by Tian Johnson, Strategist at the African Alliance.
There is a line that should never be crossed, even in the heat of political pressure and public scrutiny. This week, South Africa’s Minister of Health, Aaron Motsoaledi, did just that.
During a press conference, Motsoaledi likened civil society activists (many many of whom are queer, Black, working class, and on the frontlines of South Africa’s HIV response) to AfriForum — because they criticised his response to PEPFAR’s retreat from the country.
Let’s be absolutely clear: AfriForum presents itself as a civil rights group, but has been widely described by legal experts, media analysts, and human rights organisations as promoting white nationalist narratives.
It has lobbied internationally against land reform, downplayed the brutality of apartheid, with its own leadership once arguing that apartheid was “not a crime against humanity”, and has routinely framed white South Africans as victims of state neglect. To compare the Black-led, community-rooted HIV movement, which has fought for decades to preserve life and dignity in the face of structural violence, to such a reactionary project is more than offensive. It is an act of political violence.
And it reveals something deeper about the Minister’s worldview: that speaking inconvenient truths to power, truths about budget gaps, shuttered clinics, and the abandonment of key populations, is now seen not as democratic participation, but as sabotage. In his framing, we’re no longer allies in the struggle against HIV, we’ve become enemies of the state.
Subscribe to our newsletter
But we remember who was silent when hundreds of thousands were dying of AIDS unnecessarily. We remember who denied treatment while activists lay chained to hospital gates. We remember who went to court not to defend the vulnerable, but to defend inaction. And we remember who fought back, not with press briefings, but with funeral vigils, hunger strikes, and protests.
That the Minister now tries to place himself at the centre of South Africa’s HIV response story is not surprising. It’s a familiar feature of political memory: erase the movement, centralise the ministry, and reframe resistance as disruption. But this isn’t just historical revisionism, it’s a strategic attempt to delegitimise those sounding the alarm today.
Because what activists are saying is uncomfortable: that 8,000 health workers have been lost; viral load testing is declining; key population clinics have been shut down and their clients abandoned or transferred to facilities many cannot access safely. That government’s promises, pivot tables, and PR efforts are cold comfort to a trans person or sex worker who now has nowhere to refill her meds without being humiliated.
None of this is AfriForum. This is what accountability looks like. This is what it means to prioritise lives over reputations. AfriForum exists to uphold a status quo that favours the white minority in South Africa.
The HIV movement exists to dismantle systems that produce premature death. The two could not be further apart. To collapse them into one another is to collapse justice itself. And what makes the comparison even more galling is that it arrives wrapped in a speech filled with self-congratulation.
Behind the successes
The Minister recites staggering achievements, reduced maternal mortality, expanded ARV coverage, and increased life expectancy as if these happened in a vacuum. But we know better.
These milestones were not granted by benevolent ministers.
They were fought for by communities who made it politically impossible to ignore them. It was activists who took this government to court, who forced it to make HIV treatment available when denialism was policy and indifference was fatal.
To be told that our organising resembles AfriForum’s tactics is gaslighting.
If we’re going to talk about AfriForum, then let’s talk honestly about whose methods resemble theirs.
It is AfriForum that silences dissent with spin. It is AfriForum that weaponises media platforms to vilify those who demand change. Sound familiar?
We are not the problem. The problem is that government was comfortable with our activism when it served their timelines and talking points. But now that we are demanding transparency, urgency, and justice, they are uncomfortable. And in that discomfort, they’ve reached for the oldest trick in the authoritarian playbook: delegitimise the messenger.
Our legitimacy does not come from government permission. It comes from the communities who trust us. From the lives saved because we dared to speak.
And from history, a history in which it was not ministers, but movements, who led.
Call for accountability
This is not about ego. This is about accountability. And if the Minister is serious about defending the health system, he must start by acknowledging who built its foundations. It was the activists he now slanders. The nonprofits he now dismisses. The key population networks he now expects to quietly absorb into a public system in which many of them have never been safe.
We are not collapsing the HIV response. We are trying to save it. We are not enemies. We are the authors of the very progress this government claims to protect.
So, Minister, with respect: withdraw your comparison. Acknowledge the harm. And return to the work, not of defending your image, but of defending people’s lives. Because if this moment is not met with courage and truth, it won’t be Trump, or activists, or funders who endanger South Africa’s HIV response.
It will be your refusal to face the truth. And that will be on you.
______________________________________________________________________________________
Tian Johnson is Strategist at the Pan-African health justice non-profit, the African Alliance. Together with civil society partners, they have been calling on the South African government to deliver a coordinated emergency response to the country’s escalating healthcare crisis.
- Read our open letter to the SA Government of 5 February 2025 here.
- Read our open letter to the SA Government of 18 March 2025 here.
- Read our 24 April 2025 letter, setting out our meeting with the DDG of Health and officials, which was held on 22 April 2025, and our further questions, here.
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.
