Prioritise health spending says RHAP to Parliament’s Special Appropriations Committee
The boost of R754 million to the health sector through the Special Appropriations Bill this year has been welcomed by the Rural Health Advocacy Project.
But they argue that the allocation remains insufficient to adequately support vulnerable rural communities.
Addressing Parliament’s Special Appropriations Committee following submissions on the Special Appropriations Bill, RHAP Research Assistant Hanifa Mahlangu told Parliament that the funding should be used to ensure meaningful improvements to frontline services.
“In South Africa, health care is not a privilege; it is a right guaranteed by our Constitution,” she said. “The Special Appropriation Bill is a step in the right direction. But we must be honest, it is not enough.”
Mahlangu highlighted that most of the allocation will be used to address inflation and salary adjustments, leaving limited support for critical health system challenges. “Many provinces are already struggling to stay afloat. They carry large debts, unpaid suppliers, and shortages of essential medicines and staff.”
She also expressed concern about the withdrawal of donor funding from HIV and TB programmes, which has placed thousands of frontline workers at risk of losing their jobs. “If these posts are lost, the gains of the past two decades will be undone,” she said.
RHAP noted that rural provinces such as KwaZulu-Natal, Eastern Cape, North West, and Limpopo would be hardest hit, particularly in areas like maternal health and adolescent care. Teenage pregnancy rates remain high and antenatal care coverage remains below adequate levels in several rural areas. “These numbers are not just statistics; they are young lives facing futures cut short,” Mahlangu said.
Other major areas of concern include the rising burden of diabetes and hypertension, especially among rural women, and the persistent impact of HIV and TB. “Losing health workers now means losing lives tomorrow,” she added.
RHAP has called for five urgent actions to safeguard rural healthcare, including protecting a portion of the new funding for primary healthcare services, absorbing donor-funded workers into the public health system, and requiring regular reporting from provinces on service continuity.
“The real measure of success is whether a mother in Lusikisiki, or a young man in Giyani, can still walk into a clinic and receive care with dignity,” Mahlangu said. “Every budget decision must bring us closer to that promise.”