Aaron Motsoaledi | |
|---|---|
.jpg) Motsoaledi in 2016 | |
| 24th and 27thMinister of Health | |
| Assumed office 3 July 2024 | |
| President | Cyril Ramaphosa |
| Deputy | Joe Phaahla |
| Preceded by | Joe Phaahla |
| In office 11 May 2009 – 29 May 2019 | |
| President | Jacob Zuma Cyril Ramaphosa |
| Preceded by | Barbara Hogan |
| Succeeded by | Zweli Mkhize |
| Minister of Home Affairs | |
| In office 30 May 2019 – 30 June 2024 | |
| President | Cyril Ramaphosa |
| Deputy | Molefi Sefularo Gwen Ramokgopa Joe Phaahla |
| Preceded by | Siyabonga Cwele |
| Succeeded by | Leon Schreiber |
| Member of the National Assembly | |
| Assumed office 6 May 2009 | |
| Personal details | |
| Born | Pakishe Aaron Motsoaledi (1958-08-07)7 August 1958 (age 67) |
| Political party | African National Congress |
| Spouse | Thelma Dikeledi |
| Relations | Elias Motsoaledi (uncle) |
| Alma mater | University of the North University of Natal (MBChB) |
Pakishe Aaron Motsoaledi (born 7 August 1958) is a South African politician is theMinister of Health in thecabinet of South Africa, having been appointed in this position with effect 3 July 2024.[1] He was previously theMinister of Home Affairs from 2019 to 2024 as well as theMinister of Health from 2009 to 2019. A member of theNational Assembly since 2009, he is also a member of theNational Executive Committee of theAfrican National Congress (ANC).
Motsoaledi was born inLimpopo and trained as a medical doctor at theUniversity of Natal, where he was active in theanti-apartheid student movement. In subsequent decades, he practiced as a doctor inSekhukhuneland while remaining involved in political activism. After theend of apartheid, he represented the ANC in theLimpopo Provincial Legislature for three terms from 1994 to 2009. During that time, he served near-continuously in theExecutive Council of Limpopo, holding several different portfolios under PremiersNgoako Ramatlhodi andSello Moloto. A long-time member of the ANCProvincial Executive Committee, he was elected to the National Executive Committee for the first time inDecember 2007.
After joining the National Assembly in the2009 general election, Motsoaledi was appointed as Minister of Health inthe cabinet of PresidentJacob Zuma. He held the position throughoutZuma's presidency, during which time he developed the policy and legislative framework for a new system ofNational Health Insurance. He also presided over a transformation in South Africa's policy onHIV/AIDS and a concomitant four-fold expansion in the size of the country'santiretroviral programme.
Zuma's successor, PresidentCyril Ramaphosa, appointed Motsoaledi as Minister of Home Affairs after the2019 general election. He was elected to his fourth consecutive term on the ANC National Executive Committee in December 2022.
Motsoaledi was born on 7 August 1958 inPhokwane, a village in theSekhukhuneland region of the formerNorthern Transvaal (present-dayLimpopo Province).[2] He was one of nine children – seven boys and two girls – born to Kgokolo Michael Motsoaledi, a school principal, and Sina Sekeku Maile.[2] As a child duringapartheid, he was influenced by the arrest of a neighbour on apass law offence, and later by theSoweto uprising of 1976.[2] In addition, his paternal uncle wasElias Motsoaledi, aRivonia Trialist and stalwart of theAfrican National Congress (ANC).[2]
After matriculating at the Setotolwane High School, Motsoaledi completed apre-medical course at theUniversity of the North atTurfloop, where he was involved inanti-apartheid student politics.[2] He went on to study medicine at theUniversity of Natal, where he served on the medical school's student representative council from 1980, succeedingZweli Mkhize as its president in 1982.[2] He was also a founding member of theAzanian Students' Organisation (AZASO) and was elected as its national correspondence secretary, serving under presidentJoe Phaahla.[2] He attended the launch of theUnited Democratic Front (UDF) inMitchells Plain in 1983 and helped establish UDF structures at the University of Natal.[3] Later that year, he graduated with aBachelor of Medicine, Bachelor of Surgery.[2]
Motsoaledi practiced as a doctor in the Northern Transvaal, including through his own surgery inJane Furse. At the same time, from 1986 to 1994, he was chairperson of the Sekhukhune Advice Office, which provided legal advice to anti-apartheid activists;[2] in this capacity he worked withNelson Diale and others.[4] He was also chairperson of the Hlahlolanang Health and Nutrition Education Project in 1989.[5] In addition, he maintained links to the outlawed ANC, including to an undergroundUmkhonto we Sizwe unit in Sekhukhuneland.[2]
