Tag: South Africa

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Unpacking the State of Our Nation’s Health

On By ModernMedia

Harnessing the power of preventative care and incentivised wellness to lessen the burden and cost of disease in South Africa.

By Damian McHugh, Chief Marketing Officer, Momentum Health.

South Africa is at a critical juncture in its healthcare landscape. The burden of disease -primarily driven by non-communicable diseases (NCDs) such as diabetes, hypertension, and mental health disorders – has escalated alarmingly. Over the past two years, NCDs have increased from 51% in 2022 to 55% in 2024, with diabetes rising by 12% and hypertension increasing from 8% to 10%1. Not only straining our healthcare system but also substantially hampering economic productivity and growth.

Current State of our Nation’s Health

It’s estimated that poor health-related absenteeism costs the South African economy up to R19.1 billion annually2. Beyond these direct financial implications, this hidden drain stifles business growth, reduces workforce efficiency, and hinders overall economic progress. Lifestyle-related diseases contribute significantly to rising healthcare costs – with an estimated R270 billion in healthcare claims projected to be linked to preventable conditions in 20253.

However, we have an opportunity to reverse this trend by embracing preventative care and incentivised wellness- two powerful levers that can help shift our healthcare paradigm from sick care to proactive disease prevention.

Why Prevention Is the Key to a Healthier, Wealthier Nation

I’ve always believed in the notion that your health is your wealth. Preventative healthcare is no doubt one of the most effective ways to reduce the burden and cost of disease. Simple lifestyle changes, such as regular exercise, balanced nutrition, deeper connections with loved ones, routine screenings to know one’s numbers, and effective stress management – have all been proven to dramatically lower the risk of chronic conditions. Yet, despite these clear benefits, many South Africans struggle to prioritise their health due to financial constraints, limited access to wellness education, and the ever-evolving demands of daily life.

This is where the private healthcare sector, in collaboration with policymakers and employers, can make a significant impact. By incentivising wellness behaviours, we can empower citizens to take control of their health while alleviating the financial burden on our healthcare system.

The Power of Incentivised Wellness

At Momentum Health, we have witnessed firsthand the positive outcomes driven by wellness rewards programmes. By rewarding members for engaging in preventative health activities—such as completing health screenings, maintaining an active lifestyle, or adopting healthier eating habits, we foster sustainable behaviour change through our wellness rewards programme, Momentum Multiply.

When effectively designed, these programmes offer tangible benefits such as lower healthcare costs through a rewards system and encourage healthier lives that rely less on medical intervention in the first place. There is sound evidence that ahealthier population results in fewer medical claims and lower insurance premiums, benefiting both individuals and employers.

It can also be linked to increased productivity as healthy bodies host healthy minds. We have seen that employees who proactively manage their health take fewer sick days, leading to enhanced workplace performance and reduced absenteeism. As a result, these factors contribute immensely to stronger economic growth asa healthier workforce contributes to improved business efficiency and a more resilient economy. However, to fully realise the potential of preventative care and incentivised wellness, we cannot do it alone. It’s pivotal that we adopt a multi-stakeholder approach.

Stronger and healthier together

A collaborative approach where healthcare insurers & providers expand access to preventative screenings, personalised health coaching, and digital health solutions that track and reward healthy habits and behaviour. Where employers adopt and implement workplace wellness programs that encourage employees to prioritise their health through corporate wellness incentives and adequate mental health support.

Where we, the private sector, work alongside Government & Policymakers strengthen the current system, build capacity for future skills andimplement national awareness campaigns to showcase the importance of preventative care.

As it stands, in 2024 the Gauteng Department of Health (GDoH) set aside R38.1 million in 2024/25 financial year and R119.7 million over the MTEF allocated for health and wellness campaigns, as well as physical activity programmes in prioritised areas such as Townships, Informal Settlement and Hostels and more recently, the GDoH announced a budget of R474.6 million in 2024/25 and R1.4 billion over the MTEF allocated for strengthening mental healthcare services. But ever more importantly, we also need every day South Africans to take proactive steps to manage their health by making better choices in the lives they live.

A Shared Responsibility for a Healthier Future

The numbers are clear. If we don’t act now, the cost of preventable diseases will only continue to rise – jeopardising both the sustainability of our healthcare system and economic stability. By harnessing the power of preventative care and incentivised wellness, we can significantly reduce the burden of disease, improve quality of life, and foster a healthier, more productive South Africa.

We remain committed to leading this change by innovating healthcare solutions that empower South Africans to take charge of their health and provide more health to more South Africans for less when they need it. Together, through collective action and a preventative mindset, we can and must build a healthier nation – one choice at a time.

Categories : Healthcare Politics and Regulations HIVTags : Leave a comment

SA Health Research Facing Catastrophic Financing Cuts

On By ModernMedia
Professor Ntobeko Ntusi is the president and CEO of the South African Medical Research Council. (Photo: SAMRC)

By Catherine Tomlinson

Cuts to United States funding of health research could have “catastrophic” consequences, says Professor Ntobeko Ntusi, who is at the helm of the country’s primary health research funder. He says the South African Medical Research Council is “heavily exposed” to the cuts, with around 28% of its budget coming from US federal agencies.

After an unprecedented two weeks of aid cuts by the United States government that left HIV programmes and research efforts across the world reeling, the Trump administration took the drastic step of freezing aid to South Africa in an executive order on 7 February.

The order – which is a directive to the executive branch of the US government and holds the weight of law – was issued to respond to what the White House called “egregious actions” by South Africa. It specifically points to the Expropriation Act and the country’s accusation of genocide against Israel at the International Court of Justice as the primary reasons for the funding freeze.

While there are some limited wavers and exceptions to the cuts, Spotlight understands that these have so far been poorly communicated and many HIV services remain in limbo.

The funding cuts, following an earlier executive order issued on 20 January,  are interrupting critical health research underway across South Africa and will ultimately undermine global efforts to stop HIV and TB.

