NHI, housing, employment and education — What Ramaphosa got right and where he fell short

Doctors Without Borders supporters march in protest to the US Consulate in Johannesburg, on 22 March 2012 to hand over a memorandum regarding a lack of funding notably by the US-based Global Fund towards the fight against HIV/Aids. In 2025, US funding is again in the spotlight following the recent freeze on aid. (Photo: Cornel van Heerden / Foto24 / Gallo Images)

By Lerato Mutsila, Naledi Sikhakhane and Tamsin Metelerkamp

7 Feb 2025

While some civil society organisations are cautiously optimistic about statements from President Cyril Ramaphosa’s State of the Nation Address 2025, a repeated refrain across a number of sectors was: ‘We’ve heard it all before’.

President Cyril Ramaphosa’s first State of the Nation Address (Sona) since the formation of the Government of National Unity (GNU) was not only an indication of the government’s priorities for the year to come, but also a significant milestone in the changed political landscape that emerged from the 2024 general elections.

Civil society organisations in sectors such as health, housing, education and food justice offered their thoughts on the President’s 2025 address, flagging the statements that held promise, as well as those that might just be empty promises.

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On health — ‘A clear mission statement for the GNU’

Doctors march over US funding Doctors Without Borders supporters march in protest to the US Consulate in Johannesburg on 22 March 2012 to hand over a memorandum regarding a lack of funding notably by the US-based Global Fund towards the fight against HIV/Aids. In 2025, US funding is again in the spotlight following the recent freeze on aid. (Photo: Cornel van Heerden / Foto24 / Gallo Images)

Ramaphosa appeared to spend more time addressing health in his speech this year, touching on issues such as the National Health Insurance (NHI), the digitisation of records and the recent freeze on the US President’s Emergency Plan for Aids Relief (Pepfar).

Russell Rensburg, director of the Rural Health Advocacy Project, said: “The State of the Nation this year provided a clear mission statement for [Ramaphosa’s] Government of National Unity. He moved forward on the NHI, announcing the establishment of a key ministerial advisory committee on health benefits [and] electronic health records, but emphasised the strengthening of the public sector.”

The NHI continues to be a controversial issue in the GNU. News24 recently reported that Planning, Monitoring and Evaluation Minister Maropene Ramokgopa said an informal agreement had been struck on the NHI, after the ANC agreed to drop sections of the law that could collapse medical aids. However, Minister of Health Aaron Motsoaledi said later that he was unaware of any such agreement.

On the Sona red carpet on Thursday evening, 6 February, Motsoaledi told Daily Maverick that a decision to not fully phase out medical aids wouldn’t be possible under the NHI Act.

Ramaphosa did not touch on the future of medical aid schemes in his speech.

Read more: Pressure grows for NHI compromise ahead of Cabinet lekgotla

Khanyisa Mapipa, head of the health rights programme at SECTION27, said the organisation supported the idea of universal healthcare, but had reservations about certain provisions in the NHI, including its governance structure, the exclusion of migrant communities from accessing primary health services and the readiness of provincial structures for the changes the programme will bring.

“We believe that NHI has the potential to help many individuals who live in South Africa and the government has missed many opportunities to showcase the benefits of NHI,” she said.

Mapipa noted that Ramaphosa’s promise of a single electronic health record for services in South Africa is not new, having been introduced when the potential of a national health insurance programme was first explored.

“The NHI Act provides the framework for this system. However, the government has yet to issue regulations on how exactly this will be done,” she said.

Read more: Pressure mounts on Health Minister Motsoaledi to remedy ‘catastrophic consequences’ of US aid freeze

Pressure has mounted on the South African government to remedy the impacts of the US aid freeze on local health services. In an open letter released this week, health and human rights organisations described “chaos and confusion” among Pepfar-supported programmes that remain paused, jeopardising the lives and livelihoods of thousands of people.

A waiver on US President Donald Trump’s funding freeze was announced on 28 January, allowing “life-saving humanitarian assistance” to continue. However, health organisations say that most Pepfar implementing partners have not received any direct communication from the US government allowing them to resume work. The future of the aid programme remains uncertain.

In his address, Ramaphosa said: “We are looking at various interventions to address the immediate needs and ensure the continuity of essential services.”

Mapipa told Daily Maverick that Ramaphosa’s statements on the crisis were “lacking”, adding that SECTION27 had hoped for more details on how the government would be tackling the situation.

“The funding freeze affects over 15,000 healthcare workers and millions of persons living in South Africa who rely on funding from [the United States Agency for International Development] and Pepfar for their HIV and TB medication and treatment… The whole country is waiting for the government to reveal the plan on how it will address the issue and adjust should the US withdraw funding permanently,” she said.

On housing — ‘Back to being a government priority’

Noziphiwo Sigwela, researcher at housing rights law centre Ndifuna Ukwazi, told Daily Maverick that the organisation was encouraged to see that “unlike previous years, the housing challenge has found its way back to being a government priority”.