When the ANC was unbanned in 1990 during thenegotiations to end apartheid, Motsoaledi became involved in running the party's overt structures in the Northern Transvaal. He was deputy chairperson of the Northern Transvaal branch from 1991 to 1992, and in 1994, ahead of theupcoming democratic elections, he was a member of the party's elections task team in the province.[5] Aaron Motsoaledi Succeeded his eye surgery at public facility insouth Africa .[6]
In the first post-apartheid elections in April 1994, Motsoaledi was elected to represent the ANC in the newly establishedLimpopo Provincial Legislature (then still named after the Northern Transvaal). He was also appointed to theExecutive Council ofNgoako Ramatlhodi, thePremier of Limpopo, who named him as the province's inauguralMember of the Executive Council (MEC) for Education.[5][7] He remained in the portfolio until 1 July 1997, when Ramatlhodi announced that Motsoaledi had been sacked and replaced by Joe Phaahla, his former AZASO colleague.[8] He retreated briefly from the provincial executive, serving as an ordinaryMember of the Provincial Legislature.[5]
However, he returned to the Executive Council on 24 August 1998, when Ramatlhodi appointed him to succeedBenny Boshielo as MEC for Transport;[9] his reappointment reportedly followed an intervention by ANC deputy presidentJacob Zuma.[10] After the1999 general election, he swopped portfolios withTshenuwani Farisani,[11] becoming MEC for Agriculture, Land and Environment until 2004.[12] Thereafter, from 2004 to 2009 under PremierSello Moloto, he returned to his former office as MEC for Education.[12][13]
Throughout this period, he was a member of theProvincial Executive Committee of the ANC's Limpopo branch.[2] Indeed, he was viewed as a possible candidate to run against Ramatlhodi for the position of ANCProvincial Chairperson.[14] In December 2007, he graduated from the Provincial Executive Committee at the ANC's52nd National Conference inPolokwane, where he was elected for the first time to the ANC'sNational Executive Committee. He received 1,591 votes across roughly 3,600 ballots, making him the 56th-most popular member of the 80 candidates elected.[15]
In the2009 general election, Motsoaledi did not seek re-election to the Limpopo Provincial Legislature but instead won a seat in theNational Assembly, the lower house of theSouth African Parliament.[16] After the election, he was appointed to succeedBarbara Hogan asMinister of Health inthe cabinet of newlyelected President Jacob Zuma.[17] His appointment was viewed as surprising, given that he was a relative "unknown" in national politics.[18] However, he went on to hold the office for the next decade.
During his first fortnight in office, Motsoaledi was faced with the threat of a national doctors' strike.[19] In later years, and in addition to regular programmes and new policy initiatives of theDepartment of Health, he presided over the national government's response to the 2014Ebola outbreak in West Africa,[20] the 2017listeriosis outbreak in South Africa,[21] and theLife Esidimeni scandal inGauteng.[22] He also appointed a ministerial task team to investigate maladministration at theHealth Professions Council of South Africa, leading in 2016 to several high-level dismissals.[23]
TheMail & Guardian said that Motsoaledi was "a tour de force internationally", in particular commending him for "raising the international profile" of the campaign againsttuberculosis, including during a September 2018 high-level meeting at theUnited Nations.[24] He was also a member of theUNAIDS–Lancet Commission on Defeating AIDS, which ran from 2013 to 2015, and led one of its working groups withMark Dybul.[25] In domestic politics, however, towards the end of his tenure, critics accused him of hostility towards non-citizen residents,[26][27][28] with aSunday Times editorial remarking in March 2019 that he had "earned something of a reputation in theforeigner-bashing department".[29]
Many observers, even those who were critical of the broader functioning of the healthcare system during Motsoaledi's tenure, praised him for his impact onHIV/AIDS policy, which they labelled his greatest achievement and legacy.[30][31] Continuing the work of his predecessor, Motsoaledi set about "undoing the damage"[32] wrought byThabo Mbeki's health minister,Manto Tshabalala-Msimang, who was frequently accused ofHIV/AIDS denialism.[31] By August 2011, theTreatment Action Campaign said of Motsoaledi, "We've seen a massive change since the Manto years – he listens and he understands the challenges we face in HIV/Aids. I’d say he’s one of the best deployments the ANC has ever made".[32]
