Cholera outbreak exposes South Africa’s infrastructure crisis and political dysfunction

South Africa’s capital city, Pretoria, is facing a devastating cholera outbreak that has claimed the lives of 29 people, shedding light on the country’s deteriorating infrastructure and political dysfunction. The crisis in the Tshwane municipality, just north of Pretoria, underscores the dire state of water services and the collapse of basic amenities across the nation. Years of neglect and corruption have left the country grappling with inadequate sewage systems and a lack of investment in infrastructure. The government’s failure to address these issues has resulted in rolling blackouts, public anger, and now, a cholera outbreak in an urban area. The situation highlights the urgent need for substantial improvements and investment in South Africa’s water and sanitation services.

Deadly Disease Arrives at the Doorstep of South African Power

By Antony Sguazzin and Janice Kew

Pretoria is the capital of Africa’s most industrialised economy, where ministers meet in buildings that overlook lush gardens and a giant statue of Nelson Mandela. The city hosts more than 100 embassies and high commissions, verdant parks and two universities.

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Yet just 20 miles (32 kilometres) north of the seat of government up the N1 highway, the Tshwane municipality that includes Pretoria is also home to the latest alarming evidence of South Africa’s ongoing political dysfunction.


The country’s worst cholera outbreak in 15 years has so far killed 29 people. It highlights the dire state of water services in Hammanskraal north of Tshwane municipality. It also speaks to the collapse of basic services across South Africa after years of neglect and corruption and the inability of an administration riddled with infighting to run a metropolitan area of 3.6 million people.

The diarrheal disease was largely wiped out in developed economies by modern sewage systems introduced in the 19th century, and its proximity to the heart of South African power today shows how far the country’s infrastructure has declined.

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The country has been hit by outbreaks before. They’ve normally been in remote rural areas, though. In 2008, it spilled over the border into the north of the country from Zimbabwe, where cholera is again rampant this year. Rarely have they been in cities.”Let us be clear of the enormity of this issue,” said Ferrial Adam, manager of the water program at the Organisation Undoing Tax Abuse, a non-profit group focused on exposing corruption. “In the capital of Africa’s most advanced economy, people are dying of cholera.”

As far back as 2004, the authorities recognised that the Rooiwal Waste Water Treatment Works in Tshwane was operating beyond its capacity. Raw sewage was pouring into the Apies River and ending up in the Temba water treatment plant. South Africa’s Department of Water and Sanitation declared part of the river a disaster area in 2011, and an upgrade of Rooiwal was promised by 2015. That never happened.

That’s not unusual in a country where chronic mismanagement and lack of investment in infrastructure has led to rolling blackouts and public anger at corruption and cronyism.  

A government report on 6 June showed that last year 334 waste-water facilities were in critically poor condition. Senzo Mchunu, the country’s water minister, talked of “a sharp decline in the delivery of water and sanitation services.”


Pretoria is known for some of the apartheid era’s most-notable brutalist architecture, as well as the regal Herbert Baker-designed sandstone Union Buildings. To the south is the Voortrekker Monument, an imposing granite edifice that commemorates the ox-wagon trek northeast by Afrikaners to escape the yoke of British rule in the Cape. It’s a nod to Pretoria’s history as the capital of one of the two original Boer republics.


That’s a world apart from Hammanskraal. Here, residential plots slowly blend into a disorderly mix of shacks, isolated single-story structures and potholed roads with cows grazing on the patches of grass that dot the uneven sidewalks. Amenities and jobs are scarce, and many residents subsist on welfare.

Little money has been spent on the area either by the African National Congress, which ran the city alone until it lost control in 2016 after local elections, or the coalition governments that have led it since. The source of the cholera outbreak hasn’t been conclusively identified. But political parties have been rushing to apportion blame. 

President Cyril Ramaphosa, who visited the area on 8 June, said the city hadn’t been using its annual grant from the national government to upgrade its water infrastructure and had ignored several directives from the water department to do so, resulting in legal action.

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The opposition Democratic Alliance, which has had several mayors in Pretoria since 2016, inherited a dilapidated city, according to leader John Steenhuisen.

“It’s very difficult to run the city with eight or nine hands on the steering wheel,” he said. “It’s in a pretty poor shape, and it was in a pretty poor shape when we got it. Those issues, Hammanskraal, et cetera, were pre-existing conditions.”


The Democratic Alliance had to rely on the Economic Freedom Fighters, which current Pretoria Mayor Cilliers Brink described as the party’s “ideological nemesis,” to push through decisions.

In March 2020, the start of the Covid-19 pandemic, control of the city was taken by the wider provincial government run by the ANC. Pretoria officials were left powerless until the decision was overturned by a court seven months later. 

“This is a blight on successive administrations,” Brink said. “I am at the end of this long line of failure.”

The municipality has to rely almost entirely on government grants for its annual capital budget of about 2.5 billion rand ($136 million) because of poor revenue collection. From that, it has to finance all its infrastructure needs. That compares with Cape Town’s budget, that’s more than four times bigger for a city with a population only about a third larger.

Litigation by South Africa’s government states that just about all of the grants Pretoria receives should go toward improving water and sanitation. Instead, the city has pledged 450 million rand from its own budget over three years as part of a four billion-rand program to upgrade the plant and restore a permanent drinking water supply by June 2026. 

For the next ten months, though, residents of Hammanskraal will have to rely on water tankers until a temporary treatment plant can be put in place. And the money for that hasn’t been secured yet. “There are no guarantees; let me be absolutely clear,” Brink said. “It’s very ambitious.”

–With assistance from Timothy Coulter “Tim”.

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