The US is a major source of financing for health research in South Africa. Many of the country’s research institutes, groups, and universities receive funding from the US through the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), USAID, and the President’s Emergency Plan for Aids Relief (PEPFAR).

Over the past few weeks, these funding sources have come under siege by the Trump administration resulting in a gaping, and most likely insurmountable financing gap, for many health research endeavors in the country.

US spending accounts for just over half (55%) of all spending on global health research around the world. In 2022, the super power spent $5.4 billion on global health research, according to Impact Global Health –  an NPO that tracks health research spending.

While the US gives money to global health research through several different government departments and programmes, the largest source of funding for global health research is the NIH. The NIH contributed 65% of global financing for HIV research between 2007 and 2022, according to Impact Global Health and 34% of tuberculosis research financing in 2023, according to New York-based policy think tank, the Treatment Action Group.

South Africa has the biggest HIV epidemic in the world in absolute terms and is among the top 10 countries in terms of TB cases per capita.

Catastrophic consequences

“South Africa is the biggest recipient of NIH funding outside of the US”, Professor Ntobeko Ntusi, president and CEO of the South African Medical Research Council (SAMRC), told Spotlight. “[T]he consequences will be catastrophic if [funding] is stopped… for science that is important for the whole world,” he said.

South Africa plays a critical role in advancing HIV science, said Ntusi, adding that “many of the major trials that have advanced our understanding of both the effective strategies for HIV management, as well as understanding the mechanisms of disease emanated from South Africa”.

People in the US, for example, are now able to access long-acting HIV prevention shots, largely because of research that was conducted in South Africa and Uganda. Research conducted in South Africa has also been critical to validating new tuberculosis treatments that are currently the standard of care across the world.

Heavily exposed

Stop work orders were sent to research groups receiving USAID funding at the end of January. These stop work orders coupled with the halting of funding have already interrupted critical HIV research efforts, including efforts to develop new vaccines against HIV.

Ntusi said that the SAMRC is currently “heavily exposed” to the halting of grants from USAID and the CDC, with research programmes supported by USAID and the CDC already being stopped.

The SAMRC’s research on infectious diseases, gender-based violence, health systems strengthening, as well as disease burden monitoring are also affected by the funding cuts.

“In addition to support for HIV research, we have significant CDC grant funding in our burden of disease research unit, the research unit that publishes weekly statistics on morbidity and mortality in South Africa,” said Ntusi. “Our health systems research unit has a number of CDC grants which have been stopped [and] in our gender and health research unit we had a portfolio of CDC funding which also has been stopped.”

Along with programmes being impacted by the halting of USAID and CDC funding, Ntusi said there will also be major staffing ramifications at the SAMRC as well as at universities.

He said that if funding from the NIH is stopped “there would be huge fallout, we just wouldn’t be able to cover the hundreds of staff that are employed through the NIH granting process”.

The SAMRC’s combined annual income from US grants (NIH, CDC and USAID) is 28% of its total earnings (including both the disbursement from the SA government as well as all external contracts) for the 2025/2026 financial year, according to Ntusi. “So, this is substantial – effectively a third of our income is from US federal agencies,” he said.

Pivot away from infectious disease?

In addition to the executive order freezing funding to South Africa, it is unknown whether the NIH will remain a dominant funder of global health. Robert F. Kennedy Jr., the US health secretary nominee, has called for cutting to the NIH’s infectious disease research spending to focus more on chronic diseases.

Looking beyond health, Ntusi said the executive order halting aid to South Africa will be felt across a range of different development initiatives such as water and sanitation, and climate change.

Republished from Spotlight under a Creative Commons licence.

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Categories : Diet and Nutrition VaccinesTags :

Study in SA Children Finds Undernutrition may Weaken Measles Vaccination

On By ModernMedia
Photo by National Cancer Institute

Amid a global surge in measles cases, new research suggests that undernutrition may be exacerbating outbreaks in areas suffering from food insecurity. A study involving over 600 fully vaccinated children in South Africa found those who were undernourished had substantially lower levels of antibodies against measles.

Researchers from McGill University, UC Berkeley School of Public Health and the University of Pretoria tracked the children’s growth over time as an indicator of undernutrition and measured their antibody levels through blood tests. Children who were stunted around age three had an average of 24-per-cent-lower measles antibody levels by age five compared to their typical-sized peers.

The findings, published in Vaccine, suggest that undernutrition may affect the duration of vaccine protection.

This indicates that addressing child hunger could be a key piece of the puzzle in preventing viral outbreaks, said senior author Jonathan Chevrier, an Associate Professor at McGill.

A growing threat worldwide

Measles is a highly contagious viral infection that causes symptoms such as a rash, fever and cough, and can lead to severe complications, especially in young children. The disease is a threat in regions where it was once under control, including Canada, which in 2024 reported its highest number of cases in nearly a decade.

“Global measles cases declined from 2000 to 2016, but the trend reversed in 2018, driven in part by under-vaccination and the impact of the pandemic. Measles is now making a strong comeback in many parts of the world despite being preventable with vaccination and adequate immunity,” said co-author Brian Ward, Professor at McGill’s.

“We need to vaccinate children against infectious diseases that are preventable and ensure they are protected,” said first author Brenda Eskenazi, Professor at the University of California, Berkeley. “This is especially important now, given that many known diseases are expected to spread with climate change.”

About 22% of children under age five worldwide – approximately 148 million – were stunted in 2022, Chevrier added, with the highest rates in Asia and sub-Saharan Africa.

The team plans to monitor the children in the study as they grow older to understand whether the effects of early-life undernutrition persist.

Source: McGill University

Categories : Diet and Nutrition Metabolic DisordersTags :

Millions of Diabetes and Heart Disease Cases Linked to Sugary Drinks, New Study Finds

On By ModernMedia
Photo by Breakingpic on Pexels

A new study from researchers at Tufts University, which appears in Nature Medicine, estimates that 2.2 million new cases of type 2 diabetes and 1.2 million new cases of cardiovascular disease occur each year globally due to consumption of sugar-sweetened beverages.

