In his budget vote speech delivered to Parliament on 15 May 2018, Minister of Health Aaron Motsoaledi, quoting the President of the Republic of South Africa, said: “The time has now arrived to finally, implement Universal Health Coverage through the National Health Insurance.”

The National Health Insurance (NHI) is a financing system that will make sure that all citizens of South Africa (and legal long-term residents) are provided with essential healthcare, regardless of their employment status and ability to make a direct a monetary contribution to the NHI Fund. In other words, the NHI is a health financing system that is designed to pool funds to purchase and provide access to quality and affordable healthcare services for all. The Department of Health (DoH) argues that “healthcare is a human right – this is a widely accepted international principle. This right should not depend on how rich we are or where we happen to live”.

The proposed implementation of the NHI in South Africa is consistent with international, regional and domestic rights frameworks. Internationally, South Africa ratified the International Covenant on Economic, Social and Cultural Rights (ICESCR) in 2015. The ICESCR (Article 12) underpins the right to health, recognizing the right of everyone to “the enjoyment of the highest attain Domestically, the Constitution of South Africa, Section 27 (Health Care, Food, Water and Social Security) reaffirms this right. It states in Section 27(1a), “everyone has the right to have access to healthcare services, including reproductive healthcare”. The progressive realization of this right will contribute to a healthy population that benefits the entire nation. Furthermore, the provision of the NHI could potentially move the country one step forward in achieving the Sustainable Development Goals (SDG), Goal 3 – “Good health and well-being for people”.

Amnesty International South Africa (AISA) supports the move by the South African government
to improve access to the right to health, and to provide Universal Health Coverage (UHC) for all. With this in mind, we call on the government to ensure that the NHI moves beyond rhetoric into concrete application and benefits for all. From our initial scoping analyses, we have observed numerous challenges to overcome: For the NHI to work effectively, the DoH urgently needs to improve the quality of service in most public facilities, it needs to address the shortage of medical practitioners and specialists in the public system and it has to tackle the persistent problem of
institutional discrimination faced by people when trying to access healthcare services.

AISA further calls on the DoH to work towards addressing the unacceptably high rates of maternal
mortality. It needs to improve access to healthcare facilities for pregnant women as well as information dissemination to maternal health patients and healthcare workers. This is consistent with the recommendations in our research titled ‘Struggle for Maternal Health: Barriers to Antenatal Care in South Africa’.
AISA commits to hold the government accountable as we continue to measure the progress made in the implementation of the NHI, and the progressive realisation of the right to health for all.


This article first appeared in LESEDI, a publication of Amnesty InternationalSouth Africa

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Samson Ogunyemi
Samson Ogunyemi 1 posts

Economic, Social & Cultural Rights Officer, Amnesty International South Africa

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