South Africa is one of the most unequal nations in the world, and despite having the highest GDP on the continent, it boasts poor health indicators and faces a high burden of disease, both communicable like HIV and non-communicable like diabetes; high rates of violence and injury and mortality.
Socio-economic inequity underpins inequities in health and access to health care. Forty-four percent of all health care spending is concentrated in the private sector, which serves only 16% of the population. The remaining 84% — those with the largest share of the burden of disease who need the most care — rely almost entirely on the under-resourced and dysfunctional public sector (a minority also pays out-or-pocket for limited private care at the primary care level).
Consequently, there is huge public-private inequality; massive unmet health care need in South Africa and a failure to approach anything near universal health coverage (UHC) through accessible, equitable and effective health care services.