In developing countries, the case count is particularly sobering. In Sub-Saharan Africa, the study found that sugar-sweetened beverages contributed to more than 21% of all new diabetes cases. In Latin America and the Caribbean, they contributed to nearly 24% of new diabetes cases and more than 11% of new cases of cardiovascular disease.

Colombia, Mexico, and South Africa are countries that have been particularly hard hit.  More than 48% of all new diabetes cases in Colombia were attributable to consumption of sugary drinks. Nearly one third of all new diabetes cases in Mexico were linked to sugary drink consumption. In South Africa, 27.6% of new diabetes cases and 14.6% of cardiovascular disease cases were attributable to sugary drink consumption.

Sugary beverages are rapidly digested, causing a spike in blood sugar levels with little nutritional value. Regular consumption over time leads to weight gain, insulin resistance, and a host of metabolic issues tied to type 2 diabetes and heart disease, two of the world’s leading causes of death.

“Sugar-sweetened beverages are heavily marketed and sold in low- and middle-income nations. Not only are these communities consuming harmful products, but they are also often less well equipped to deal with the long-term health consequences,” says Dariush Mozaffarian, senior author on the paper and director of the Food is Medicine Institute at the Friedman School.

As countries develop and incomes rise, sugary drinks become more accessible and desirable, the authors say. Men are more likely than women to suffer the consequences of sugary drink consumption, as are younger adults compared to their older counterparts, the researchers say.

“We need urgent, evidence-based interventions to curb consumption of sugar-sweetened beverages globally, before even more lives are shortened by their effects on diabetes and heart disease,” says Laura Lara-Castor, NG24, first author on the paper who earned her PhD at the Friedman School and is now at the University of Washington.

The study’s authors call for a multi-pronged approach, including public health campaigns, regulation of sugary drink advertising, and taxes on sugar-sweetened beverages.  Some countries have already taken steps in this direction. Mexico, which has one of the highest per capita rates of sugary drink consumption in the world, introduced a tax on the beverages in 2014. Early evidence suggests that the tax has been effective in reducing consumption, particularly among lower-income individuals. 

“Much more needs to be done, especially in countries in Latin America and Africa where consumption is high and the health consequence severe,” says Mozaffarian. “As a species, we need to address sugar-sweetened beverage consumption.”

Source: Tufts University

Categories : General Interest Healthcare Politics and RegulationsTags :

Health in 2024: The Year in Fewer than 1000 Words

On By ModernMedia

By Marcus Low and Adiel Ismail

From the NHI Act to major advances in HIV prevention, it has been another busy year in the world of healthcare. Spotlight editors Marcus Low and Adiel Ismail recap the year’s health developments and identify some key trends in fewer than 1000 words. 

For a few weeks in June, it seemed that the surprising outcome of South Africa’s national and provincial elections would usher in far-reaching political and governance changes in the country. As it turns out, some significant changes did come, but not in the health sector. 

Rather than a new broom, it was déjà vu as Dr Aaron Motsoaledi returned as Minister of Health – he was previously in the position from 2009 to 2019. In both Gauteng and KwaZulu-Natal – the country’s most populous provinces – ANC MECs for health from before the elections kept their jobs. The ANC garnered well under 50% of the votes in both of those provinces and nationally and accordingly had little choice but to form national and provincial coalitions. 

To be fair, five of the nine MECs appointed after the elections were new, but these changes were mainly in the less populous provinces. 

Policy-wise, the trajectory also remains much as it was a year ago. Two weeks before the elections, President Cyril Ramaphosa signed the National Health Insurance (NHI) Act into law (though most of it has not yet been promulgated). While Ramaphosa has since then asked Business Unity South Africa (BUSA), the country’s largest employer association, for new input on NHI and while talk of mandatory medical scheme cover had a moment in the headlines, there is no solid evidence that the ANC is open to changing course – if anything, Motsoaledi has doubled-down in the face of criticism. The Act is being challenged in various court cases. 

The sense of discord in healthcare circles was further deepened in August when several organisations distanced themselves from Ramaphosa’s updated Presidential Health Compact. The South African Medical Association, the South African Health Professionals Collaboration—comprising nine associations representing over 25 000 public and private healthcare workers—and BUSA all declined to sign the accord. BUSA accused government of “unilaterally” amending the compact “transforming its original intent and objectives into an explicit pledge of support for the NHI Act”.  

Away from these reforms, a trend of health budgets shrinking year-on-year in real terms continued this year. This funding crunch, together with well-documented shortages of healthcare workers, has meant that even well-run provincial health departments are having to make impossible trade-offs – that while governance in several provincial health departments remains chronically dysfunctional. This was underlined by a landmark report published in July that, among others, highlighted leadership instability, lack of transparency, insufficient accountability mechanisms, and pervasive corruption. New reports from the Auditor General also didn’t paint a pretty picture. 

Gauteng health has again been in the headlines for the wrong reasons. The provision of cancer services in the province remains mired in controversy as the year comes to an end, with plans to outsource some radiation services to the private sector apparently having stalled, despite the health department having the money for it. A deal between the department and Wits University was also inexplicably derailed. With high vacancy rates, serious questions over senior appointments, reports of corruption at Thembisa Hospital, and much more, it seems that, if anything, governance in the province has gotten even worse this year. 

In a precedent-setting inquest ruling in July, Judge Mmonoa Teffo found that the deaths of nine people moved from Life Esidimeni facilities to understaffed and under-equipped NGOs “were negligently caused by the conduct of” former Health MEC Qedani Mahlangu and former head of the provincial health department’s mental health directorate Dr Makgabo Manamela. 

Outside our borders, Donald Trump’s election victory in the United States is set to have far-reaching consequences. A return of the Global Gag Rule seems likely, as does major changes to the Food and Drug Administration, the President’s Emergency Plan for AIDS Relief, and the National Institutes of Health – the latter funds much HIV and TB research in South Africa. 

