South Africa’s president Cyril Ramaphosa on Wednesday signed a new law which aims to provide universal healthcare, two weeks before a general election and despite pushback from the opposition and business groups.
The fund established under the law will provide healthcare for all at rates to be determined by the government, in one of the world’s most unequal nations.
“The National Health Insurance (NHI) is a commitment to eradicate the stark inequalities that have long determined… who receives adequate healthcare and who suffers from neglect,” Ramaphosa said at a televised signing ceremony in Pretoria.
However, it could take years to put the system into practice around the country, experts say.
MPs approved the controversial new law in June last year after years of debate and consultation.
“The provision of healthcare in this country is currently fragmented, it is unsuitable and it is wholly unacceptable,” Ramaphosa said.
The president slammed the opposition which has been critical of the new law and insisted that South Africa was acting in line with a global commitment.
“Those who are trying to hold us back… are completely out of line,” he said.
South Africa inherited 14 health systems from the apartheid era.
A merged system has limped along post-1994 to spark a parallel industry of private but pricey quality care, which the state argues is unfair and unsustainable.
In 2022, only eight million of South Africa’s 62 million people had access to private medical care, with the rest entirely dependent on the government, according to government figures.
The fund would redress the burdened public healthcare system and the private sector’s unaffordability, the president said.