South Africa

Under section 27 of the Constitution, everyone has the right to have access to health care services, including reproductive health care, sufficient food and water; and social security. The State is assigned a duty to take reasonable legislative and other measures, within its available resources, to achieve the progressive realisation of these rights. Lastly the Constitution states that no one may be refused emergency medical treatment.

Responsibilities over health matters are shared at the national level and the local level. Under schedule 4, part A, health services fall under the concurrent national and provincial legislative competence. In case of conflicts between national legislation and provincial legislation, the national legislation prevails if the national legislation is aimed at preventing unreasonable action by a province that is prejudicial to the health of another province or the country as a whole (Section 146). Local government are, among others, constitutionally tasked to promote a safe and healthy environment and to encourage the involvement of communities and community organization in the matters of local government (section 152). Finally it is worth noting that the South African Human Rights Commission must yearly require the relevant organs of the state to provide information on the measures taken towards the realisation of the rights in the Bill of Rights concerning housing, health care, food, water, social security, education and the environment (section 184).

No current national health policy was located in the country.

The Strategic Health Plan 2021-2025 responds to the priorities embodied in the Medium-Term Strategic Framework for 2019-2024 and identifies two main impact goals: improving the life expectancy of South Africans by 66.6 years by the year 2024, and 70 years by the year 2030; and progressively achieving Universal Health Coverage for all South Africans and protecting all citizens from the catastrophic financial impact of seeking health care by 2030 (page 28).

The document lists several legislative and regulatory documents, including the Constitution of 1996, the National Health Act, of 2003, the Medicines and Related Substances Act, of 1965, the Hazardous Substances Act, of 1973, the Occupational Diseases in Mines and Works Act, of 1973, the Pharmacy Act of 1974, the Health Professions Act of 1974, the Dental Technicians Act of 1979, the Allied Health Professions Act of 1982, the SA Medical Research Council Act of 1991, the Academic Health Centres Act of 1993, the Choice on Termination of Pregnancy Act of 1996, the Sterilisation Act of 1998, the Medical Schemes Act of 1998, the Council for Medical Schemes Levy Act of 2000, the Tobacco Products Control Amendment Act of 1999, the Mental Health Care Act of 2002, the National Health Laboratory Service Act of 2000, the Nursing Act of 2005, the Traditional Health Practitioners Act of 2007, etc. (pages 4-6).

The Strategic Plan lists several actions related to legislative and regulatory frameworks. For instance, the plan proposes interventions on the development of a comprehensive policy and legislative framework to mitigate the risks related to medical litigation, as well as the development of an enabling legal framework for the implementation of the NHI Bill as supporting the achievement of UHC impact goal (page 31).