The South African Medical Association (SAMA) has written to President Cyril Ramaphosa calling for an urgent, independent investigation into the reported expenditure of almost R182m on NHI and health communications and events by the national Department of Health, reports MedicalBrief.
The department has also escalated the allegations of the inflated contracts to the Special Investigating Unit (SIU), the Auditor‑General and the Public Protector.
This is in the wake of media reports last week that these contracts ranged from as little as R1 620 to more than R180m, apparently draining funds from HIV/Aids and other essential programmes, like TB and child nutrition, and sparking public outrage.
But department spokesperson Foster Mohale said the figures were implausible, and that the allegations must be tested by independent investigators.
“We welcome the involvement of neutral institutions. This matter cannot be settled through press statements and counter‑statements. We want the truth established beyond doubt,” he said, adding that “the state does not even issue tenders for such small amounts”.
Although Health Minister Dr Aaron Motsoaledi is on sick leave, he and Deputy Minister Dr Joe Phaahla have jointly endorsed the call for investigations, saying the allegations attempt to link them personally to corruption.
Sounds familiar
The allegations echo concerns raised in numerous past scandals, including the Tembisa Hospital looting, which have left the public highly sensitive to corruption claims.
Mohale acknowledged this, but said investigations should be thorough and free of interference.
SAMA, calling for a thorough investigation, said in a Facebook post that the investigation must uncover how the funds were allocated, what procurement processes were followed, which healthcare programmes funded the expenditure and whether appropriate financial controls and safeguards were followed.
It said of particular concern are reports that funding linked to HIV/Aids, TB, child nutrition and an NHI allocation intended to support the development of a payment mechanism for contracting GPs into district health services may have been used for communications and advertising.
Acting Director‑General Nicholas Crisp is already probing irregular staff appointments and procurement flagged by the Auditor General and the Public Service Commission, and the department believes some individuals under investigation may be attempting “pre‑emptive action” by leaking selective documents, Mohale claimed.
“Some of these so‑called whistle-blowers may be trying to shield themselves from accountability. That is why independent scrutiny is vital,” he added.
He said the advertising contracts in question were not solely for NHI promotion but covered broader health communication campaigns.
“These adverts are critical to fight HIV/Aids, TB, malaria, smoking, alcohol abuse, diabetes, and cancer. Companies spend billions advertising harmful products. We cannot fold our arms while diseases are being sold to the public. Health communication is not a luxury, it is a necessity.
“It is far more expensive to sit back and allow people to get sick than to invest in prevention.”
Balloons and more balloons..
According to News24, the bulk of the contracts for marketing and health communications, originally worth little more than R1 000 and eventually escalating to a combined R182m, went to KMTV Media, directed by former City Press editor Khathu Mamaila who has been paid R146m off a R1 620 contract.
The money was diverted from critical healthcare programmes, with the combined R182m being given to just two companies.
They were both appointed “at a cost so vague” that neither has a specified total value, leaving the budgets effectively uncapped, with some funds drawn from an NHI budget meant to develop the system that would govern how doctors are paid under NHI.
KMTV Media was appointed for strategic communication at a cost of R1 620 “per transaction”, reports News24, with the company having already been paid more than R146m since September 2024.
The other company, Dots Design Agency, directed by businessman Musa Likobo, was appointed for events management at R540 “per transaction” and was paid more than R35m between September 2024 and September 2026.
The NDOH has been marketing the NHI on its social media pages since around 2025, with pamphlets featuring taglines such as “people before profit… That’s ubuntu” and “NHI is coming”.
The companies
Former journalist Mamaila served as deputy editor and editor of City Press after a career at The Star, and was also involved with the SA National Editors Forum (Sanef) since around 2008. As late as 2024, he was listed as its contact person in guidelines for journalists covering elections.
He registered KMTV Media in 2016 and has, since 2022, been awarded at least four government contracts by various departments.
In National Treasury’s Central Supplier Database, KMTV is classified under “accommodation and food service activities/food and beverage service activities” and declares an annual turnover of under R10m.
Mamaila, however, told News24 that his company is classified as a media company by the Companies and Intellectual Property Commission (CIPC), but it is registered under “business activities not restricted”.
Dots Design Agency’s director, Likobo, has been embroiled in controversy since around 2019, when former SA Council of Messianic Churches in Christ secretary-general Buyisile Ngqulwana claimed in an affidavit that former ANC secretary-general Ace Magashule donated R141 000 towards establishing the African Transformation Movement (ATM), and used Dots Design to facilitate the payment.
Ngqulwana’s affidavit was deposed in response to Magashule’s R500 000 defamation suit in the Free State High Court. Magashule denied the allegations, saying there was “no factual basis” to them.
In 2020, the Mail & Guardian reported that Maluti-A-Phofung municipality appointed Dots Design through an emergency procurement process for a R1.3m call centre tender for the QwaQwa community to report water challenges. More than R1m was wasted, and no call centre was established.
Likobo told the Mail & Guardian his company had done “more than just the mounting of the outdoor signage to the centre”.
In 2025, Likobo clashed with SARS over R570 940 owed in personal income tax and penalties. SARS issued the certified statement on 28 August 2025, and it was court-stamped on 26 January 2026 – around the same time Dots Design was receiving payments from the department.
