NHI presentation to parliament World Aids Day 2021


30 November 2021, Johannesburg — SECTION27 and the Treatment Action Campaign (TAC) will present our concerns with the National Health Insurance (NHI) Bill to the Portfolio Committee on Health in Parliament tomorrow, Wednesday 1 December 2021. 

1 December is commemorated around the world as World AIDS Day. While South Africa has made significant progress in tackling the HIV epidemic over the past twenty years, we still face significant challenges with testing for HIV, which have been exacerbated by the COVID-19 pandemic. According to research conducted by former National Department of Health DDG Yogan Pillay et al, there was a reduction of 3.44 million HIV tests conducted between March 2020 and December 2020 in comparison to the same period in 2019. We also have a retention crisis which has led to reduced viral suppression, meaning that the country lags behind in the 95-95-95 targets. With the continued impacts of HIV/AIDS, coupled with the added pressures of COVID-19, the need for quality universal healthcare coverage as envisaged by the NHI is as urgent as ever. 

Against this backdrop, SECTION27 and the TAC will present submissions about the NHI Bill to ensure that the unequal health systems in South Africa are bridged urgently and sustainably. While the NHI Bill offers crucial strides towards realising the goal of quality universal health coverage, we will communicate some serious structural and substantive concerns about the NHI Bill. These concerns do not detract from our belief in the need for and possibility of quality, universal health coverage. We welcome the opportunity to present our position to parliamentarians about the following:

  • The need for clearer governance structures embedded in the NHI Bill; 
  • Potential threats of corruption and mismanagement given the complexity and size of the NHI fund; 
  • The need to put principles of transparency, participation, rule of law and universality into practice through the Bill; 
  • Concerns about how the NHI will be financed;
  • The need to consider Competition Law and the findings of Health Market Inquiry 
  • The urgent need to build consensus surrounding health reform and practically move beyond current stalemates to realise the vision of an equal, equitable and quality unified healthcare system that all South Africans want and are constitutionally entitled to.

As it stands, we believe that considerable work is needed to make the proposals of the NHI Bill comprehensive, coherent, coordinated and constitutionally compliant. Nonetheless, we remain committed to advocating for a health system that benefits all who live in South Africa. 

Our oral presentation will be based on written submissions that we made to the portfolio committee in 2019. The written submissions were endorsed by twelve civil society organisations working in the social justice and healthcare sectors. They were further informed by community dialogues that we held, including 1280 people across seven provinces and the results of a survey to which 232 responded. 

In addition, our submissions will consider updated research from interviews with 33 key stakeholders across the health system, including the health officials, academia, unions, medical schemes, private health providers, health journalists, regulators, and public tertiary hospital managers. This research, which was conducted by SECTION27 and Concentric Alliance will be published in the form of a report entitled “Health Reform: Perspectives and Proposals” on Wednesday. An embargoed copy of the report is attached. The report can be quoted and published after 12pm midday on Wednesday 1 December 2021. 

Despite our context of financial constraints, an ongoing pandemic and a lack of trust across the system, we believe that this portfolio committee on health can – and must – do much more to move forward health system reform and advance the rights of everyone in South Africa to equality, dignity and to access healthcare. 

Our submission will be made virtually on Wednesday 1 December 2021, from 10:00 to 12:00. Proceedings will be streamed live on Parliament’s YouTube Channel: https://www.youtube.com/channel/UC-JR9Voq8LwxPCxKwqieRpQ 

For media queries, contact:

Please note the embargo on the Health Systems Reform report. Embargo lifted on Wednesday 1 December 2021 at 12pm midday.