by Tian Johnson, Founder of the Pan African health justice non-profit The African Alliance
On 2 June, we observe International Sex Workers Day, a date rooted in defiance. It marks the 1975 occupation of Saint-Nizier Church in Lyon by over 100 sex workers protesting police harassment, abuse, and state neglect. Nearly five decades later, that occupation feels less like history and more like prophecy. Today, South African sex workers face the same abandonment, in the guise of data gaps, moral posturing, and political silence.
The criminalisation of sex work in South Africa is not a policy gap. It is an intentional architecture of abandonment. It denies sex workers legal standing. It invites abuse from clients and police alike. It forces people into dangerous working environments. It ensures that even when sex workers are brutalised, the state offers no remedy, only the threat of arrest, stigma, or worse.
And now, that same state has stood by as an entire layer of sex worker health services has collapsed under the weight of external funding cuts, offering no plan, no budgetary commitment, and no real accountability.
This is what collapse looks like
Since the abrupt withdrawal of USAID and PEPFAR funding, the country’s HIV response for sex workers has been decimated. What took over a decade to build – peer-led services, gender-affirming care, mobile clinics, and safety networks – has been torn down in weeks.
Entire programmes once run by Wits RHI, Anova, Right to Care, and others have shut their doors. Thousands of peer educators, nurses, and support staff have been retrenched. Clinics in Gauteng, KwaZulu-Natal, Limpopo, and the Eastern Cape, many of them trusted community spaces, have gone dark. Meanwhile, thousands of sex workers on ART and PrEP are now adrift, many with no access to treatment or care.
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Transfer plans were haphazard or absent. Even where referral letters were issued, sex workers arriving at Department of Health facilities have been turned away or left in limbo. Mobile infrastructure, laptops, phones, and vehicles sit idle and unusable under new bureaucratic constraints. Some services were replaced with WhatsApp groups and voucher systems. But you cannot WhatsApp your way through a public health collapse.
Abandoned in the name of budget cuts
Organisations like SWEAT, Sisonke, and TB HIV Care are tracing lost clients manually, weeks after the programmes that served them were terminated. Staff are volunteering their time. Temporary stipends are being handed out. Laptops are locked. Files transferred with no follow-up. Some peer educators have been reduced to distributing dignity packs with no idea where their former clients are now. And while frontline workers scramble to hold the line, the national government has offered only platitudes and circulars, no emergency plan, no budget top-ups, no safeguarding of peer networks or community-led infrastructure.
The result? A second abandonment, not just by funders, but by the very institutions mandated to protect public health.
No data, no justice
Perhaps the most insidious form of violence sex workers face is statistical erasure. Despite overwhelming evidence of high rates of violence, rape, and police abuse, South Africa collects no disaggregated data on violence against sex workers. As a result, they are invisible in our national crime reports, absent from policy dashboards, and left out of programmatic design.
This year’s national crime statistics lay bare a worsening crisis. Sexual offences, particularly rape, are on the rise again, with Gauteng and KwaZulu-Natal driving a national uptick. But within the dense matrix of tables and trends, the experiences of sex workers remain entirely absent. This is not an oversight, it is a strategy. When a population is not counted, it can be ignored. When violence against them is not named, it does not have to be solved.
And so the silence continues. Not just in the stats, but in Parliament. In budget votes. In policy summits. Violence against sex workers is not a footnote to South Africa’s GBV crisis. It is one of its most deliberate chapters.
Criminalisation traps, decriminalisation frees
The mythology that decriminalising sex work would “open the floodgates” to chaos is both untrue and unoriginal. We have real-world evidence to the contrary. In countries like New Zealand and jurisdictions like New South Wales, decriminalisation has reduced violence, improved health outcomes, and allowed sex workers to report crimes without fear.
Here in South Africa, criminalisation continues to produce the very crisis it claims to prevent. It makes sex workers more vulnerable to client abuse. It invites sexual extortion by police. It forces people into dangerous, isolated working conditions. It discourages condom use when condoms are used as “evidence” of criminality. And it ensures that sex workers have little recourse when harmed.
Decriminalisation is not a symbolic act. It is a material change that removes the legal basis for abuse. It does not mean the state endorses sex work. It means the state stops enabling rape, extortion, and denial of healthcare under the guise of legality.
What must change now
On this International Sex Workers Day, we are not calling for pity. We are demanding a reset of state obligations and political courage. The following must happen immediately:
- Full and unconditional decriminalisation of sex work.
- A domestically funded, peer-led HIV service infrastructure for sex workers.
- Real-time data disaggregation and inclusion of sex workers in GBV statistics.
- An emergency transition plan for clients abandoned by defunded programmes.
- National policy integration of sex workers into all GBV and health frameworks.
Anything less is complicity.
To lawmakers who claim feminist credentials, to ministers who speak of human rights at podiums, to funders who play geopolitics with people’s lives, the question is no longer whether the violence will continue. It will. The question is: who will stop it?
You do not get to mourn GBV victims while ignoring sex workers. You do not get to celebrate Pride while excluding trans sex workers from care. You do not get to invoke the Constitution while violating its promises through criminalisation and abandonment.
The state has a choice: to continue this cycle of violence and invisibility, or to break it.
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Tian Johnson is the Founder of the Pan African health justice non-profit, The African Alliance and GBV Advisor to the Hands Off 2 programme which actively collaborates with sex worker-led organizations, religious leaders, law enforcement, service providers and NGOs dedicated to human rights in efforts to reduce violence against sex workers.
The views and opinions expressed in this opinion piece are those of the author, who is not employed by Health-e News. Health-e News is committed to presenting diverse perspectives to enrich public discourse on health-related issues.
