s plans for dealing with climate change, helping South Africa move to a “fair mix” of energy sources and creating “climate jobs” in this field, click here. |
| Food security | The EFF will provide monthly food packages and free electricity and water to needy families, in addition to social grants. The party will make more staple foods VAT free, but doesn’t name the items. By 2025, it will give all learners in South African schools two free meals a day (including during school holidays). By that year, the EFF government will also have capped the price of food sold at tertiary training institutions. The EFF will launch state-led, urban vertical farming. (Vertical farming grows crops on top of each other in stacked layers, rather than in conventional, horizontal rows. Vertical farming requires less water and land than traditional farming, which is good for the environment, but because it’s done inside buildings in controlled environments, it uses a lot of energy for things like special lights and air conditioning, which, in turn, releases a lot of carbon, which could harm the environment.) |
| Social grants | An EFF government will double (or almost double) most social grants to reduce poverty. Grants will be processed by a state-owned bank. No budget or timeline is provided in the EFF’s manifesto. (The baseline amounts of grants stated in the EFF manifesto have been updated to the actual, current amounts.) Want to see a full breakdown of the amounts, click here. |
| Basic income grant | A basic income grant is not mentioned, but all recipients of social grants will receive free water and electricity. Grants will be processed by a state-owned bank. |
| Tuberculosis (TB) | The EFF says it will allocate more funding for gender-based violence (GBV), HIV, TB and diabetes research, but doesn’t specify how much more. The party will increase the sentences for perpetrators of GBV, murder and rape, and anyone who defrauds the state, but it doesn’t specify by how many years or what type of sentence. The EFF says it will have zero tolerance for police brutality and corruption. |
| HIV | |
| Corruption | |
| Gender-based violence |
| Universal access to healthcare (UHC) Universal health coverage — which gives everyone access to the same basic health services regardless of whether they can pay for it — is a 2030 sustainable development goal. | The party says as a way to redistribute healthcare resources away from “the true wielders of power [who] are unelected institutions and those with money”, it will put into practice the National Health Insurance (NHI) scheme, for which the Bill has already been passed and some staff and heads appointed. It will also make sure that all health facilities will have at least the same standard (but they don’t say what that standard will be) and increase the number of health workers by training more at medical schools, of which all universities will have one. It supports “medical pluralism”, which means people will have a choice to use “alternative and traditional African healthcare and healing in public/private facilities”. MKP promises a state pharmaceutical company to counter “private capitalist monopoly” to “protect the property rights of traditional African healthcare practitioners”. Annual health screening will be mandatory and will address teenage issues like depression, pregnancy and suicide, and social work support and other services will be offered through schools. |
| Climate change The effects of climate change — a hotter Earth and more droughts and storms — will increase lung diseases, make HIV and TB spread faster, and allow diseases transmitted by insect hosts, such as malaria, to spread to countries where they’ve never been experienced before. | The party’s manifesto doesn’t mention anything about the climate or the country’s international commitments to slow global warming (such as, for example, the Paris Agreement; under this agreement South Africa pledged to work towards achieving net zero carbon emissions by 2050.) The party says it will make sure that the state owns and controls all natural resources, including renewable energy. It will “reverse and rescind the unjust transition from coal, renew Eskom’s coal fleet and accelerate Eskom’s nuclear new build programme”. |
| Food security | Noting that “over 25% of children are stunted and more than 60% suffer from malnutrition”, MKP promises to ensure that all schools and early education centres serve breakfast, lunch and an after-school meal for all children. The party doesn’t say where the money for this will come from. In 2022, one in five people in the country did not have enough food, and 12.9% reported going hungry. MKP promises to divide farmland equally among farmers and give new farmers money and support to make sure they succeed. The party says it will fast track land distribution policies, ensure food security and increase food exports. |
| Social grants | The party says it will set up a social security system that will “guarantee a well-defined minimum standard of living”. For this: – the child support grant (currently at R530) will increase to the food poverty line of R760 (this is the least someone needs to buy enough healthy food for a month) – the old-age pension (currently at R2 180 or R2 200, depending on your age) and the disability grant (also R2 180) will increase, the party says “to the minimum wage of R4 500”. (Minimum wage is currently set at R27.58 an hour; if someone were to work 160 hours a month, this will work out to R4 412.80.) – All military veterans and their dependants will have their daily expenses covered under military pensions. The party doesn’t say where the extra budget for these grants will come from. |
| Basic income grant | In addition to its package of grants, an MKP government will introduce a basic income grant above the poverty line (of which the upper bound is currently R1 558) for those who are not able to work. The manifesto doesn’t say where the funding for this grant will come from. |
| Tuberculosis (TB) | The MKP manifesto doesn’t mention tuberculosis specifically. TB kills more people than any other illness in South Africa. |
| HIV | The MK Party manifesto doesn’t mention HIV. About 7.8-million South Africans are living with HIV of whom about 75% are on antiretroviral treatment. |
| Corruption | The party’s manifesto promises to overhaul law enforcement agencies so that they will be able to combat crime and corruption effectively and efficiently. In policing, MKP will increase the funding of the investigative directorate so that they can increase the amount of work they take on. (The investigative directorate is a unit of the National Prosecuting Authority, which has to investigate high-level and complex corruption, like state capture.) The party promises to root out corruption among correctional officials and police. |
| Gender-based violence | The party promises to ensure that each police station will have a well-resourced specialised unit for investigating gender-based crimes. The manifesto notes high rates of teenage pregnancy and crimes against the elderly, women and children. (In 2022, one in seven births at healthcare facilities were to teenage girls, and between October and December last year, there were 12 211 rapes and 3 073 sexual offences or attempts in the country.) The party doesn’t say where the funding for this will come from. |