Motsoaledi's ministry launched aR1.4-billionHIV testing and counselling programme in March 2010, hailed by the South African National Aids Council as the largest programme of its kind "in the history of the Aids pandemic around the world".[33] Other projects included the provision of flavoured, multicolouredcondoms at tertiary institutions, which Motsoaledi said would help address "condom fatigue" caused partly by the perception that "the standard-issued choice condoms just aren't cool enough".[34][35] He was praised by civil rights groups in 2011 for agreeing to be the keynote speaker at a conference on the sexual health ofmen who have sex with men.[36]
Above all, however, Motsoaledi was commended for expanding access toantiretroviral (ARV) treatment. The number of people on ARVs in South Africa almost doubled between 2008 and 2012, and South Africa's was the largest ARV programme in the world by 2013.[37][38] The ministry achieved this in part through cost reduction: beginning with a tender renegotiation in 2010,[39][40] the health ministry andNational Treasury together attained the cheapest ARV supply in the world by 2019, along with continued American support through thePresident's Emergency Plan for Aids Relief.[30] His department announced a switch to afixed-dose combination ARV,efavirenz/emtricitabine/tenofovir, in 2012,[41] and Motsoaledi launched the new treatment regimen in April 2013 inGa-Rankuwa.[42] In January 2015, ARV access was expanded to meetWorld Health Organisation treatment guidelines for the first time,[43] and from September 2016, free ARVs were rolled out to allHIV-positive residents, regardless of theirimmune status.[44] Also in 2016, South Africa became one of the first countries to roll out an ARV (Truvada) aspre-exposure prophylaxis to HIV-negative sex workers.[45][44]
Although South Africa faced significant ARV shortages near the end of Motsoaledi's term in 2018,[24] in all, during his tenure, the Department of Health provided ARV access to an addition 4 million people, with the programme expanding from 792,000 patients in 2009 to an estimated 4.7 million in 2019.[31] Between 2008 and 2018, largely owing to improved access to ARVs, annual AIDS-related deaths halved andaverage life expectancy improved by eight years for women and six years for men.[30]
Apart from HIV/AIDS, the central policy initiative of Motsoaledi's term was the newNational Health Insurance (NHI) proposal, which would aim to provideuniversal healthcare to all legal residents. He linked the initiative to his critique of the private healthcare sector, which he said was a "brutal system" that had brought about "rampant commercialisation" in healthcare.[46] Upon taking office in 2009, he appointed a 25-member advisory committee on the initiative,[47] culminating in agreen paper on NHI which was approved by the cabinet in August 2011 and which suggested a 14-year implementation timeframe.[48][49] An audit of all health facilities began in the same year,[50] and a pilot programme was rolled out in ten districts on 1 April 2012.[51]
Finally, Motsoaledi introduced the draft Medical Schemes Amendment Bill and NHI Bill in Parliament in June 2018.[52] However, the legislation was not processed before he left the ministry, and theSunday Times commented in May 2019 that, although Motsoaledi had frequently entered into conflict with the private healthcare sector over the policy, "As the years pass, the NHI has remained a blur, and Motsoaledi has done little to clarify the outlines of this grandiose project."[29]
In his public appearances, Motsoaledi emphasised the importance ofpreventive healthcare and therefore ofprimary healthcare.[53] In early 2012, he warned that his department would "be making a lot of noise" about smoking, alcohol consumption, diet, and exercise, which he said were key factors in South Africa's high burden ofnon-communicable diseases.[54] He said that he had declared war ontrans fatty acids and that not even his cabinet colleagues were exempt from his campaign: according to Motsoaledi, he used "every available opportunity" in cabinet meetings to lecture about healthy diets.[55] The following year, he signed an amendment to the Foodstuffs, Cosmetics and Disinfectants Act of 1976 which instituted limits on thesodium content of several processed foodstuffs, including bread.[56] He also said that he would support bans onelectronic cigarettes[57] and onalcohol advertising.[58]
