NHI: South Africa’s current dual healthcare system is medical care apartheid, says Prof Salim Karim

Professor Salim Abdool Karim, who is the director of the Centre for the AIDS programme of Research in South Africa (Caprisa). File Picture

Professor Salim Abdool Karim, who is the director of the Centre for the AIDS programme of Research in South Africa (Caprisa). File Picture

Published May 15, 2024

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Hours before President Cyril Ramaphosa “publicly” signs the divisive National Health Insurance (NHI) Bill into law at an auspicious occasion set for the Union Buildings in Pretoria, a respected epidemiologist says the spin-offs will not not be instantaneous.

IOL reported earlier this week that Ramaphosa is set to sign the NHI Bill into law on Wednesday.

Infectious diseases epidemiologist, Professor Salim Abdool Karim, who is the director of the Centre for the AIDS programme of Research in South Africa (Caprisa) spoke to broadcaster Newzroom Afrika on Wednesday morning regarding the impact of Ramaphosa signing the highly criticised and equally welcomed law.

“I do not think much is gonna happen (soon after the signing) because it is gonna take many years before we can rectify the fundamental challenges we experience in the healthcare system that the NHI Bill aims to address,” he said.

President Cyril Ramaphosa. File Picture

“So (there will be) no fireworks or anything of that sort but I think what today is signalling is the commitment to address universal healthcare.”

However, Karim underpinned that the current dual system where those who afford are attended at private facilities and the economically challenged are confined to public healthcare facilities is some form of an apartheid.

“At the moment the way the South African health system works it is residual care, which means if you can afford it and a small proportion of our population can … and if you can’t, you go to the public healthcare system,” Karim said.

“That dual system that runs parallel to each other is basically a form of medical care apartheid – if you afford you get, if you cannot afford you get something much less,” he said
Health Minister Dr Joe Phaahla. File Picture: Jacques Naude/Independent Media

“So, the idea is to create a universal system where everybody has equal access. There are many challenges in doing that and there are many ways in which one can try to do that but NHI as a funding mechanism is one of the key ways most countries have tried to move in that direction from a split healthcare system that is both private and public.”

During the 2024 State of the Nation Address (Sona), Ramaphosa mentioned that the Bill arrived in his office, teasing that: “I am still looking for a pen” to sign.

The objective of the NHI Bill is set to provide universal access to quality health care for all South Africans of all races, rich or poor, and legal long-term residents.

Minister of Health, Dr Joe Phaahla, will interact with the media at the Union Buildings immediately after the signing ceremony.

IOL