A member of the African National Congress (ANC), he dropped out of the Executive Council after failing to gain re-election to the Free State Provincial Legislature in the 2019 general election.
Malakoane was best known for his tenure as Member of the Executive Council (MEC) for Health from 2013 to 2016, in which capacity he faced continuous opposition from the Treatment Action Campaign.
[1][6][2][7] Malakoane did not initially secure re-election to the Free State Provincial Legislature after the 2009 general election,[8] but instead continued as Matjhabeng municipal manager until 2010,[1] when he was appointed chief executive officer at Bloemwater, a state-owned entity where he had previously served as chairperson of the board from 2009.
[15] The Treatment Action Campaign also claimed that unlawful stem cell trials had been conducted in the Free State with Malakoane's full knowledge.
[18] He remained in that post for one year: in the 2019 general election, he was ranked 24th on the ANC's party list and did not secure re-election to his seat in the provincial legislature.