Responding to News24, Likobo said he could not provide a detailed response by email. He said the ATM allegations were untrue and cleared by the ANC Integrity Committee, that he delivered the specifications on the call centre contract and that there is no SARS judgment against him.
The timeline
Both companies were appointed after the NDOH cancelled an initial tender for a “multi-pronged communication campaign” for “public health policy issues” on 11 August 2023.
Weeks later, the NDOH advertised a new tender for the same scope, this time including NHI and health and wellness campaigns.
Mamaila told News24 that KMTV submitted a bid for the first tender.
Health Department spokesperson Mohale said the bid committee’s recommended bidder was found to be non-compliant with all tender requirements, and recommended that the tender be cancelled and re-advertised.
An approval letter addressed to now-suspended director-general Dr Sandile Buthelezi, dated 28 May 2024, puts the value of KMTV’s entire contract at just R1 620 per transaction plus a 10% management fee.
Dots Design Agency was appointed at R540 per transaction plus a 9.50% management fee. It was the only bidder evaluated on pricing because seven others were disqualified before that stage – meaning it had no competition at all.
There is no definition anywhere in the documents of what a “transaction” is or how many were expected. The tender advert asked bidders to quote hourly rates for 12 staff roles plus a management fee for third-party costs – not a “per-transaction” price. Without a total contract value, any price comparison between bidders was meaningless.
The approval letter shows that senior health officials – including Buthelezi, now-suspended acting head of corporate services Dr Percy Mahlathi, then-CFO Phaswa Phineas Mamogale and chief director of supply chain and assets management Dikeledi Tshabalala – signed off on the appointments without knowing what the department would ultimately pay.
Mohale said that not all tenders are evaluated on a ceiling price and that this type of contracting “is normal”, especially in cases where service providers are contracted on an “as needed” basis.
However, the Public Finance Management Act (PFMA) requires that at least an estimate be calculated for the tender advert. Regulations also do not allow for major deviations from the tender.
Mamaila told News24 that the R1 620 bid was an hourly rate charge, but that KMTV later decided not to charge on this basis and “never submitted an invoice based on the hourly rate for work done”.
“We are of the view that the SLA [service level agreement] offers a more effective way of compensation in that the department would have first approved the quote before any assignment is undertaken,” Mamaila said.
A R52m commitment
The department then committed R52m to KMTV’s contract for “advert marketing”, a figure that appears nowhere in the tender documents or appointment letter.
The commitment, a purchase order seen by News24, lists a vague “quantity” of eight units at R6.5m each. It is unclear what eight units means for marketing services, or how R6.5m relates to the original R1 620 bid price. No documents explain this.
The commitment was coded under the NHI indirect grant to develop the payment mechanism for contracting with general practitioners into district health services.
The R52m commitment was signed off by Mohale, who apparently acted as chairperson for the bid committee for the second tender but not the first – meaning the same person who evaluated the tender also signed off on payments – as well as Crisp.
An invoice submitted by KMTV does not use the R1 620 pricing. Instead, it charges: R195 000 per TV advert, R750 000 per TV commercial and R60 000 per billboard – totalling R4 012 500.
The 10% management fee, totalling R321 000, was applied to KMTV’s own production costs, not third-party services as specified in the tender advert.
Before payment, the department’s finance team raised concerns about whether KMTV had submitted a progress report in accordance with its service level agreement.
An email from the payment office asks: “I also need to understand if this is an advance payment of work still to be done, as the invoice states ‘scope of work to be done’.”
Crisp responded, confirming he had the report and added: “I can confirm that I have been monitoring progress through daily interactions.” Neither Mohale nor Crisp confirmed whether the payment was an advance.
Mamaila told News24 that while the 10% management applied to third-party costs in the tender advert, the service level agreement changed this to apply to all goods and services.
Clause 6.2 of the SLA gives the SLA precedence in a conflict, if there is any.
News24 also asked Mamaila what he anticipated the full contract price would be for the bid his company was submitting: he confirmed there was none.
“We could not estimate the total contract value because the scope and number of assignments were not known at the time of bidding. We understood that the NDOH would commission work as needed,” he said.
The drawdown
Between September 2024 and September 2026, the department paid KMTV R146 436 115, according to the payment information. Another invoice of R126 500 is registered as pending – still to be paid.
To date, the combined value to both companies is R181 895 021, with one year remaining.
Mohale confirmed that the actual billing had nothing to do with the R1 620 and that “per transaction” was an “administrative description”.
“KMTV was asked to prepare quotes for specific activities such as adverts, commercials and billboards,” he said. “The department only paid the service providers for the finished products and services rendered, not according to hours spent.”
Mohale also confirmed that the contracts had no total value.
“The contract is activity or project-based, hence it was signed without a budget attached to it,” he said.
Mohale also defended the use of money from the various health programmes and explained that there is no central budget for health campaigns, so each programme funds its own awareness activities.
On his own role, Mohale said he was appointed as an ordinary committee member by the accounting officer but “nominated to stand in as acting chairperson” when the appointed chair was unavailable. He confirmed he authorised payments as acting chief director of communication.
The Citizen article – NHI tender scandal: Investigators probe ‘inflated’ contracts (Open access)
See more from MedicalBrief archives:
NHI scheme will open doors to corruption
Health committee’s new chair says technology will thwart NHI corruption
IRR submission on NHI Bill: ‘Blatant elite enrichment’