South Africa: Motsoaledi Advocates for Universal Health Coverage

In an address marking Universal Health Coverage (UHC) Day 2025, Health Minister Dr Aaron Motsoaledi has examined South Africa’s healthcare system, challenging the current model of healthcare financing and advocating for transformative change.

“We are sick of unaffordable health costs,” Motsoaledi said in Pretoria on Friday, highlighting the day’s theme.

Universal Health Coverage Day advocates for urgent government efforts to implement UHC, ensuring that everyone can access quality healthcare services without facing financial hardship.

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This global campaign is led by the UHC2030, which is a global, multi-stakeholder platform for accelerating sustainable progress towards UHC. It is hosted by the World Health Organisation (WHO), in collaboration with the World Bank and the Organisation for Economic Cooperation and Development (OECD).

The Minister’s speech traced the historical transitions in healthcare, drawing on The Lancet’s analysis report of three critical epochs, including sanitation, vaccination, and now, UHC.

“The Lancet says the third transition is on the horizon, and it will signify the time when people don’t have to pay cash for their healthcare needs.”

Motsoaledi said the financialisation of health referred to a growing influence of financial markets, investors, and corporate interests in the healthcare sector.

“Nobody invests money without expecting profit. But should we do that with sick people,” he questioned.

The Minister shared examples of how financial motivations compromise healthcare, including an anecdote about an elderly patient being prepared for surgery without clear consent or medical necessity.

“Healthcare becomes unaffordable for poor and marginalised communities, exacerbating disparities and inequalities,” Motsoaledi said, adding that the current system prioritises profits over patient well-being.

NHI

The Minister said the solution is the National Health Insurance (NHI), which he described as “a strong global antidote to financialisation of health”.

South Africa has made significant progress toward achieving UHC with the introduction of the National Health Insurance (NHI).

The NHI is based on the establishment of a single purchaser, the NHI Fund, which will acquire healthcare services from accredited and contracted providers in both the public and private sectors.

This initiative aims to ensure that all citizens receive quality, affordable healthcare without facing financial hardship.

This is despite significant legal threats and challenges facing the implementation of the NHI Act, which is part of the country’s transformative agenda.

He also spoke about a UHC model focusing on comprehensive care that particularly protects women and children, who are “the biggest losers in a financialised system.”

He also touched on South Africa’s potential to lead global healthcare transformation, drawing on the country’s successful HIV treatment campaign of 2010 as proof of what can be achieved when healthcare is prioritised over profit.

The Minister traced significant public health achievements, particularly in HIV/AIDS treatment, where maternal mortality rates dramatically decreased from 240 to just below 99 per 100 000 live births around 2019.

He highlighted the affordability of a new HIV treatment, lenacapavir, initially priced at US$28 000 per person, now available for US$40 thanks to the Global Fund and other organisations.

South Africa plans to launch lenacapavir, a groundbreaking long-acting HIV prevention method, as early as March 2026.

“We are at the verge of eliminating HIV AIDS as a public health threat in our lifetime,” the Minister said.