There is so much “irrational and negative” propaganda against National Health Insurance (NHI) that the health department is pressing ahead with its planned advertising campaign, despite the current HIV/Aids funding crisis, health minister Aaron Motsoaledi has told parliament.
The health department is scrambling to find the money to fill the gap left by US President Donald Trump’s moves to cut back on foreign aid, which have cut a swathe through SA’s HIV/Aids programmes.
Services provided by non-governmental organisations that were supported by grants from the US President’s Emergency Plan for Aids Relief (Pepfar) via the US Agency for International Development have ceased, and the health department has yet to secure emergency funding from the Treasury to bridge the gap.
The department had anticipated receiving R6.27bn from the US government in the 2025/26 fiscal year, according to figures provided to parliament by the minister in February.
“There is currently no intention to put an end to all advertising for NHI and redirect that funding towards the funding shortfall,” the minister said in a written response to questions posed by Action SA MP Kgosi Letlape.
“Given the ongoing irrational and negative propaganda against NHI, the department believes that it remains important to continue directing efforts towards providing accessible information that educates and empowers the public about NHI and the benefits of universal health coverage to the country and the population,” the health minister said.
The health department plans to spend R65.9m advertising NHI over the medium term, according to Treasury’s Estimates of National Expenditure.
Letlape said the minister should not be using public funds to persuade people of the merits of NHI.
"Advertising is when you use money to convince people of things they don't need. Health (policy) is not something that requires advertising: it's something that requires you to be rational and for society to buy into it," he said.
NHI is the government’s controversial plan for achieving universal health coverage. It seeks to reform SA's health financing system so that all health services are purchased by a government-controlled fund and the role of medical schemes is sharply reduced.
Spotlight reported earlier this month that a modelling study commissioned by the health department estimated that the termination of Pepfar funding to SA could lead to between 150,000 and 295,000 additional HIV infections by the end of 2028. There are currently 50,000 HIV-related deaths and 150,000 new infections a year, according to an editorial published this month in the SA Medical Journal.
The health department had not responded to Business Day's request for comment at the time of publication.
Letlape also asked the minister whether the Health Promotion Levy - a tax on sugar-sweetened beverages - or any of the funds allocated to the conditional grants for NHI could be directed to HIV/Aids programmes.
The minister was in discussion with Treasury about the most effective and sustainable mechanisms to address the funding gap, and there had been no decision to use revenue raised from the levy for this purpose.
On the question of redirecting conditional grants, he said: “We value all our patients equally, and hence we see no wisdom nor value nor any gain in shifting money from [one] group of patients to another. The conditional grants allocated towards NHI are for specific interventions,” he said.
These included contracting health professionals, developing health information systems and implementing the centralised chronic medicine dispensing and distribution programme, he said.
Letlape said he was disappointed at the minister's response. If specific taxes were to introduced specifically for NHI, then it followed that the health promotion levy could be set aside for the heatlh sector, he said.
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