Away from politics and governance, the biggest HIV news of the year came in late June when it was announced that an injection administered every six months was extremely effective at preventing HIV infection. It will likely be several years before the jab becomes widely available in South Africa.

Another jab that provides two months of protection per shot is already available here, but only to a small number of people participating in implementation studies. 

It is estimated that around 50 000 people died of HIV related causes in South Africa in 2023 and roughly 150 000 were newly infected with the virus (reliable estimates for 2024 will only be available in 2025). A worrying one in four people living with HIV were not on treatment in 2023. There was an estimated 56 000 TB deaths and around 270 000 people fell ill with the disease. While these HIV and TB numbers have come down dramatically over the last decade, they remain very high compared to most other countries. 

There are some concerns that a new TB prevention policy published in 2023 is not being universally implemented. We have however been doing more TB tests, even while TB cases are declining – as we have argued, this is as it should be. Also positive, is that a massive trial of an TB vaccine kicked off in South Africa this year. 

With both TB and HIV, South Africa is making progress too slowly, but we are at least trending in the right direction. With non-communicable diseases such as diabetes, there are unfortunately signs that things are getting worse. As we explained in one of our special briefings this year, our diabetes data in South Africa isn’t great, but the little we have painted a worrying picture. As expected, access to breakthrough new diabetes and weight loss medicines remained severely constrained this year, largely due to high prices and limited supply. 

Ultimately then, at the end of 2024, South Africa is still faced with chronic healthcare worker shortages, severe governance problems in several provinces, and major uncertainties over NHI – all while HIV and TB remains major public health challenges, though a shift toward non-communicable diseases is clearly underway. 

Republished from Spotlight under a Creative Commons licence.

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The High Cost of Having Too Few Pharmacists in SA

On By ModernMedia
Photo by National Cancer Institute on Unsplash

By Chris Bateman

It’s acknowledged in key policy documents, well known at the coalface and much ventilated in the media: South Africa’s public healthcare system has too few healthcare workers, especially medical doctors, certain specialists, and theatre nurses. Less recognised however is the shortage of public sector pharmacists. We lift the lid on this until now largely hidden problem – and its impact.

There are too few public sector pharmacy posts across South Africa to deliver a comprehensive service, with no clear staffing norms, and an uneven distribution of pharmacists, especially in rural districts. This contributes in part to medicine stockouts and the emergence of deadly hospital-acquired drug-resistant infections.

This is according to Dr Andy Gray, a senior lecturer in the Division of Pharmacology at the University of KwaZulu-Natal’s School of Health Sciences and co-head of the World Health Organization Collaborating Centre for Pharmaceutical Policy and Evidence Based Practice. His views are echoed by at least two other key local stakeholder organisations.

Flagging the alarming rise in resistance to antimicrobials – an urgent global public health threat – driven by the misuse of antibiotics in hospitals and ambulatory care, Gray told Spotlight that there are not enough pharmacists to intervene if they see inappropriate use of medicines.

“This just continues without any effort to fix it. Inadequately trained and understaffed prescribers are working under immense stress, so they are prone to use the wrong medicines at the wrong time with the wrong doses,” he said. “There are also very few microbiologists and certainly not enough pharmacists at the bedside. They’re not doing what’s necessary to ensure the proper use of medicines – for example, better control over antimicrobials.”

The excessive dependence on antibiotics has resulted in the emergence of antibiotic-resistant bacteria, commonly known as superbugs. This is called bacterial resistance or antibiotic resistance. Some bacteria are now resistant to even the most powerful antibiotics available.

South Africa has been ranked 67th out of 204 countries for deaths – adjusted by age per 100 000 people – linked to antimicrobial resistance. It has been estimated that around 9 500 deaths in the country in 2019 were directly caused by antimicrobial resistance, while 39 000 deaths were possibly related to resistant infections.

The National Department of Health warned in a background document that rising antimicrobial resistance and the slow-down of new antibiotics could make it impossible to treat common infections effectively. This could also lead to an increase in the cost of healthcare because of the need for more expensive 2nd or 3rd line antimicrobial agents, as well as a reduced quality of life.

Low numbers

Gray said that while not matching the paucity of public sector doctors and nurses, pharmacists stand at 24% of the staffing levels calculated as necessary to deliver a comprehensive service.

“We need just over 50 pharmacists per 100 000 uninsured population as a target, but we’re sitting at around 12,” he said.

Gray said the SA Pharmacy Council (SAPC) has no data on the total number of pharmacists actually working in the country, or the number working in particular settings. A SAPC spokesperson said they had only provincial statistics, but could not track pharmacist movements.

“You can’t use their database to find out how many pharmacists are working where. The Health Systems Trust SA Health Review Indicator chapter has figures of public sector pharmacists per province and per 100 000 uninsured population,” Gray pointed out.

As at February 2024, there were 16 856 pharmacists registered in South Africa, (working and not working), excluding the 971 community service pharmacists.

The 5 958 pharmacists employed in the public sector represents the full complement of funded posts, but it is well below the number needed – and varies dramatically between provinces. While almost all funded posts are filled, Gray said the number of posts is less than needed to deliver a comprehensive, quality service.

Taken across South Africa’s population of around 62 million, there are around 28 registered pharmacists (working or not working), per 100 000 people (insured and uninsured). According to data from 2016, the mean global ratio stands at 73 per 100 000.

“We’re better than many other African countries, but that’s cold comfort,” said Gray.

Increases spread unevenly

There are some positives. The number of pharmacists in the public sector has grown since 2009, rising from five to 12 per 100 000 uninsured people by 2023. However, the ratio varies markedly by district – for example: from 15 in the best-served Western Cape district to a mere three in the poorest served Northern Cape district.

Gray said the more rural districts suffer the most when it comes to understaffing of pharmacists and this contributes to medicine stockouts. While the causes of medicine stockouts are complex, one of the major contributors is the refusal of suppliers to deliver any more stock until accounts are paid.

