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10.4.1.4. National Health Insurance Act of 2023 To educate people about National Health Insurance,
The National Health Insurance Act No 20 of 2023 SAMRC created a universal health coverage/ National
was signed into law by President Cyril Ramaphosa in Health Insurance (UHC/NHI) Forum which is an open
May 2024 and its aim is “to achieve universal access meeting for those interested in developments,
to quality health care services in the Republic in learning and plans related to the UHC and NHI in
accordance with section 27 of the Constitution; to South Africa and globally. The seminar focuses on
establish a National Health Insurance Fund and to set providing an update on the policy and legislative
out its powers, functions and governance structures; progress made in moving towards UHC through the
to provide a framework for the strategic purchasing phased implementation of NHI, using a progressive
of health care services by the Fund on behalf of users; and pragmatic approach based on availability of
to create mechanisms for the equitable, effective and financial resources.
efficient utilisation of the resources of the Fund to
meet the health needs of the population; to preclude 10.4.1.5. State of Health in South Africa
or limit undesirable, unethical and unlawful practices South Africa has made significant strides in improving
in relation to the Fund and its users; and to provide its health status over the past few decades. However,
2
for matters connected herewith” . the country still faces a huge burden of four colliding
epidemics as addressed in the table below.

Maternal and Child • Despite substantial investment in health in South Africa, maternal, perinatal and neonatal outcomes
Health remain suboptimal, particularly in the Free State, North-West, Limpopo and Northern Cape provinces
HIV and • Substantial advances made in treatment of HIV and tuberculosis in last 30 years.
tuberculosis • Improved clinical services and robust programmatic care, including Nurse Initiated
Management of Anti-Retroviral Therapy (NIMART), and better drugs
• However, national cascades of care for HIV and tuberculosis
Non-communicable • Chronic underinvestment in NCDs
diseases • An epidemic of NCDs, driving morbidity and mortality
• Lack of integration of clinical services
• Intersection of infections and NCDs warrants serious attention
• Hostile environment characterised by worsening social disparities and social determinants of
health
Violence and Injury • Unacceptably high rates of injury and gender-based violence rooted in patriarchy and a history
of violence

A 2019 consensus report of South African Lancet diagnostic findings and proposed four overarching
National Commission, titled “Confronting the recommendations for which their implementation
right to ethical and accountable quality health require investment, responsibility and accountability
care in South Africa” highlighted the following key on the part of all health system leaders :
3

2 Act_20_of_2023_National_Health_Insurance.pdf (parliament.gov.za). Accessed 13 September 2024
3 South African Lancet National Commission. Confronting the right to ethical and accountable quality health care in South Africa:
A consensus report. Pretoria: National Department of Health, 2019

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