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Article
Horizon Scanning: Universal Healthcare in South Africa
Author: YUSSUF IBRAHIM, Senior Analyst, IQVIA Market Prognosis
May 16, 2024
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  • Horizon Scanning: Universal Healthcare in South Africa
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This article provides a review of the proposed National Health Insurance Fund, described in IQVIA's Market Prognosis South Africa report, and presents an overview of its potential impact on key stakeholders, including healthcare professionals, medical scheme administrators and the pharmaceutical industry.

Introduction and historical context

The African National Congress (ANC), which has governed South Africa since the first post-apartheid election in 1994, has long desired the implementation of Universal Healthcare (UHC) through a single payer system. Following an inquiry into the feasibility of establishing a comprehensive social security system in South Africa, a committee concluded that the state should create a national health fund that will serve as the sole fund for the cost associated with the delivery of healthcare services. From 2009, the South African government has taken more proactive measures to lay the foundations for an eventual National Health Insurance (NHI) fund. These measures include the consultation of various advisory committees, the publication of white papers, and the roll-out of a pilot project — which was considered a disappointment.

These measures culminated in the publication of an initial piece of draft legislation in 2018, the NHI Bill, which was open for comments from various stakeholders, including those in the pharmaceutical sector. The bill was presented for review in front of South Africa's parliament, the National Assembly, in 2019, although a series of delays would mean that the bill only passed the National Assembly in June 2023.

Following parliamentary approval, the bill was adopted without any amendments (ignoring even technical corrections suggested by the Department of Health [DoH]) by South Africa's upper house of parliament, the National Council of Provinces (NCOP), in December 2023. The country's president, Cyril Ramaphosa, publicly expressed his intent to give assent to the bill and sign it into law but provided no further details on the expected timeline.

Download the article on the National Health Insurance (NHI) to learn about its challenges, objectives, financial implementation model, and potential impact on the healthcare system, private sector, and pharmaceutical industry.

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