Understaffing of pharmacists often results in nurses managing patients without any pharmaceutical oversight, Pharmaceutical Society of South Africa Executive Director, Refiloe Mogale, told Spotlight. She associates such task-shifting with medicine misuse and inappropriate prescribing, noting that while it’s a vital strategy in budget-tight environments, medication errors are on the rise. This, she argues, could be solved by ensuring appropriate pharmaceutical personnel are placed to support primary healthcare facilities – such as pharmacist assistants.

“A Primary Care Drug Therapy (PCDT) trained pharmacist can diagnose, treat, and dispense medications. So, this is not as much about task-shifting as about the pharmacist providing comprehensive care. These PCDT pharmacists can do family planning, screening for diabetes, hypertension, and other clinical tasks that take the burden off doctors. We need more of them,” she said.

‘No clear staffing norm’

Addressing the human resources quandary, Gray said the core problem had always been that the number of pharmacist posts per hospital or clinic were not evenly distributed. “There’s been no clear staffing norm. The old ‘homeland’ hospitals are likely to be under resourced with pharmacists and pharmacists’ assistants. Posts are poorly distributed and by global standards, we’re nowhere near where we should be,” he said.

The National Department of Health’s most senior pharmacy official Khadija Jamaloodien agreed that pharmacy posts should be distributed better. But she said work protocols dictate that state pharmacists must visit each clinic in their district at least once per month. She said there are 3 000 primary healthcare facilities in the country and 6 000 (albeit maldistributed) public sector pharmacists.

Nhlanhla Mafarafara, President of the SA Association of Hospital and Institutional Pharmacists, told Spotlight too many of the almost 6 000 pharmacists in the public sector are doing stock management, dispensing, administration and management work in hospitals and pharmaceutical depots. He says the numbers do not necessarily reflect pharmacists in clinical or patient facing areas.

“The reality is that pharmacists are restricted to trying to get drug stock in and out,” Gray observed.

However, the lack of pharmacists and pharmacist assistants at clinics and hospitals means timely and/or knowledgeable ordering often results in shortages of essential medicines, something all experts interviewed for this article agreed on.

Mafarafara said that by defining what services a pharmacist should render and what’s needed to enable a quality service, more realistic staffing numbers could be reached. Pharmacies are central points in all hospitals, with closure for even an hour crippling a hospital. Thus, adequate staffing is critical to ensure uninterrupted access to good quality pharmaceutical care.

South Africa, Mafarafara added, was far behind many other countries in the effective use of pharmacists’ clinical expertise in leading evidence-based care in hospitals. “I’d even go so far as to say doctors should be stopped from dispensing in favour of pharmacists to improve quality of patient care,” he said.

‘If you don’t have a pharmacist, nothing gets done properly’

Jamaloodien said the cost of having too few pharmacists is more far-reaching than just antimicrobial resistance. “You can have stock outs because there’s nobody to manage the supply chain. In my experience, if you don’t have a pharmacist, nothing gets done properly,” she said.

Her solutions? Compliance with the “comprehensive and robust” evidence-based standard treatment guidelines, access to an updated and well-maintained cell phone-based application that gives everybody access to the latest information and medicine changes – and more attendance by all healthcare professionals of webinars held after every medicine’s committee meeting, plus clinicians regularly reading drug update bulletins to keep up with new medicines.

Republished from Spotlight under a Creative Commons licence.

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Navigating the Road to Universal Health Coverage in South Africa

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By Dr Reno Morar, Director: Medical School, Faculty of Health Sciences, Nelson Mandela University

Dr Reno Morar

Johannesburg, 20 November: As Director of the newly established Medical School in the Faculty of Health Sciences at Nelson Mandela University, I am honoured to lead South Africa’s tenth and youngest medical school. Our medical students exude an infectious spirit of hope and enthusiasm as we progress toward graduating our first cohort of Mandela Doctors in 2026.

As we navigate our journey at the medical school and within the Faculty, our goal is to successfully graduate composite health professionals who are equipped to serve our communities.

This journey is inextricably linked to a larger national goal: achieving Universal Health Coverage (UHC) for South Africa.

With the signing of the National Health Insurance (NHI) Act into law, South Africa stands at a pivotal moment in its healthcare journey. Achieving UHC promises equitable access to quality healthcare for all South Africans, regardless of income or location. But transforming this vision of UHC into reality requires much more than policy reflected in the NHI, it calls for robust planning, thoughtful resource allocation, and, above all, collaboration across sectors.

Our nation’s medical schools and higher education and training institutions are essential to the UHC journey in their support of South African’s human resources for health strategy. This strategy provides a foundation for advancing universal health coverage by ensuring healthcare professionals are appropriately trained to meet the demands of a redefined healthcare system.

These institutions play an instrumental role in building a workforce ready to support the NHI system. Lessons from our response to the recent COVID-19 pandemic have already shown us the power of unity; as we move forward, this spirit of collaboration between the public and private sectors will be crucial in shaping a resilient and inclusive healthcare system that can achieve UHC.

The NHI Act sets out to provide universal access to quality healthcare services, bridging disparities and delivering equitable access to essential services for all South Africans. However, the path to UHC is about more than access, it requires quality, efficiency, and sustainability across a restructured healthcare landscape.

Photo by Hush Naidoo Jade Photography on Unsplash

The government’s role here is pivotal – responsible leadership, resource allocation, and effective oversight are critical to building public confidence. This transition poses complex governance and constitutional challenges.

Implementing the NHI Act requires establishing new accountability mechanisms, redefining roles, and reassessing funding streams. Addressing these structural challenges – especially in under-resourced and underserved regions – demands both strategic mindset and practical capacity to adapt quickly to evolving needs.

Many of South Africa’s rural and township communities face significant shortages in healthcare resources and access to quality services. For NHI to succeed in these settings, dedicated efforts in providing adequate healthcare infrastructure and equipment, staffing, and strong governance and leadership are essential.