In May 2013, he announced that, in consultation with theMinister of Finance andMinister of Basic Education, his ministry would administer freeHPV vaccines to public school children;[59] the programme rolled out to grade-four girls in 2014.[60] In the realm ofinfant andmaternal mortality, his department launchedMomConnect in August 2014,[61] and he said that he would support regulation of access tobaby formula as a means to improving infant nutrition.[62]
Motsoaledi was re-elected to the ANC National Executive Committee inDecember 2012, ranked 18th of 80 by popularity.[63] He was also appointed as the committee's chief representative in the troubled provincial branch of theWestern Cape,[64] and he was elected to a five-year term on the influential 20-memberNational Working Committee.[65] During the committee's term, he became a critic of President Zuma; he reportedly spoke in favour of both of twomotions of no confidence – one in late 2016 and one in mid-2017 – that were tabled against Zuma during the committee's meetings.[66][67][68] In November 2016, when opposition parties pursued a no-confidence motion against Zuma in Parliament, Motsoaledi did not arrive to vote in Zuma's favour, thus defying athree-line whip.[69]
Ahead of the ANC's54th National Conference, held atNasrec in December 2017, Motsoaledi supported Deputy PresidentCyril Ramaphosa's successful campaign to succeed Zuma as ANC president.[70] The same conference elected Motsoaledi to a third term on the ANC National Executive Committee; he was ranked 28th of 80 by popularity.[71] He was retained as Minister of Health inRamaphosa's cabinet when Ramaphosa replaced Zuma asPresident of South Africa in February 2018.[72]
In November 2019, Motsoaledi was named as aperson of interest in the investigation into the murder ofBloemfontein businessman Louis Siemens.[73] Stanley Bakili, who was standing trial for the murder, claimed in an affidavit that, on Siemens's behalf, he hadbribed Motsoaledi andAce Magashule to expedite the approval of a hospital license for CityMed Hospital. He said that Motsoaledi had received R150,000. Motsoaledi strongly denied the allegation, saying that he had never met or spoken to Bakili.[73] He repeated his denial on the stand when called to testify in the case in theFree State High Court.[73][74]
In the2019 general election, Motsoaledi was re-elected to the National Assembly, ranked 25th on the ANC's national party list.[16] After the election, he was appointed to a new portfolio asMinister of Home Affairs in Ramaphosa'ssecond cabinet.[75]Njabulo Nzuza was appointed as his deputy.[76]
Motsoaledi was a prominent figure in the state's response to the 2022prison break of Thabo Bester,[77] as well as in the development and passage of theElectoral Amendment Act of 2023, which, on the instruction of theConstitutional Court, introduced electoral reforms to allow independent candidacies.[78] In late 2021, he announced theDepartment of Home Affairs's highly controversial decision to terminate the Zimbabwean Exemption Permit, which since 2009 had allowed tens of thousands ofZimbabwean refugees to live and work in South Africa.[79] However, at the end of 2022, theMail & Guardian criticised him for inaction on his plan to effect a "complete overhaul ofthe immigration system", which he had announced at the beginning of the year.[80] His critics also accused him of fuellingxenophobia in South Africa.[81][82][83]
The ANC's55th National Conference was held in December 2022, and Motsoaledi was re-elected to the National Executive Committee; he received 1,448 votes across roughly 4,000 ballots, making him the 27th-most popular member of the committee.[84] He was appointed as the committee's chief representative in theEastern Cape and as deputy chairperson of the subcommittee on education, health, science and technology, under chairpersonPeggy Nkonyeni.[85]
Motsoaledi is married to Thelma Dikeledi, who is a businesswoman.[86] They have two sons and three daughters,[2] one of whom also studied to become a doctor and another of whom owns anAmsterdam-based start-up that gained her entry to the EuropeanForbes 30 Under 30.[87][88] Two of his siblings are on the medical faculty atMedunsa.[2]
In August 2013, while Motsoaledi was Minister of Health, he was commended by theEconomic Freedom Fighters andDemocratic Alliance for undergoing surgery atSteve Biko Hospital, a public hospital inPretoria.[89] He said that he insisted his family attend public school and use public health facilities.[90]