Trump 2.0, or Mad Max 2, is in typical movie fashion faster and bad(der). He signed 66 executive orders in his first month in office, about a third compared to the 220 he signed during his entire first term from 2017 to 2021.
George W Bush signed about 380 in his two terms, Barack Obama about 370, and Joe Biden 162. Executive orders are the instruments through which the US president instructs his cabinet to implement his governance programme.
It has the force of law, but is not a law and any president that wants their executive order to be law has to go through the legislative process. As was done with the Africa Growth and Opportunity Act (Agoa), which can only be terminated through non-renewal or through a legislative process by Congress.
An executive order (EO) can therefore be nullified by another EO by another president. However, for the duration of a presidency, the EO stands, unless the same president nullifies it with another.
The 66 EOs from Mad Max range in scope from tariff impositions on countries such as China, Canada and Mexico, expulsion and deportation of southern American, African and Asian migrants, the renaming of the Gulf of Mexico, stopping payments to the World Health Organisation (WHO), stipulating when people can transition from one gender to another, creating a job for Elon Musk as virtual secretary extraordinaire, to the closing down of USAID.
The USAID EO as well as the one granting a group of specific white people from this country entry into the US as refugees — while other people are being expelled — are the ones that got airtime in our country, and rightly so.
The special status of Afrikaans-speaking white people in the US followed extensive lobbying by right-wing groupings that have their origins in the racist Mynwerkersunie of Arrie Paulus, who believed that black people were “baboons”.
Despite the sophisticated attempt to rebrand as a human rights-oriented grouping, they remain encamped in their origins.
That is how they got observer status at the UN and the ear of Mad Max 1 at the White House. Their lobbying has been successful. However, Mad Max went beyond what the grouping asked for as they have no intention of emigrating.
Why are we unable to fund the entire HIV/Aids programme if we can generate R560bn from our own resources? Because the bulk is going to private health care
More importantly, the lobbying has set the scene for the non-renewal of Agoa, whose main beneficiaries are big commercial white Afrikaans-speaking farmers in the Cape who export wine without paying duties. The realisation of these unintended consequences saw the white gentlemen in Washington DC last week trying to get Mad Max to walk back on both the refugee offer and on Agoa.
The issue for the majority of people in this country, however, is the closure of USAID and the action against WHO and its impact on health systems here. It is thus significant that Mad Max announced a total ban on support for HIV/Aids treatment for South Africa, which affects a majority of black people, while the local right-wingers were pleading for Agoa.
While the impact of the ban on health support is real, the South African health system will not collapse because of this decision. There are programmes such as HIV and TB support that were completely dependent on USAID. But 70% of the HIV/Aids programmes are funded by the government, with the US President’s Emergency Plan for Aids Relief (Pepfar) contributing 24%.
South Africa spends R560bn on health annually. Of this amount, 51% goes to mainly white medical aid members, constituting 14%, while 49% of the budget is used to treat 86%, almost all of them black, through public hospitals.
The dependency on foreign aid is a scourge that we as a country and a continent need to disabuse ourselves of.
Why are we unable to fund the entire HIV/Aids programme if we can generate R560bn from our own resources? Because the bulk is going to private health care.
The price of private health care has risen dramatically from 1998 when the three main private hospitals, Mediclinic, Life and Netcare, started gobbling up the independent operators. By 1998, the independent private hospitals constituted more than 50% of private hospital beds.
Of the R31bn of the budget that goes to hospitals, R30.8bn goes to private hospitals, with only R281m going to public hospitals, according to the Department of Health.
As long as our health system is skewed towards the few, we will never be able to fund critical interventions for the poor black part of our nation. We will not be able to say to Mad Max, “keep your Pepfar”.
But it doesn’t have to be this way. The proposed National Health Insurance (NHI), with its inherent flaws due to dilapidated infrastructure and corruption, remains a beacon of hope for the poor.
The poor are going to have to stand up and have their voices heard in defence of their own interests, and challenge the din coming from self-interested companies, professionals and specialists who are milking the system. They see NHI as a threat to their interests.
So as Aaron Motsoaledi hurries around meeting NGOs that have lost their Pepfar funding, the lasting solution is not the forlorn hope that Mad Max will have a change of heart.
It won’t happen. It is instead going to get worse. Ask the EU, Nato and Ukraine’s Volodymyr Zelensky. We must wisen up and get the NHI system rolling.
• Tsedu is a former editor of Sunday Times and former chair of Sanef.
For opinion and analysis consideration, email Opinions@timeslive.co.za
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