“We note that the speech had a progressive approach to tackling housing inequality and improving urban living conditions by moving away from apartheid-era spatial planning that has marginalised communities. The focus on developing housing in inner cities near job opportunities fosters integration and creates accessible communities, while also addressing urban sprawl for sustainable development,” she said.

Sigwela noted that Ramaphosa expressed an intention to redesign housing subsidies and provide service stands to help individuals access housing in desirable areas.

“He also addressed the backlog of title deeds to improve the economic status of their owners. These are some of the many calls from the civil society that the President has positively responded to,” she said.

“Overall, the speech reflects a commitment to enhancing housing access and rethinking urban planning to promote equality and economic opportunity, setting a positive vision for more inclusive cities. We look forward to seeing these changes echoed in the Department of Human Settlement’s White Paper, and we hope to see these changes implemented.”

On education — ‘The gap between aspirations and actions’

Mahfouz Raffee, head of research at the nonprofit Equal Education, said the organisation welcomed the President’s commitments to expand and improve early childhood development (ECD) and early grade literacy, as well as the implementation of the Basic Education Laws Amendment (Bela) Act.

However, it was “ultimately disappointed by the absence of several other priority concerns that plague the basic education sector”, she added.

“Equal Education has been campaigning for more than 15 years for learners to access dignified school infrastructure. It is frustrating to note that none of the R940-billion in planned infrastructure spending was explicitly committed to school infrastructure in the Sona,” he said.

“We hope that it will be reflected in the national Budget, but if the 2024 [Medium Term Budget Policy Statement] is to give us any indication, then we are expecting a decline in annual infrastructure spending of nearly R1-billion in real terms over the next three years.”

While Ramaphosa acknowledged that education is central to the GNU’s commitment to reduce poverty and develop the economy, he offered “no concrete directives” to reduce the impacts of the budget cuts that have been “plaguing the sector” over the last decade, Raffee said.

“Instead, the President told us much of what we have already heard before, without indicating the extent to which these mandates would be adequately funded. Perhaps this cautious approach comes from years of failure to hold true to his commitments,” he said.

“We have heard President Ramaphosa in previous Sonas commit to eradicating plain pit toilets and offering coding and robotics programmes in all foundation phase classrooms by 2022. He also previously committed to having a tablet in every learner’s hands by 2025. None of these have come to fruition.”

Equal Education expressed “cautious optimism” about reforms to technical vocational education and training (TVET) curricula, to partner with the private sector and combine formal learning with job training.

Raffee said: “If the GNU is to credibly claim a nation that works for all, it must move from vacuous platitudes about the importance of education towards concrete budgetary allocations, measurable timelines and transparent accountability mechanisms. Until then, the gap between the state’s aspirations and its actions will continue to betray a generation of learners whose future depends on more.”

On employment — ‘We’ve heard it all before’

With South Africa’s unemployment rate of 36.1% among the highest in the world, Ramaphosa placed heavy emphasis on job creation, which will be helped by a 3% target for economic growth.

On the youth employment front, Ramaphosa celebrated the success of public employment programmes such as the Presidential Employment Stimulus (PES), which has created almost 2.2 million work opportunities, the Social Employment Fund, which the President said had created more than 80,000 jobs in 2025, and the National Pathway Management Network, which has opened up 235,000 work opportunities for young people.

“We now need to build on these innovative programmes to create jobs for youth at an even greater scale,” Ramaphosa said.

Clotilde Angelucci, communications and network lead at Youth Capital, a youth employment advocacy campaign, said Ramaphosa’s Sona failed to provide critical and concrete actions to tackle South Africa’s urgent youth unemployment crisis.

“We have heard all of this before. Stats show that economic growth alone won’t provide inclusive growth — the proof of the President’s vision will be seen whether these initiatives will receive funding in the medium to long term,” Angelucci said.

With 9 million youth not in employment, education or training, Angelucci said public employment programmes have been a key component of the government’s strategy. However, the organisation highlighted how, while funding to the PES was extended in the 2024 Budget, the money was never provided, which meant the PES’ biggest programme, the Basic Education Employment Initiative, could not take place and 200,000 short-term employment opportunities were missed.

“Young South Africans face several systemic obstacles to complete school and make an income; they urgently deserve a firm commitment from the President to ensure that the public employment programmes are expanded and adequately funded in the medium-long term, with a focus on skills and exit pathways,”Angelucci added.

Are these long-term, permanent opportunities, or are these going to be very temporary and leave people again looking for work in a year? Are they going to be well-paid opportunities?”

Kaitlin Rawson, a 27-year-old youth capital mobiliser, pointed out that while Ramaphosa said the government would introduce a graduate recruitment scheme to attract the “best and brightest in public service”, he did not “elaborate on what that scheme would look like” said

Rawson welcomed the idea of graduate schemes, but said the proof of its success would come down to its implementation.

