Health Department Says R26bn Grant Is Not New Money

South Africa's health department says the HIV, AIDS and TB grant does not offset the withdrawal of PEPFAR funding.

Updated on Nov. 13, 2026 in COVID-19

Health Department Says R26bn Grant Is Not New Money

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The Department of Health has stated that the R26 billion HIV, AIDS and TB Conditional Grant is not new funding to offset the PEPFAR withdrawal. National Treasury provided an emergency R753 million under Section 16 of the Public Finance Management Act, with R590 million ring-fenced for HIV, AIDS and TB interventions.

Why it matters

The emergency allocation was made to immediately mitigate job losses and protect service delivery in South Africa's HIV and TB programmes. The Department's position is that the existing grant was not designed to replace donor funding that has been withdrawn.

The R26 billion grant is the standard allocation to provinces, while the R753 million Section 16 emergency allocation, of which R590 million is ring-fenced for HIV, AIDS and TB, lasted six months. Treasury's decision on the Department's 2026/27 budget bid for long-term financing has not yet been announced.

The players

National Treasury

South Africa's national finance department, responsible for the national budget and the allocation of public funds, which provided the Section 16 emergency allocation.

Department of Health

South Africa's national health department, which administers the HIV, AIDS and TB Conditional Grant and submitted the budget bid to Treasury.

The details

The Department said no separate need-based distribution was carried out for the R26 billion, which is distributed through the established grant framework and provincial business plans. The emergency funds maintained critical facility-level human resource posts, and the Department reprioritised activities within the existing grant to extend contracts for retained staff.

March 2026: the six-month emergency funding expired.
2026/27 financial year: the Department submitted a formal budget bid to National Treasury covering the 2027/28 MTEF period.

Big Picture

The emergency allocation was drawn from Section 16 of the Public Finance Management Act, a mechanism for urgent unforeseeable spending that is used here to bridge a gap left by the withdrawal of PEPFAR funding. It contrasts with the regular Conditional Grant, which the Department says was never intended to replace donor support.

Patients and health workers in South Africa's HIV and TB programmes depend on the continuity of staffing funded by the emergency allocation, which expired in March 2026. Whether those posts continue beyond the current arrangements depends on Treasury's response to the Department's budget bid.

The takeaway

Funding for HIV and TB services in South Africa is now reliant on decisions about long-term budget allocations, not only on emergency measures. Readers tracking these programmes should watch for Treasury's response to the Department's 2026/27 budget bid.