President Cyril Ramaphosa, joined by Health Minister Dr Joe Phaahla and other officials, signed into law the National Health Insurance (NHI) Bill which directs the transformation of South Africa’s healthcare system to achieve universal coverage for health services and overcome critical socio-economic imbalances and inequities. Picture: GCIS
The UN’s office in South Africa has hailed the signing into law of the National Health Insurance (NHI) bill.
It said it was convinced that the signing was a step in the right direction. President Cyril Ramaphosa signed the bill on Wednesday despite a wave of objections and threats of litigation from opposition parties and health and civil society groups.
UN Resident Coordinator in South Africa Nelson Muffuh said: “In line with our Cooperation Framework and advocacy interventions with government, the UN believes that the implementation of the NHI law stands as a beacon, guiding us towards the realisation of the Sustainable Development Goals, particularly Goal 3.8, which aims to achieve Universal Health Coverage, including financial risk protection, access to quality essential health-care services for all, and promote health and well-being across all ages.
“The UN wishes to reiterate the importance of ensuring that the NHI law is implemented in a manner that is consistent with international human rights standards, including the right to health and the right to access affordable and quality health-care services. The UN once again commends the government and people of South Africa for taking this bold step and avails itself to continue to offer technical support in implementing the NHI law for the benefit of all South Africans.”
Dr Fabian Ndenzako, the Officer-In-Charge of the World Health Organization South Africa, said that the signing of the NHI law reaffirmed South Africa's commitment to prioritise the health and well-being of its people.
“This has come in the wake of the country’s earlier endorsement of the most ambitious and comprehensive political declaration on health at the UN High-Level Meeting on Universal Health Coverage in September 2019 and again in September 2023.”
Speaking at the ceremony at the Union Buildings, Ramaphosa said in signing the bill they were clearly signalling their determination to realise the constitutional right to access to health care as articulated in the Constitution.
“Let us work together in the spirit of co-operation and solidarity to make the NHI work because the NHI bill is here and it is now about to become an act of Parliament as law that governs health in the Republic of South Africa,” said Ramaphosa.
The bill has been on Ramaphosa’s desk since December 2023 when the National Council of Province passed it, months after the National Assembly gave it the green light for it to be signed into law.
Critics of the bill have raised issues about funding of the NHI and the state of health facilities, including corruption in the public service.
Ramaphosa said the newly-enacted law was a milestone in South Africa’s quest for a much better and just society.
“This transformation of the healthcare initiative, in many ways, gives further impetus and constitutional commitment to progressively realise access to healthcare service for all its citizens,” he said. Ramaphosa said the provision of health care was currently fragmented, something he described as unsuitable and wholly unacceptable.
He said the hurdles facing the NHI could be navigated with careful planning, strategic resource allocation and steadfast commitment to achieving equity. Ramaphosa added that the implementation of NHI would be done in a phased manner with key milestones in each phase rather than as an overnight event.
“We are saying it is going to be phased. If you are afraid of NHI, take heart and courage from the fact that we are going to implement NHI in a phased manner so as to ensure every sub-milestone becomes an important one to make the NHI much more effective.”
Health Minister Joe Phaahla said the NHI Act marked a historic milestone and would guarantee that every South African would have a right to comprehensive healthcare service.
Phaahla said the new law was not just a policy but a promise of a better, healthier future for every South African that affirmed that the long wait had indeed been worth it.
Phaahla said there would be challenges on the journey to the future.
DA chief whip Siviwe Gwarube said contrary to popular belief, NHI would not equalise the healthcare system.
“In its current form, it lacks the necessary investment to provide accessible and quality healthcare as mandated by our Constitution,” she said.
Cosatu said it remained convinced that South Africa’s myriad of healthcare challenges required the creation of NHI.
“Cosatu and the overwhelming majority of workers were in support of an NHI. Society cannot afford to normalise 30 years into democracy the reality that most South Africans, in particular the working class, lack access to quality and affordable healthcare,” acting national spokesperson Matthew Parks said.
GOOD Party secretary-general Brett Herron said they supported the signing of the NHI Bill because it was a tool to address inequality and improve healthcare services for the majority of the people.
“We support the bill because we believe in the principle of universal health care, and we believe in South Africa’s future.
“We urge the incoming government to develop a programme to iron out identified wrinkles in the legislation prior to implementation,” Herron said.
Cape Times