“The graduate recruitment scheme sounds great in theory but there are questions about what type of opportunities it will create,” she said.

“Are these long-term, permanent opportunities, or are these going to be very temporary and leave people again looking for work in a year? Are they going to be well-paid opportunities?”

Angelucci added: “Youth Capital calls on the government to be more transparent in tracking progress on youth employment initiatives and to engage meaningfully with young people in shaping solutions that work for them.

“We’re hoping to hear financial commitments to these promises once the national Budget is tabled.”

Tshiamo Malatji, community organiser and founder of the 56 Tambo Youth Centre in Bloemfontein, Free State, which focuses on incubating youth-led social businesses, said that while Ramaphosa recognised the need to scale up employment initiatives, he offered no specific and concrete funding commitments. He said that for programmes to succeed, they need to be funded in the medium to long term to ensure they receive adequate support.

He cited the Basic Education Employment Initiative, which was never implemented because of funding issues, adding that the initiative would not only have created meaningful employment for young teachers but would have also increased the quality of education for learners.

“Every year, it’s always a fight to save programmes to make sure that they continue, even though the results of the programs are shown to create meaningful work opportunities,” Malatji said.

He added that the National Youth Service was under threat of having its funding cut and PES was delayed in multiple departments, especially in the creative sector.

“The Art Bank of South Africa, National Film and Video Foundation (NFVF), and National Arts Council, among many other arts organisations, implement the Presidential Employment Stimulus Programme, as it applies to the arts sector.

“There were delays in the disbursement of those funds for the NFVF. They just released a post saying that their PESP 5 funds might only be announced in April and then dispersed later, but this was a programme that was funded last year.

“We needed to hear from the President exactly what will be put in place to ensure that funding will happen for these programmes, which means that there also should have been a comment on increasing the capacity of implementation of these programmes.”

On agriculture and food security – ‘The President captured the core of agricultural matters’

Wandile Sihlobo, chief economist of the Agricultural Business Chamber of South Africa (Agbiz), said although South Africa’s agriculture has grown tremendously over the past three decades (more than doubled), it faces some challenges.

“The inefficiencies at the ports, deteriorating roads, rural crime and stock theft, rising global protectionism and inept municipalities are some challenges confronting the sector. President Ramaphosa outlined the government’s plans to address many of these challenges in his State of the Nation Address.

“The need for professionalisation of civil servants, planned improvement of water infrastructure and simplification of regulations, ongoing reforms of Operation Vulindlela in the broader network industries, interventions on logistics, and improving safety and reducing crime are some areas the Sona highlighted,” he said.

Sihlobo says the President captured the core of agricultural matters by stating: “By supporting our farmers, improving our logistics network and rural supply chains, and opening new export markets for products, we can significantly expand our agricultural sector.”

Sihlobo believes South Africa’s agriculture will see its Gross Value Added expand by 30% in the coming years, creating more jobs. “Still, we think the one fundamental area that the President should have highlighted is the urgent release of the 2,5 million hectares of state land for agriculture to appropriately selected beneficiaries with title deeds.

“Combined with the reforms outlined in the Sona and the opening of the export markets, the release of this land would help us grow the sector and close the dualism that has made South Africa a ‘Country of Two Agricultures’,” Sihlobo said.

Chengetai Dare, a senior health economist at Priceless SA, a division of the Wits Health Consortium, whose research focuses broadly on how to reduce diet-related disparities and create a more healthful food system, said: “The government will raise additional revenue for the fiscus. Empirical evidence shows that a 20% price increase on sugary drinks would result in lowering obesity prevalence by 2.4–3.8% points, averting 85,000 incident stroke cases, and 72,000 deaths among South African adults. This translates to an estimated savings of over R5-billion in healthcare costs over 20 years while increasing tax revenue.”

Qhawekazi Mahlalela, national coordinator of the South African Food Sovereignty Campaign (SAFSC), said: “On behalf of the SAFSC, we are keen to engage critically yet constructively with the President’s Sona, particularly concerning agriculture, the country's hunger crisis, and climate justice.

“We expected the President to highlight food security, yet government responses often remain trapped in a corporate-controlled model that deepens inequalities, marginalises small-scale farmers and fishers and undermines food sovereignty.

“South Africa’s approach frequently leans towards industrial agriculture and large-scale commercial solutions, which fail to address the systemic and intersecting crises of hunger, biodiversity loss, and the climate emergency.

“What we hope to see is a bold shift towards an ecologically just food system – one that recognises small-scale food producers as central actors, prioritizes agroecology as a climate-resilient solution, and ensures access to land, water.” DM

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Maverick Citizen

On health — ‘A clear mission statement for the GNU’

On housing — ‘Back to being a government priority’

On education — ‘The gap between aspirations and actions’

On employment — ‘We’ve heard it all before’

On agriculture and food security – ‘The President captured the core of agricultural matters’