Achieving the ambitious goals of NHI without a solid foundation in governance and accountability would be a costly misstep. The success of NHI demands careful, evidence-based planning with clear goals and accountability.

This approach will require decades of commitment, with the understanding that universal healthcare frameworks often take generations to mature fully. NHI will not be a quick fix, but with meticulous preparation, it has the potential to become a sustainable, far-reaching health system intervention.  

Government planning must also account for the rapidly changing landscape of healthcare needs and technology. South Africa’s healthcare system must prepare not only for current demands but also for future challenges, including digital healthcare infrastructure and data security.

Protecting patient information and ensuring uninterrupted services is paramount in a digital age where data breaches are a constant risk. Recent experiences with cybersecurity issues in the National Health Laboratory Services underscore the importance of proactive measures in this domain.

The pandemic has taught us the power of unity in times of crisis. During COVID-19, South Africa’s public and private healthcare sectors demonstrated resilience, adaptability, and a shared commitment to public health. This partnership was instrumental in resource-sharing, patient care, and vaccine distribution.

It serves as a powerful reminder that as the NHI system is implemented over the next 10 to15 years, the system will benefit from a collaborative model where the expertise and resources of the private and public sectors complement each other in the public interest and wider community access.  

Collaboration between the public and private sectors must focus on expanding healthcare infrastructure, enhancing service delivery in underserved areas, and integrating innovative technologies for more efficient patient care. By working together, public and private sectors can foster a healthcare environment that maximises strengths and mitigates gaps in service. 

To sustain the implementation of the NHI system, South Africa needs healthcare professionals equipped to handle both the scope and scale of this vision. Medical and health professions education must adapt and evolve to meet these challenges, training future healthcare providers not only in clinical skills but also in adaptability, empathy, and resilience.

At Nelson Mandela University’s Faculty of Health Sciences, we prioritise these qualities, embedding community-based learning and problem-solving into our curriculum to prepare graduates for a diverse and demanding healthcare landscape.

Students experience firsthand the disparities within South Africa’s healthcare system, and this allows our students to develop the necessary understanding of the realities their future patients face.

Our programme equips them to work in a wide array of settings – from rural clinics with limited resources to state-of-the-art urban facilities. This holistic training ensures our graduates are capable of addressing the multifaceted healthcare challenges with the empathy and innovation necessary to serve our communities across South Africa.

The journey toward UHC and the implementation of NHI system is both inspiring and challenging. It is a bold declaration of South Africa’s commitment to affordable universal access to quality health care services, healthcare equity – and must be approached with open eyes and a steady hand.

Our success will depend on a combination of strategic planning, effective governance, and a commitment to collaboration across sectors.

South Africa has a unique opportunity to build a healthcare system that is equitable and resilient. By prioritising these foundational steps, we can pave the way for a healthcare system that genuinely serves all South Africans, one that fulfils the promise of our constitution and reflects the spirit of our democracy. The future of our healthcare system is within our hands, but only if we approach it with responsibility, collaboration, and a deep commitment to the well-being of all our people.

It will be an intensely proud South African moment when we graduate our first 45 Mandela Doctors from our medical school in 2026! As South Africans, we also want to be proudly South African about the health system we build for and with our people. 

Categories : Expert Opinion IT in HealthcareTags :

Dr Jessica Voerman Highlights Key Healthcare Trends to Watch for in 2025 

On By ModernMedia
Source: Pixabay CC0

The healthcare landscape is rapidly evolving, and 2025 is poised to bring significant changes driven by technological advancements and shifting patient needs. As the sector faces ongoing challenges such as rising costs, limited access, and increasing demand for mental health services, innovative solutions will be key to addressing these issues. From the rise of virtual healthcare and wearable technologies to the growing influence of artificial intelligence, these trends are reshaping how care is delivered and experienced.

“The healthcare sector must embrace innovation to address challenges like affordability and accessibility while leveraging technologies such as AI, virtual healthcare, and wearables to reshape how we deliver care,” said Dr Jessica Voerman, Chief Clinical Officer at SH Inc. Healthcare.

