Johnson Progress.

South Africa’s Gauteng High Court has issued a scathing ruling against the state for failing to stop xenophobic vigilante groups from blocking access to public healthcare facilities in Johannesburg.

The judgment, handed down on December 4, 2025, orders national, provincial, and municipal authorities, as well as the police, to take immediate action to ensure unhindered access to clinics for all people, including undocumented migrants.

The case was brought by the Treatment Action Campaign, Médecins Sans Frontières, and Kopanang Africa Against Xenophobia after vigilantes were found to be turning away anyone without a South African identity document at the Yeoville and Rosettenville clinics.

Judge S D J Wilson stated that the conduct of clinic staff and security guards, who either stood by or effectively ceded control of access to the facilities to the vigilantes, amounted to a breakdown of the rule of law and a serious violation of the constitutional right to healthcare.

In his judgment, Judge Wilson described xenophobia as one of the greatest threats to democracy and human rights in South Africa, stating that it feeds on hatred and misdirects public anger away from the real causes of poverty and inequality.

“Xenophobia is one of the greatest threats to democracy and human rights we presently face,” he said.

The judge rejected arguments by health authorities and the police that responsibility lay elsewhere, ruling that the Constitution and the National Health Act impose a positive duty on the state to remove barriers to healthcare access.

The court ordered the immediate removal of unauthorised individuals blocking clinics, the deployment of adequate security, and proactive police intervention, as well as the posting of notices warning that obstruction of healthcare services is unlawful.

The state has been instructed to report back to the court on steps taken to comply with the order.

The judgment is being widely viewed as a landmark affirmation that xenophobia cannot be allowed to override constitutional rights in South Africa.

“It feeds on the hatred of the other, is animated by fantasy, and in its practised form is merely another kind of racism, for white foreigners seldom have much to fear,” Judge Wilson said.

“If we can blame foreigners, we need not look to ourselves for the solutions to the poverty and inequality that scar our society.”