Despite Finance Minister Enoch Godongwana having tabled a special appropriation Bill providing an extra, emergency R754.5m to the Health budget in the financial year, this is insufficient, and risks being used, instead, to settle provincial debts to suppliers, Parliament was told last week.
Business Day reports that the bulk of the money (R590.4m) is allocated to provincial conditional grants to fund HIV/Aids programmes, while the remainder goes to the SA Medical Research Council (R132m) to continue clinical research and the National Health Insurance indirect grant (R32.1m) to strengthen SA’s health system.
The Bill was tabled shortly before the Trump administration announced that some Pepfar funding is to be restored under a six-month “bridge plan” that will see SA provided with R2bn to help maintain HIV/Aids programmes until end-March.
But the Pepfar money and the Treasury emergency allocation was simply not enough, representing barely more than a third of the money Pepfar had previously promised SA, SECTION27 told Parliament’s Select Committee on Appropriations.
“Basic arithmetic shows this will not cover the full gap left by the withdrawal of Pepfar funding. A significant number of HIV patients who relied on Pepfar-funded (treatment) programmes risk losing access,” said SECTION27 researcher Mduduzi Nkosi.
Cash-strapped provinces might divert the extra funds from Treasury to other projects, he warned.
“Provinces are under severe financial pressure and the allocation for HIV programmes risks being swallowed up by existing debts or (other) expenditure priorities,” he added.
Sharing his concerns was the TB Consortium, which urged the committee to ask provinces to present financing and implementation plans detailing how they intended to use the funds.
Transparency would reduce the risk of the funds being absorbed into existing deficits, said TBAC project co-ordinator Sihle Mahonga, highlighting the huge accruals facing provincial Health departments.
Accruals are debts to suppliers rolled over from one financial year to the next: the collective accruals racked up by provincial health departments was more than R24bn at the end of the 2024/25 financial year, a 10.4% increase on the total accruals of R21.5bn the year before, according to a national Health department presentation to Parliament last week.
It shows Gauteng and the Eastern Cape were the worst offenders, with accruals of R8.1bn and R7bn, respectively, at end-March.
See more from MedicalBrief archives:
Plan for ‘special Bill’ to plug health funding gap
Treasury bails out HIV/Aids projects blindsided by Pepfar cuts