KEY TRENDS POISED TO DEFINE HEALTHCARE IN 2025

  1. RISING HEALTHCARE COSTS AND ACCESS CHALLENGES
    As we approach 2025, the escalation of healthcare costs is expected to persist, with medical aid contributions outpacing inflation and the general expense of healthcare services becoming increasingly burdensome. This growing financial pressure is placing significant strain not only on patients, but also on healthcare providers and the broader healthcare system. In response, identifying and implementing innovative solutions to alleviate this looming financial crisis remains a critical priority for healthcare businesses nationwide. For many South Africans, the rising cost of healthcare is exacerbating issues of accessibility and affordability, with an increasing number of individuals unable to access necessary medical care. In light of this, we anticipate a strong focus on policy reform aimed at addressing these inequalities. As such, addressing healthcare disparities will continue to be a central theme in the ongoing development of healthcare policies and initiatives in the coming years. 
  2. INCREASING DEMAND FOR MENTAL HEALTHCARE SERVICES
    One of the most prominent shifts anticipated in the healthcare landscape by 2025 is the significant rise in demand for mental healthcare services. The recognition that mental health is integral to overall well-being has led to a growing push to integrate mental health services into primary healthcare systems. Such integration is proving to be both preventative and curative, as early intervention can improve long-term outcomes. Furthermore, mental healthcare is particularly well-suited for the adoption of digital health tools, such as virtual consultations, which can enhance access to care, particularly in underserved or rural areas. The increased focus on mental health will likely continue to drive growth in this sector, as more individuals seek professional support to manage mental health challenges. 
  3. EXPANSION OF VIRTUAL HEALTHCARE
    The trend towards virtual healthcare is expected to continue its upward trajectory in 2025, as more patients turn to telemedicine as either a primary or supplementary means of accessing healthcare services. According to a McKinsey report, telemedicine is projected to account for more than 20% of outpatient consultations by 2025. This shift is expected to be particularly pronounced in areas such as primary healthcare, chronic disease management, dermatology, and mental healthcare. Virtual consultations offer patients the convenience of receiving care remotely, which can help to reduce barriers related to distance, time, and accessibility. For healthcare providers, virtual healthcare offers opportunities to streamline services, increase operational efficiency, and reach a broader patient population. 
  4. THE ROLE OF WEARABLES AND HEALTH DATA COLLECTION
    Wearable health technologies, including biosensors capable of monitoring, transmitting, and analysing vital signs, represent another exciting frontier in digital health. These devices have the potential to revolutionise the management of both acute and chronic conditions by providing continuous, real-time data that can inform clinical decision-making. With their ability to track everything from heart rate and blood glucose levels to oxygen saturation and sleep patterns, wearables offer unprecedented insights into an individual’s health status. This wealth of data has the potential to improve patient outcomes, empower individuals to take a more proactive role in managing their health, and help healthcare providers tailor interventions more precisely. As these technologies evolve, they will become an increasingly important tool in both disease prevention and management. 
  5. THE GROWING IMPACT OF ARTIFICIAL INTELLIGENCE (AI)
    Artificial intelligence (AI) continues to make significant strides in healthcare, particularly in areas such as clinical decision-making, diagnostics, and operational efficiency. AI algorithms have demonstrated their ability to improve the speed, accuracy, and reliability of diagnoses, enabling healthcare professionals to make more informed decisions. Furthermore, AI-driven tools are improving clinical workflows, optimizing resource allocation, and enhancing the overall patient experience. In the realm of surgery, robotic-assisted technologies are increasingly being used to improve the precision of procedures, reduce the risk of human error, and shorten recovery times for patients. Additionally, the use of virtual and augmented reality technologies in medical training and physical rehabilitation is gaining traction, offering immersive, interactive experiences that improve learning outcomes and accelerate recovery for patients.

Looking ahead to 2025, healthcare is set to evolve rapidly, driven by technological advancements and growing demand for accessible, affordable care. Key trends such as rising costs, expanded mental health access, virtual healthcare, wearable technologies, and artificial intelligence are reshaping the sector.

For businesses and policymakers, staying ahead of these changes is crucial to ensuring sustainable, equitable, and effective care. By embracing digital tools, AI, and data-driven solutions, the healthcare system can improve both patient outcomes and overall efficiency. Collaboration and innovation across all sectors will be essential to meeting the evolving needs of patients and society.

Categories : Healthcare Politics and RegulationsTags :

The NHI Act: a Flawed Execution of a Laudable Idea

On By ModernMedia

By Prelisha Singh, Partner, Martin Versfeld, Partner and Alexandra Rees, Senior Associate, Webber Wentzel

Robust contestation on how to best fulfil the fundamental rights of South Africans complements and strengthens our constitutional democracy. Recent debate has centred on the effective realisation of the right to access healthcare, which the state is required progressively to realise for all South Africans, irrespective of their background and income.

The right to access healthcare came into sharp focus on 15 May 2024, when President Cyril Ramaphosa signed the National Health Insurance (NHI) Act into law, prompting the initiation of constitutional challenges by concerned stakeholders. The most recent of these was filed on 1 October 2024 in the North Gauteng High Court, Pretoria by the South African Private Practitioners Forum (SAPPF), represented by Webber Wentzel.

According to the government, the NHI Act is intended to generate efficiency, affordability and quality for the benefit of South Africa’s healthcare sector.

An assessment of South Africa’s current healthcare landscape shows a stark difference between private and public healthcare. The country has a high quality, effective private healthcare offering. However, it is currently inaccessible to the many South Africans who cannot afford private care or medical aid payments. Public healthcare, on the other hand, is understaffed, poorly managed and plagued by maladministration and limited facilities.

The NHI Act has been positioned as the vehicle to address this disparity and a desire to take steps towards achieving universal healthcare in South Africa. But a closer reading of the Act highlights numerous problems with its content and implementation design. The absence of clarity, detail or guidance contained in the Act makes it impossible to assess how the Act will actually be implemented (or, by extension, what the effects of this implementation will be).

This is particularly concerning given that years have passed since the economic assessments, on which the Act was based, were undertaken. Also problematic is the apparent lack of consideration given by the government to submissions made by affected stakeholders during multiple rounds of constitutionally required public participation.

SAPPF underscores these deficits in seeking both to have the President’s decision to assent to the Act reviewed and set aside, and the Act itself declared unconstitutional.

President Ramaphosa was obliged, in terms of sections 79 and 84(2)(a) to (c) of the Constitution, not to assent to the Act in its current form. Section 79 requires the President to refer back to Parliament any bill that he or she believes may lack constitutionality. In this case, it is difficult to conceive how the President, or any reasonable person in the President’s position could not have had doubts regarding the constitutionality of the NHI Bill. The decision by the President to sign unconstitutional legislation into law, instead of referring it back to Parliament for correction, is also irrational.

The President’s duty properly to have referred the NHI Bill back to Parliament is affirmed by the fact that the President is enjoined, by section 7(2) of the Constitution, to respect, protect, promote and fulfil the rights contained in the Bill of Rights.

SAPPF’s application demonstrates that the NHI Act, in its current form, infringes upon the rights to access healthcare services, to practice a trade, and to own property. Patients, including those using private healthcare, will be forced to use a public healthcare system that currently fails to meet its key constituents’ needs. Practitioners’ rights to freedom of trade and profession will be infringed upon, and the property rights of medical schemes, practitioners, and financial providers will be unjustifiably limited.

On its current text, the Act could make South Africa the only open and democratic jurisdiction worldwide to impose a national health system that excludes by legislation private healthcare cover for those services offered by the state – notwithstanding the level or quality of case.

Concerns regarding the rights infringements in the NHI Act are exacerbated by its lack of clarity and the fact that crucial aspects of its implementation are relegated to regulations, with no clear guidance provided in the Act itself.

