National Health Insurance
Conclusions and Implications for a Future NHI
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The key issue remains for planning in South Africa – that the number of elderly people is expected to increase rapidly and that chronic disease and cancer prevalence and need for hospital facilities are strongly related to age. While the extent may be difficult to quantify precisely, there is no doubt that there will be an increasing burden on the health system in future.
Add to this the well-documented and modelled HIV/AIDS epidemic and related epidemics of sexually-transmitted infections and tuberculosis, and the immense challenges for a sustainable National Health Insurance system become apparent.
The graph overleaf shows the combination of the projections of future disease in South Africa, taken from the three policy briefs dealing with CDL chronic diseases, HIV/AIDS and cancer.
Figure 4: The Burden of CDL Chronic Diseases, Cancer and HIV/AIDS in South Africa, 1985 to 2025
Combining the 25 CDL chronic diseases, cancer (very small on the graph) and HIV, the numbers with these diseases have increased from 3.6 million in 1994 to 9.9 million in 2009 and could rise to 11.3 million by 2025. The non-CDL chronic diseases, the burden of violence and infectious diseases needs to be added for a more complete picture. The resourcing requirements in terms of staff needed in the health system become particularly stark when compared to the burden of disease in the national health system.
Produced for IMSA by
Professor Heather McLeod
6 September 2009
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