Health care SA (NHLS) Gesondheidsdienste

The priority diseases in South Africa remain the HIV and TB epidemics, which require significant volumes of testing to support their management, the sheer burden of which is unparalleled globally.   With the increased pressure of the HIV 90-90-90 targets and END TB strategies, this is likely to remain an important mandate of the NHLS. The prevalence of HIV is estimated at 12.6% for the general population and rises to 18% in the 15-49-year age group. Over 7 million South Africans are HIV infected with approximately 4,3 million individuals on antiretroviral therapy.  ( (NHLS) – National Health Laboratory Service)

What does government spend money on? | Statistics South Africa



Medical testing laboratories are distributed across the public and private health sector in South Africa. The NHLS was established in 2000 by an Act of Parliament to provide pathology services for the public health sector, servicing over 80% of the population across all nine provinces. The population of South Africa is growing rapidly with recent figures suggesting 56,52 million individuals (STATS SA, July 2017, mid-year population estimates) who require healthcare compared to the 53,7 million estimated in 2014, just prior to the development of the current 5-year strategic plans. The demographics, geographic distribution and prevalence of disease contribute greatly to the type and capacity of laboratory services required.

Gauteng (14,3 million) is the most highly populated province, followed by KwaZulu-Natal (11,1 million). Both provinces are characterised by migration and significant population influxes. South Africa has a population of young people, with at least 29.6% being younger than 15 years of age and only 8% being older than 60 years. Life-expectancy varies across gender and age groups, with males having a significantly lower life-expectancy rate than females at 61,2 years versus 66,7 years, respectively. Nearly 1 million births occur per annum with most occurring to mothers in the 20-24-year age group (31%) and an alarming number in the 10-19 year (13.9%) category (STATS SA, 2016: recorded live births).

Health care

South African general government spent R1,79 trillion in 2018/19, according to the latest Financial statistics of consolidated general government statistical release.1 This roughly translates to about R31 000 per person that year, if we consider South Africa’s population of 57,9 million people.

The size of each bubble represents the amount of money spent. Comparing the bubbles across the board highlights some interesting facts:

  • Government spends more money on police services than it does on tertiary education or housing.
  • Defence accounts for 3% of total spending.
  • On the social front, slightly more money was spent on old-age grants than on grants related to family and children (child support, foster care and care dependency grants).
  • Environmental protection is one of the smallest items, accounting for 0,8% of total expenditure.
  • Executive and legislative services account for 11%. This function includes costs mainly related to the administration of parliament, the provincial legislatures and mayoral offices.
  • For every R10 of total government spending in 2018/19, R1 was used on debt payments, including interest payments on debt. This was more than what was spent on either housing, hospitals, tertiary education or police.

Compensation of employees accounted for R694 billion, or 41,9% of total government expenses in 2018/19.3 This was followed by purchases of goods and services (21,3%) and social benefits (13,6%). Other items accounted for the remaining 23,2%.

The Financial statistics of consolidated general government statistical release debuted in 2006 with data for 2004/05. That financial year, compensation of employees accounted for 39,2% of total expenses, rising to a peak of 42,4% in 2010/11 and moderating slightly to the 41,9% recorded in 2018/19.


The South African government spent 7,3% more in 2017/18 than it did in 2016/17. The rise was largely driven by general public services, education and health.  This pushed total government spending up to R1,71 trillion1 in 2017/18, R116 billion more than the R1,59 trillion spent in 2016/17.   This is according to the latest  Financial  statistics of consolidated general government report that summarises a range of financial data for all 712 government institutions.   The 7,3% rise is higher than the increase recorded in 2016/17 (5,0%), but lower than the 10,1% recorded in 2015/16.


Geographical location of health and laboratory facilities in South Africa. Map to reveal geographic location of ~4756 health facilities (as at 2011/2012); including primary care, community centers and hospital-based clinics (black dots) and 260 NHLS routine pathology service laboratories, across nine provinces and the related 52 districts. Insert reveals the proportions of different category of health facilities requesting CD4 testing.



Health Care in SA
National Health Insurance (NHI)
NHI bill – “nationalization of health care in SA – DA” – is much more
‘Cuban health specialists’ – 28 April 2020
Corruption, fraud and abuse ongoing – healthcare
Mamelodi Day Hospital – bad treatment
Hospitale in Suid-Afrika (NO BEDS)

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