South Africa: Civil society organisations welcome Court ruling affirming right to access to healthcare

The Treatment Action Campaign (TAC), Doctors Without Borders (MSF), and Kopanang Africa Against Xenophobia (KAAX) - represented by SECTION27, welcome the judgment handed down today by the Gauteng High Court, Johannesburg, which orders the state to take immediate and decisive action to end the obstruction of access to public healthcare facilities in Gauteng.

In this landmark judgment, Wilson J ​ has found that the lack of action by state authorities charged with the constitutional mandate to protect the right to access to healthcare for all, including the City of Johannesburg Metropolitan Municipality, the National Department of Health (NDoH), the Gauteng Department of Health (GDoH) and the South African Police Service (SAPS) violated the constitutional rights of patients seeking healthcare at the Yeoville and Rosettenville clinics by failing to prevent the obstruction of access to public health facilities.

In the judgment, the respondents are directed to take all reasonable measures to ensure safe and unhindered physical access to the Yeoville and Rosettenville clinics for all persons seeking health services. They must confront and take all reasonable steps to secure the removal of any unauthorised persons from the clinics' premises or immediate surroundings who are hindering or obstructing physical access and the provision of health services within the clinics. The respondents are also ordered to ensure that adequate numbers of trained security personnel are stationed at all access points to the clinics to ensure compliance with this order. ​ The court has also ordered that they file a detailed report within ten court days outlining the actions taken to comply with the interim order.

Despite their insistence to the contrary, the Court confirmed that national and provincial authorities have an indisputable legal interest in matters affecting municipal-run clinics, including acts that occur outside those facilities. The Court held that on a proper interpretation of section 27 of the Constitution, the respondent state authorities are all required to ensure the realisation of the right to access to healthcare services. Wilson J premised his decision on the long-standing constitutional principle of cooperative governance, stating further that all spheres of government: national, provincial, municipal and SAPS are constitutionally and statutorily obliged to act, and must do so together.

Quoting from Grootboom, Wilson J states that government must identify and remove barriers that prevent people from accessing their rights. In this context, the Minister of Health and the provincial health authorities have a clear duty to understand the barriers that hinder access to healthcare and to take such reasonable and effective steps as are within their means to remove those barriers. This includes confronting and eliminating the actions of xenophobic vigilante groups who attempt to block people from entering public health facilities.

This judgment comes on the heels of the Gauteng High Court ruling against Operation Dudula in Kopanong Africa against Xenophobia and others v Operation Dudula and Others, which confirmed that acts of intimidation and harassment of migrant persons are unlawful. While both cases deal with the unlawful conduct of vigilante groups against persons without South African identity documents, the case brought by the applicants in the recent case seeks relief against the state authorities charged with the constitutional mandate to protect the right to access healthcare services. ​ 

The organisations launched the case after months of inaction by authorities, despite repeated reports that individuals at many facilities were blocking patients, including migrant persons and South Africans who are unable to produce South African identity documents, from entering clinics and receiving essential medical care.

The applicants brought the urgent Part A application asking for interim relief that compels the state respondents to take immediate steps to resolve the disruption at affected clinics, pending the outcome of Part B, in which the applicants seek broader structural relief and the confirmation of the interim orders.

In support of the application, the organisations documented a clear and escalating pattern of vigilante activity at public healthcare facilities across Gauteng. Patients reported being denied entry if they could not produce South African identity documents. ​ Since September 2025, the applicants have repeatedly and consistently observed unchecked obstruction at numerous clinics across Gauteng, with particularly high instances at the Rosettenville and Yeoville clinics. Individuals dressed in plain clothes and unaffiliated with the Department of Health or authorised security services operated with apparent impunity, blocking and restricting access to care. These vigilante groups acted openly in the presence of the facilities’ security guards and, in some cases, police officials, who failed to intervene despite witnessing the unlawful conduct. The Court has ordered the two clinics to post notices at all public access points stating that:

"No unauthorised person may obstruct or hinder physical access to this clinic or the provision of healthcare services within the clinic. Any person violating this instruction will be removed from the premises and its surrounds and reported to the police."

This judgment marks an important affirmation that healthcare facilities are not battlegrounds for discrimination but spaces where dignity, equality, and life itself must be protected. ​ With the Court’s order now in place, the state must act swiftly to restore access and uphold its constitutional duties. MSF, TAC, KAAX, and SECTION27 will continue monitoring the implementation to ensure these obligations are met.

For media enquiries, please contact:

Doctors Without Borders (MSF) | Jane Rabothatha Jane.Rabothata@joburg.msf.org

Treatment Action Campaign (TAC) | ngqabutho.mpofu@mail.tac.org.za

Kopanang Africa Against Xenophobia (KAAX) | Mike Ndlovu media@kaax.org.za

SECTION27 | info@section27.org.za

A picket in Johannesburg outside Novo Nordisk's office asking them to drop the price of insulin pens to $1, and to end the double standard on insulin pen supply. Photographer: Bafana Ngwenya/MSF | Date: 14/11/2024 | Location: South Africa

Jane Rabothata

Communications Specialist, Doctors Without Borders

• jane.rabothata@joburg.msf.org
• 0712873613

About Doctors Without Borders (MSF)

Doctors Without Borders (MSF) is a global network of principled medical and other professionals who specialise in medical humanitarian work, driven by our common humanity and guided by medical ethics. We strive to bring emergency medical care to people caught in conflicts, crises, and disasters in more than 70 countries worldwide.

In South Africa, we currently run a non-communicable diseases (NCDs) project in Butterworth, Eastern Cape province, where we support the Department of Health (DoH) in improving care for patients with diabetes and hypertension. The project focuses on improving screening, diagnosis, management, and prevention of NCDs through advocacy, research, health promotion, training, and mentorship of Community Healthcare Workers.

MSF is also recognised as one of the pioneers in providing antiretroviral treatment (ART) in the public sector. It started the first HIV programme in South Africa in 1999. The organisation's earlier interventions in the country have primarily been on developing new testing and treatment strategies for HIV/AIDS and Tuberculosis (TB) in Eshowe (Kwa-Zulu Natal) and Khayelitsha (Western Cape). The Eshowe project was handed over to DoH in 2023 after 12 years of operations. The Khayelitsha project was closed in 2020 after 22 years of activities and campaigning for improved HIV and TB treatment.

Other projects we have been involved in include our Migrant Project in the country's capital, Tshwane, which was handed over to authorities and a local Community-Based Organisation after building the capacity to work with undocumented populations. We also previously offered free, high-quality, and confidential medical care to survivors of sexual and gender-based violence in Rustenburg, North West province.

To learn more about our work in South Africa, please visit this page on our website (www.msf.org.za). To support MSF’s work: