The Healthcare Sector in South Africa 2025

This report on South Africa’s healthcare sector covers public and private healthcare, including emergency medical services, auxiliary services and complementary healthcare. There is information on the number and distribution of facilities and practitioners, healthcare budgets and expenditure, standards compliance, staffing shortages, infrastructure development and maintenance. There is information on notable players, corporate actions and developments and discussion and analysis of issues such as TB and HIV treatment and funding, the NHI, training and skills, corruption and fraud, and treatment of foreign nationals. There are profiles of 49 companies including major players such as Life Healthcare, Netcare and Mediclinic, other notable hospital groups such as Lenmed, Busamed and Medicross, optical companies such as Toga Optical and Neovision, pathology practices including Lancet, Ampath and National Health Laboratory Service, and several emergency services and blood banks.

Challenges

Cybercrime vulnerability. Emergency medical services strain. High maternal and child mortality. High rates of non- and communicable diseases. Increasing mental health issues. Inequality in rural access and resource distribution. Input cost pressures. Integrated electronic health records. International aid shortfalls. NHI concerns. Private sector policy reforms and tariff regulations. Public sector incompetence, mismanagement and corruption. Public sector infrastructure decay. Staff shortages and high vacancy rates.

Introduction

• South Africa spends between 8% and 9% of its GDP on public healthcare, well above the World Health Organisation’s guideline.
• The system is highly unequal, with 85% of the population relying on an overstretched and underfunded public system.
• Key challenges include significant gaps in access, chronic staff shortages, poor management and a heavy burden of preventable diseases.
• The NHI Act was signed into law in May 2024, but its rollout faces delays and uncertainties.

Opportunities

Digital health and telemedicine. Environmental sustainability. Health infrastructure development. Medical devices and diagnostics. Medical tourism. NHI rollout. Pharmaceutical manufacturing and supply. Primary healthcare and preventive medicine. Private sector growth. Supply chain and logistics. Traditional and alternative healthcare. Wellness, prevention and community health services. Workforce training and skills development.

Outlook

• South Africa’s healthcare system sits at a crossroads.
• Economic constraints, political choices, shrinking donor inflows, climate and infrastructure shocks and rapid technological change will shape the sector’s future.
• Major trends are shifts from inpatient to outpatient care, digitisation of services, integration of traditional and community care and sustainability investments.
• The sector remains challenged by funding shortfalls and fiscal constraints, workforce shortages, infrastructure decay, corruption and weak governance and regulatory and policy uncertainty around the NHI.

Trends

Advances in genomics and increased viral research. Focus on wellness, lifestyle management and chronic diseases. Healthcare infrastructure growth and sustainability. Implementation of NHI. Increased integration of mental health wellness. Private sector consolidation. Strong push for health equity and universal healthcare access. Tailored care models and personalised medicines. Technology, digital health and innovation. Traditional and alternative medicine integration.