ANTHONY BUTLER: The space where Gwede Mantashe and Aaron Motsoaledi meet
While they weather the slings and arrows, Ramaphosa lives to fight another day
First published in Business Day and BusinessLive
31 January 2025
On the face of it, health minister Aaron Motsoaledi and mineral & petroleum resources minister Gwede Mantashe have little in common. Motsoaledi was a medical doctor who served in Jacob Zuma’s cabinet as health minister. Mantashe is a former trade unionist and communist party leader, who spent the Zuma years running the ANC as secretary-general.
Motsoaledi oversaw a fourfold expansion of the country’s antiretroviral programme. He declared war on unsaturated fats and lectured his cabinet colleagues on the importance of healthy eating. Mantashe defended Zuma from allegations of corruption and defied the health minister by ingesting fatty acids and concealing them about his person.
However, in 2018 it emerged that the two men had a shared project. Motsoaledi was part of the “CR17” campaign team for the Nasrec conference, while Mantashe was the key Luthuli House insider behind Cyril Ramaphosa’s rise to the presidency. Ramaphosa has since deployed the loyalists to his cabinets.
Mantashe was appointed mineral resources & energy minister in 2019, in the middle of an insurmountable electricity crisis. The route out of the crisis was not blocked by technical obstacles. International concessional finance was available to accelerate coal plant retirement and the wholesale market road map was two decades old. The problems were political: ideological opposition to “privatisation”; coal lobbies dominated by ANC donors; trade unions opposed to renewables; and “just transition” issues in Mpumalanga.
Mantashe became the “fossil fuel dinosaur”, stubborn and immovable, with the low centre of gravity of a brontosaurus. He argued that abundant coal resources could drive growth and that Western envoys could not be trusted. He refused to attend the COP26 climate conference in Glasgow, arguing that “many people will be frightened” — he meant of him, rather than of visiting Glasgow.
Mantashe’s theatrics look understandable in retrospect, given developed countries’ failure to honour their commitments and the slowdown in their own fossil fuel decommissioning. He also bought time for investment to adapt the grid for renewables, an important matter that early evangelists had overlooked.
Mantashe kept coal interests and unions on his side, and maintained a theatrical opposition to increases in the licensing threshold until exhaustion and despair with power blackouts reached their peak. Once Ramaphosa lifted the threshold (to great personal acclaim), 4,000MW was added in two years. Wealthy households also bought or rented solar systems at their own expense to further ease the generation gap.
Motsoaledi may well be doing the same job for Ramaphosa in the health sector. The new international consensus about healthcare, signalled in the pro-market Economist magazine in April 2018, is that “universal healthcare, worldwide, is within reach [and] the case for it is a powerful one — including in poor countries”. The trouble is designing sensible reforms and getting them past opposition from vested interests: ideologues, health sector unions, hospital groups, insurance companies and health professionals.
The status quo — unsustainable, inhumane and deeply inefficient — is in nobody’s long-term interests. Long-delayed system reform is needed. But the National Health Insurance (NHI) Act that Ramaphosa signed into law last year has few sincere champions. The ANC’s coalition partners mostly reject it. Four high court challenges from key actors in the sector look watertight, a fact confirmed by the Treasury and other legal advisers long ago.
The idea of universal healthcare is broad and ambiguous, and basic building blocks such as mandatory health insurance remain contested. Moreover, Ramaphosa cannot let NHI become a proxy issue in ANC factional battles. Nonetheless, once the time is right (which had better be soon), he may find a compromise that does not look like a retreat.
Motsoaledi, like Mantashe, will absorb the pain. Ramaphosa and the government of national unity may then live on to fight another day.
Butler teaches public policy at the University of Cape Town.

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