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8 August 2019


SANAC Civil Society Forum welcomes the release of the NHI Bill and supports the objectives of the establishment of the NHI fund. Our submissions to the Draft Bill in September 2018 have been captured to our satisfaction. We are happy, we are in full support and we are ready to engage in this journey as society will debate this bill to ensure it reflects our views of what universal health coverage should be in line with Section 27 of the South African Constitution.

We would like the public consultation to be meaningful, but at the same time move with speed so that the National Health Insurance can be enacted as an Act of Parliament so that implementation can happen. We do not want the engagement to happen longer than it is necessary as some processes happen forever. We have called for the NHI, and we make this call now again that we want the NHI now!

As civil society we appeal that this Parliamentary process should not be delayed in order to satisfy private sector lobbyists, or any lobbyist whose purpose is to delay, frustrate or design ways in which to financially benefit from the NHI whilst the health provision does not improve. Parliamentarians serve at the behest of the people, and this Parliament should ensure that before its current term ends in 2024, this NHI should long have been passed and enacted as an Act. We don’t want to see Parliamentary capture.

As SANAC Civil Society Forum, we have long called for implementation of universal health care system in South Africa. When the idea of the National Health Insurance (NHI) was introduced many years ago, we were very excited that our call for a universal health system will be realized. We didn’t know that many years later, we would still be talking, advocating and fighting for the NHI instead of seeing it being rolled-out. The delay in our view, was as a result of 2 main stumbling blocks viz:

  1. Private sector hell-bent maximizing profit by excluding the majority of South Africans, especially poor people from accessing health services through “stealing money meant for the public health system to subsidize private health system by sustaining apartheid era medical aid tax benefits. This has resulted in South Africa currently spending 8.5% of GDP on health care with the private sector spending 4.4% of GDP on health which benefits only 16% of the population.
  2. Government kowtowing to the whims of the private sector and in the process failing in its duty to ensure that Section 27 of the Constitution is implemented, which simply enjoins government to provide quality health service to the population. This has resulted in South Africa currently spending 8.5% of GDP on health care with the public sector spending 4.1% of GDP on health care for 84% of the population.

We are happy now that government is governing once more in terms of the NHI.

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. Transforming the South African society requires that we put people before profits.

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. Communities must rise and confront Afro-pessimism agents, particularly those who have strategically placed themselves at the ‘centre’ of the health services on behalf of communities when in fact they are opponents of the values of the Constitution of South Africa and Agenda for Sustainable Development Goals – a universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity.

The people, especially the African poor majority are most affected by HIV and TB, and they rely solely on the public health system for treatment. The NHI seeks to improve and support the public health system, and this will result in immense benefits for the people. With such an approach, we will see the people through their communities taking their place at the front, center and back of the their health needs, and by extension the response to end HIV and TB.

The SANAC CSF we call for the redirection of health financing and accountability through the NHI to address community systems strengthening. This goes beyond the challenges confronted by the narrow bio-medical centred definition of health as pursuing “absence of disease and infirmity” that is offered by current health systems (both public and private) through the administration of drugs, to be replaced by a broader community capacity enhancement based definition of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” At the centre of this approach is the NHI.

We are fully behind the ANC led government, the President, the Minister and Deputy Minister of Health, all progressive MPs and civil society formations that are involved in ensuring we realize the NHI in our lifetime. We will use all power and influence we have to be active agents in this journey.


For more information and interviews, contact:



Mabalane Mfundisi

SANAC Resource Mobilization Committee Co-Chairperson

SANAC Civil Society Forum

078 683 9535


Solly Nduku

Deputy Chairperson

SANAC Civil Society Forum

081 059 6113