For example, section 49 provides that the NHI will be funded by money appropriated by Parliament, from the general tax revenue, payroll tax, and surcharge to personal tax. However, this stance does not reconcile with section 2, which provides that the NHI will be funded through ‘mandatory prepayment’, a compulsory payment for health services in accordance with income level. Crucially, the extent of the benefits covered by the NHI’s funding mechanism and its rate of reimbursement, which impact affordability and the provision of quality healthcare, remain unknown.

The Act is, at best, a skeleton framework, seemingly assented to in haste. It is conceptually vague to the extent that the rights it seeks to promote will, in fact, be infringed if implemented. This renders the Act irrational, in addition to its other constitutional defects.

The NHI Act represents a radical shift of unprecedented magnitude in the South African health care landscape. This should be – and is required to be – underpinned by meaningful public participation, up-to-date socio-economic impact assessments and affordability analyses and final provisions that provide a clear and workable framework for implementation.

It is not sufficient for these vital issues to be addressed after the fact. Further engagements with stakeholders and the solicitation of proposals by the government cannot be used to splint broken laws. Collaborative engagement, including the solicitation of inputs for meaningful consideration, should take place during the law-making process, not after its conclusion.

A shift of the magnitude proposed by the Act, absent compliance with the structures of the law-making process and adherence by the state to constitutional standards, including rights protections, would be detrimental to the entire healthcare sector – public and private – and not in the best interests of patients and practitioners.

Notwithstanding the legal contestation surrounding the Act, it and the laudable goals underlying it can also be a watershed. The achievement of universal health coverage is an opportunity for the different stakeholders in South Africa’s healthcare system to meaningfully collaborate and inform well-supported, factually informed, rational and genuinely progressive legislative steps by the state.

Given the questions surrounding the Act and the evident need it seeks to address, the space exists for healthcare stakeholders to align around shared goals and values. They can leverage their available resources to design a healthcare system that serves all of South Africa’s people fairly and equitably, using the significant existing resources invested in the country’s healthcare sector.

Categories : Expert Opinion Healthcare Politics and RegulationsTags :

Building a Patient-centric Healthcare Ecosystem in SA: A Bold New Vision

On By ModernMedia
Bada Pharasi, CEO of The Innovative Pharmaceutical Association of South Africa (IPASA)

Imagine a healthcare system which ensures that every patient’s voice helps shape their treatment, where barriers to life-saving care are dismantled, and where innovation is driven by meaningful collaboration. In South Africa, this vision is no longer a distant aspiration; it’s an urgent mission to create a system that truly serves its people, writes Bada Pharasi, CEO of the Innovative Pharmaceutical Association of South Africa.

South Africa’s healthcare system stands at a critical crossroads. Despite remarkable medical advancements, countless patients remain on the sidelines, hindered by financial, regulatory, and logistical barriers. Today, there’s an opportunity to reshape this reality by building a patient-centred healthcare model that expands access, amplifies patient voices, and creates strategic partnerships.

Empowering patient voices

In a truly inclusive healthcare system, patients aren’t just recipients of care; they are active contributors. By integrating patient perspectives into decision-making, healthcare becomes more responsive to those it serves. 

Through collaborations with patient advocacy groups, educational campaigns, and year-round initiatives, there’s a growing movement to create an environment in which patients feel heard and empowered to influence the care they receive. While events such as World Patient Safety Day help highlight the importance of prioritising patient needs, the goal is to make this a constant focus, not just an annual observance.

Key prerequisites for achieving this are efficient regulatory frameworks, impactful public-private partnerships, rare disease management, and a true commitment to innovation. 

Streamlined regulatory partnerships

Timely access to groundbreaking treatments depends on efficient regulatory frameworks. Collaborating closely with regulatory authorities such as the South African Health Products Regulatory Authority (SAHPRA) is pivotal in expediting access to new therapies. 

Such partnerships ensure that treatments meet rigorous safety standards while streamlining approval processes so that life-changing therapies reach patients without unnecessary delays. Maintaining high standards for post-market safety also strengthens public trust and reinforces the resilience of the healthcare system.

Public-private partnerships: Catalysts for innovation

Expanding access to quality healthcare in South Africa demands strong public-private partnerships (PPPs) that leverage both public resources and private sector innovation. 

Collaborative efforts with the Department of Health and other key stakeholders maximise impact by ensuring that resources are effectively allocated and that patients benefit from the latest treatments. These alliances are vital for achieving universal health coverage (UHC) under the National Health Insurance (NHI) framework, helping to ensure that equitable, high-quality healthcare becomes a reality for all.

Closing gaps in rare disease management

For patients with rare diseases, access to treatment is often riddled with obstacles, from limited therapies and high costs to a lack of awareness. Multi-stakeholder collaborations, including advisory boards initiated by organisations such as Rare Diseases South Africa, bring together patients, healthcare professionals, and industry experts to advocate for better support and access to treatments. 

This prioritisation of open communication and patient-centred outcomes offers hope to rare disease patients who, through these partnerships, gain better access to essential treatments and the support they deserve.

Breaking down barriers to innovation

The drive for a more accessible healthcare system also requires addressing policy barriers. Streamlined processes, simpler registration pathways for new drugs, and patient-centred reimbursement policies ensure that patients receive the right treatment at the right time. 

Working alongside policymakers, healthcare providers, and civil society, a concerted effort is being made to create a system in which innovation and equity go hand-in-hand to provide better outcomes and quality of life for all South Africans.

Shaping the future of healthcare

The future of South Africa’s healthcare lies in a system that prioritises patients, breaks down barriers, and capitalises on partnerships to make innovation accessible. 

The call to action is clear: build a healthcare ecosystem that is dynamic, inclusive, and adaptable to ensure that every South African has access to the care they need. By promoting patient voices and ensuring collaboration across sectors, we can transform South Africa’s healthcare system to be more responsive, resilient, and equitable – a system that truly serves its people.