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3 July 2019





The ANC resolution on the NHI, just to remind Cabinet states that “The ANC must ensure that legislative framework on the NHI must be finalized by end of the current term”. The current term ended on 8 May 2019 and there was dololo NHI legislative framework.

As long as this NHI Legislative Framework is not in Parliament, all pronouncements are just rhetoric that promises South Africans universal health coverage, whilst in reality there is no political will. The political will must be matched by actions.

We remain hopeful that the current ANC government will not provide excuses for its failure to deliver on this simple but necessary requirement to change the legacy of apartheid.

We were disappointed that ANC led Cabinet in their last meeting of 2018 that took place on Wednesday, 5 December 2018 failed to execute the organisation’s December 2017 ANC Conference Resolution on the National Health Insurance (NHI). Cabinet failed to release the NHI Bill to go through Parliamentary processes, and even to date, this NHI Bill has not gone to Parliament.

Capitulation to the whims of the minority views of business, opposition political parties and social partners by not releasing the revised Bill in 2018 is betrayal of the resolution of the ANC branches and by extension the South African population who voted for the ANC. Simply put, Cabinet failed to do the simple thing – approve the NHI Bill so that this long journey can come to an end. We hope that when the NHI Bill is released in 2019, it will be more radical than the Bill that was presented for public comment in June last year.

As Civil Society Forum together with other actors in civil society, we will meet between 4 – 5 July 2019 at Kopanong Conference Centre to engage in a consultation about Universal Health Coverage choice for South Africa in the form of NHI. We will sharpen our inputs to call on government to make the correct pronouncements at the United Nations High Level Meeting that President Cyril Ramaphosa will attend in September 2019 that will focus on Universal Health Coverage. We are too tired of talking, of pronouncements, we need action matched by political will.

In the 2014 Manifesto, the platform through which the majority of South Africans gave the ANC the mandate to govern, the ANC promised the population that it will “Enter a new phase in the implementation of the National Health Insurance (NHI) through the creation of a publicly funded and publicly administered NHI Fund, strengthening and expanding the free primary health care programme, improving management of public hospitals, and reducing the costs of private health care”. In the 2019 Manifesto, the ANC declares that “The goal of achieving universal health coverage and overcoming our two-tier health system through the National Health Insurance (NHI) programme remains a central priority. The NHI will be publicly funded and administered to guarantee quality health care to all South Africans and will be free at the point of use. All South Africans should be covered by NHI by 2025. The tabling of the NHI Bill in parliament will be a crucial milestone for rolling out funding for universal access and implementing key elements of the NHI.”

It is not enough for the South African government, led by the ANC to make promises in the electoral manifestos and not do everything to fulfill those promises. It is not enough for the ANC led government to make statements on 12 December every year on Universal Health Day about supporting universal health coverage, as was the case in 2018 whilst the actions of Cabinet indicate a contrary approach. In September 2019, the United Nations is hosting High Level Meeting on universal health coverage, and once more the President will pronounce on the podium South Africa’s support in words but the deeds may once more indicate no appetite to implement. This pronouncement must be matched by an NHI Bill out for public engagements led by Parliament.

With a clear commitment in the electoral manifesto once more, as was the case in 2009, 2014 and now 2019 manifesto, supported by an unambiguous conference resolution of the ANC, we are perplexed as to why something so simple and important is not seen in the same light by the ANC President and Ministers deployed to Cabinet to deliver. Leaders, act now to deliver NHI as our choice of universal health coverage.

We call on Cabinet at its next sitting to do the right thing by approving the revised NHI Bill so that what the 5th Parliament couldn’t do, this 6th Parliament moves with speed to address. The NHI talk must translate into an NHI Act that must be implemented successfully. The NHI cannot only be something to be celebrated through glossy statements – it must be implemented and implemented now!

“We must fix the health system whilst we implement the NHI. Transforming access to health by all South Africans requires that we put people before profits of medical aids and those who are undermining government efforts under the guise that they are the voice of civil society who think they know best and have solutions whilst they advocate against NHI” says Steve Letsike, Chairperson of Civil Society Forum.

As CSF, there are two issues that are non-negotiable in the fixing of the public health system and these are effective and efficient management of human and materials resources as well as accountability mechanisms that must be enforced. Managers must manage and all health workers must execute their tasks without being forced to do so and communities must be partners in doing their bit to make the system work. We need one country with one health system. Secondly and most importantly we want to see the fixing of the health system being about community members taking health in their own hands because health starts at home, at school and in the community. Education, empowerment and ownership of health is key to fixing the health system.

These actions will demonstrate a commitment to move from talk to action. We require Cabinet to do the right and simple thing – approve the NHI Bill so that it goes to Parliament for debate informed by engagement with all interested stakeholders in health. We cannot fail the voting public by not providing them with access to health care because we must nurse the feelings of those who profit from people’s health, excluding them just because they do not have money to pay for medical care.

The NHI is a platform to ensure the spirit and the letter of section 27 of the RSA Constitution and the Article 12 of the United Nations Convent on Economic, Social and Cultural Rights, 1966 are realized, where the private sector is happy or not happy.

“During the Presidential Health Summit, through Commission 8 on Community Engagement, with one voice, as civil society we called for the fast-tracking the education, engagement and implementation in communities of NHI. We are starting 2019 where we will ensure that we go to the 9 provinces to do exactly what we said should happen” says Steve Letsike, Chairperson of Civil Society Forum. We fully support and are participating in the Presidential Health Compact. We are ready to sign the Compact, contribute as we have outlined and advocate for its implementation by all stakeholders.

SANAC Society Forum will continue to confront the highly racialised model of funding for the health in South Africa, as we are doing in terms of the HIV and TB response. We will continue fight against a system of funding that seeks to sustain an apartheid modus operandi that deepens inequalities along racial lines through patterns of development that restrict the lives of black South Africans.

Universal health coverage for all South Africans, and all people of the world is our goal.




For more information and interviews, contact:




Mabalane Mfundisi


Civil Society Forum Task Team on the NHI, UHC and Presidential Health Summit

SANAC Civil Society Forum

078 683 9535




The SANAC Civil Society Forum (CSF) is a formal advisory body established in 2012 by the South African National AIDS Council to facilitate the participation of Civil Society Organisations and networks, including those representing People Living with HIV, in the HIV and AIDS and TB within the National HIV response and for the implementations thereof National Strategic Plan (NSP) 2012-2016 through Sectors. It is made up of the following 18 sectors:

  1. People Living with HIV and AIDS (PLHIV) – N.B. The PLHIV sector is engaging on the NHI Bill and Presidential Health Summit processes outside of the CSF. This sector is advocating as part of the public users of health system. This statement does not represent the views of the PLHIV sector organisations. It must however be noted that the other 17 sectors represent and includes participation of People Living with HIV and those affected by HIV.
  2. Sex Workers
  3. Faith
  4. Higher Education
  5. Sport, Arts & Culture
  6. Labour
  7. Research
  8. Law & Human Rights
  9. Youth
  10. Men
  11. Women
  12. Non-Governmental Organisations
  13. Traditional Leaders
  14. Traditional Health Practitioners
  15. Health Professionals
  16. People with Disabilities
  17. Children
  18. LGBTIQ+ (Lesbians, Gays, Bi-sexuals, Trans-gender, Intersex, Queer & gender non-conforming people)

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