Pandemic likely to delay NHI rollout

Johannesburg – As the country prepares for the massive rollout of vaccines to curb the spread of Covid-19, the implementation of another crucial health intervention, the National Health Insurance (NHI), looks set to be delayed.

President Cyril Ramaphosa challenged his colleagues in the ANC national executive committee lekgotla meeting at the weekend to discuss the impact of the pandemic on the country’s ability to proceed with NHI.


The lekgotla includes ANC allies the SACP and Cosatu, the two strong proponents of universal healthcare who helped catapult Ramaphosa to the Union Buildings. Delivering a political overview, the president said his comrades should pay attention to the impact of coronavirus on the nature, scale and pace of the rollout of the policy.

“While the pandemic has underscored the need for the NHI, we must look at what impact it has had on our ability – whether from a capacity or fiscal position – to proceed with the implementation of the NHI,” he said.

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The NHI – which is a health financing system that is designed to pool funds to provide access to quality affordable personal health services for all South Africans based on their health needs, irrespective of their socio-economic status – is one of the ANC’s biggest policy interventions post the 1994 democratic breakthrough. It has been opposed by opposition parties such as the DA and medical aid schemes.

A Cosatu official who attended the virtual meeting said their interpretation of Ramaphosa’s statement was that the deadly virus was going to delay the implementation of the NHI.

“I think he meant our healthcare system is battered and needs a lot of work. It [Covid-19] will delay rollout,” he said.

Ramaphosa also noted the impact of the pandemic on other diseases, saying there had been “slippages” on other health services, including child immunisation and HIV and TB programmes.

“This may cause public health challenges further down the line. We have heard that a number of our people have not been showing up at health facilities for chronic medication.”

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As the government scrambles for cash to fund the procurement of vaccines amid criticism that the country dropped the ball in joining the vaccine race late, the president told the meeting that his administration’s first source of funding for doses would be the fiscus.

“This is a public good that is vital to the wellbeing of all our people and it is therefore correct that public funding should be used, even if this means increasing public borrowing.”

While South Africa had extensive experience in the development, trial and manufacture of vaccines, the country was not prepared to tackle Covid-19, Ramaphosa said, adding that there needed to be investment in South Africa’s vaccine development and production for future pandemics.

“This continent should never again find itself in a situation where it must rely on others outside of our continent to immunise its population against a devastating disease.”

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