South Africa has a quadruple burden of disease and failing health systems. This has created a health crisis that continues to worsen. As a response, the Department of Health has proposed a 10-point plan to transform the health system, one of which is the National Health Insurance. The NHI is in need of civil society engagement and citizen participation. The NHI Civil Society Coalition is aiming to facilitate this engagement and re frame the mainstream discussion around the NHI while working to achieve universal coverage in South Africa.

NHI Coalition on the NHI Green Paper

The NHI coalition feels that the Green Paper on NHI correctly outlines many of these problems and takes into account the current burden of disease in South Africa. It outlines a philosophical approach to ensuring universal access for everyone with a focus on primary health care. It is founded on the right to access to healthcare, social solidarity, equity and affordability. Its strengths are its emphasis on primary health care; the inclusion of practical strategies to implement this following the “Re-engineering Primary Health Care” approach; and the recognition of the social determinants of health, which shape all health inequalities.

However, the Green Paper in its current form is only a vague statement of intent from the Department of Health. Its lack of clarity on the crucial issues of financing and implementation reflect the conflicting vested interests within the health sector – between the financial interests of the private sector and the need to deliver health cre for all. The Green Paper provides the opportunity to build a truly universal health system that allows universal quality healthcare for all South African citizens – but this opportunity threatens to be undermined by the powerful interests of the private sector.


NHI Campaign

As activists striving for a people’s health system, our aim is to identify the critical areas of struggle, critique the inconsistencies and identify dangerous areas within the Green Paper and responses to it. All of these critical issues need to be closely monitored in the process leading up to the White Paper and the NHI Bill. Unless we implement a truly universal NHI with a strong public sector, the glaring health inequalities in South Africa will persist.

On a micro level, the NHI coalition is dedicated to providing educational workshops to community members who have the most to benefit from the NHI. By raising awareness and mobilizing support for the NHI, we gain greater citizen involvement and input into the process.

At a misa level, the NHI Coalition will be a leader in galvanizing national civil society support and engagement in coalition building and networking around the National Health Insurance policy process through research and advocacy efforts. By identifying suitable intervention points to engage in the process such as submitting responses to government policy documents, presentation at government hearings and organizing local, provincial and national educational and mobilization campaigns to increase input and citizen involvement in the NHI process.

At a macro level, the NHI coalition sees itself as having a long-term impact on advocacy and mobilization around the continued struggle to de-commoditize health in South Africa. The coalition will aim to play a long-term civil society monitoring and watchdog role throughout the process of health systems transformation in South Africa.

For more information on the NHI Coalition, please feel free to contact coordinator@phmsouthafrica.org or any of the listed partners below.



  • People’s Health Movement-South Africa (Secretariat)

  • Section 27 & Rural Health Advocacy Project (RHAP)

  • Treatment Action Campaign


  • Marie Stopes


  • Black Sash

  • RuDASA

  • Africa Health Placements

  • EarthLife Africa

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