AI-based medicine will revolutionise care including for Alzheimer’s and diabetes, predicts a technology expert, but it must be accessible to all patients
AI image created with Gencraft
Healing with Artificial Intelligence, written by technology expert Daniele Caligiore, uses the latest science research to highlight key innovations assisted by AI such as diagnostic imaging and surgical robots.
From exoskeletons that help spinal injury patients walk to algorithms that can predict the onset of dementia years in advance, Caligiore explores what he describes as a ‘revolution’ that will change healthcare forever.
Economically, the market for AI in healthcare is experiencing rapid growth, with forecasts predicting an increase in value from around USD 11 billion in 2021 to nearly USD 188 billion by 2030, reflecting an annual growth rate of 37%. AI is already being used in some countries, for example to search through genetic data for disease markers, or to assist with scheduling and other administrative tasks – and this trend is set to continue.
However, the author caveats his predictions of progress by warning these technologies may widen existing inequality. Caligiore suggests that AI-based medicine must be available to all people, regardless of where they live or how much they earn, and that people from low-income nations must not be excluded from cutting-edge care which wealthier nations can access.
Other challenges posed by the advancement of AI in healthcare includes who takes responsibility for treatment decisions, especially when a procedure goes wrong. This is a particular challenge given widespread concerns around explainable AI, as many advanced AI systems operate as black boxes, making decisions through complex processes that even their creators cannot fully understand or explain.
Caligiore says AI should support doctors and patients, not replace doctors who, says the author, have a ‘unique ability to offer empathy, understanding, and emotional support’.
“AI should be viewed as a tool, not a colleague, and it should always be seen as a support, never a replacement,” writes Caligiore.
“It is important to find the right balance in using AI tools, both for doctors and patients. Patients can use AI to learn more about their health, such as what diseases may be associated with their symptoms or what lifestyle changes may help prevent illness. However, this does not mean AI should replace doctors.”
Despite his warnings, Caligiore is largely optimistic about the impact of AI in healthcare: “Like a microscope detecting damaged cells or a map highlighting brain activity during specific tasks, AI can uncover valuable insights that might go unnoticed, aiding in more accurate and personalized diagnoses and treatments,” he says.
In any case, Caligiore predicts the healthcare landscape will look ‘dramatically different’ in a few years, with technology acting as a ‘magnifying glass for medicine’ to enable doctors to observe the human body with greater precision and detail.
Examples of where AI will make profound impacts in healthcare include, regenerative medicine, where gene and stem cell therapies repair damaged cells and organs. Spinal cord injury patients are among those who could benefit.
AI may also provide personalised therapies, suggesting treatments tailored to specific individuals often based on their unique genetic profile. Studies are being conducted into targeting different tremor types in Parkinson’s and breast cancer subtypes
The convergence of regenerative medicine, genetically modified organisms (GMOs), and AI is the next frontier in medicine, Caligiore suggests. Genetically modified organisms (GMOs), living organisms whose genetic material has been altered through genetic engineering techniques, have already paved the way for personalised gene therapies.
Blending real and virtual worlds may also prove useful to healthcare, for example the ‘metaverse’ – group therapy where patients participate with an avatar, or ‘digital twins’ – AI simulations of a patient’s body and brain on a computer so doctors can identify underlying causes of disease and simulate the effects of various therapies for specific patients to help doctors make more informed decisions.
These advances and others will reshape the doctor-patient relationship, according to Healing with Artificial Intelligence, but the author suggests the key is for patients and clinicians to keep a critical mindset about AI.
Caligiore warns that role of physicians will evolve as AI becomes more integrated into healthcare but the need for human interactions will remain ‘central to patient care’.
“While healthcare professionals must develop technical skills to use AI tools, they should also nurture and enhance qualities that AI cannot replicate – such as soft skills and emotional intelligence. These human traits are essential for introducing an emotional component into work environments,” he explains.
A comprehensive five-year analysis of gap cover claims reveals a healthcare funding crisis that’s rapidly escalating across the South African private healthcare sector. Data from Sirago Underwriting Managers shows that its mega gap claims – those exceeding R50,000 – have exploded by 512% in volume and 437% in value between 2020 and 2024.
The numbers tell a stark story: where 89 mega gap claims totalling R6.2 million were paid in 2020, this figure rocketed to 549 claims worth R34 million in 2024. Perhaps most concerning is that claims exceeding R60 000 are now daily occurrences, with the average large loss gap claim sitting at R63 000 – a far cry from the R6000 to R12 000 averages seen pre-2020.
The Perfect Storm: Medical Scheme Erosion Meets Provider Cost Inflation
This upward trajectory reflects a fundamental shift in South Africa’s healthcare landscape. Medical schemes – constrained by affordability, access, aging membership populations, and where private healthcare already consumes up to 20% of household income – are systematically reducing benefits and transferring more risk onto the member, rather than increasing premiums to match out-of-control healthcare provider cost inflation.
Healthcare provider costs have consistently outpaced inflation by more than double for years, yet unlike pharmaceuticals, there’s no pricing regulation on healthcare provider tariffs. In a country facing a dire shortage of healthcare professionals, specialists are free to charge rates often 500%+ higher than medical scheme reimbursements.
The regulatory framework compounds this issue. The Registrar of Medical Schemes mandates that for Prescribed Minimum Benefit (PMB) conditions, where no Designated Service Provider agreement exists, healthcare providers must be paid in full regardless of the charge – essentially providing a blank check.
Breaking Down Sirago’s Large Loss (Mega) Gap Claims Data (2020-2024)
Five-Year Trend Analysis
2021: 118% increase in claims value paid compared to 2020, driven by COVID-19 impacts and deferred elective surgeries.
2022-2024: Average annual increase of 35% year-on-year in large loss claims volumes.
Highest claims: R200,000+ for ischaemic heart disease conditions in the 50+ age group.
Age Demographics Challenge Assumptions
Contrary to expectations, healthcare crises aren’t limited to older populations:
50-65 years: 31% of claims (average: R65,065)
66-75 years: 27% of claims (average: R64,213)
76+ years: 18% of claims (average: R62,773)
30-49 years: 18% of claims (average: R58,116)
0-29 years: 5% of claims (average: R63,360)
The under-49 age group constitutes 23% of all large loss claims, dispelling notions that major health expenses only affect older demographics, and which highlights the risk transfer challenges faced and imposed by medical schemes.
Claims Distribution
62%: R40,000-R60,000
30%: R61,000-R100,000
6%: R101,000-R150,000
2%: R151,000-R210,000
Leading Conditions Driving Claims
Musculoskeletal Dominance
Over 51% of claims across all age groups involve musculoskeletal conditions, with spinal stenosis leading the charge. Medical schemes often impose strict limits on elective musculoskeletal surgeries due to high costs, particularly for internal prosthetics where co-payments can reach 30% of the hospital account if members don’t subscribe to the scheme-imposed protocols.
Cancer and Circulatory Conditions
Each representing 10% of large loss claims, these conditions reflect both the effect from the delayed diagnosis impact of COVID-19 and the high-cost nature of specialised treatments. Malignant neoplasms of the breast, prostate, and colon lead cancer claims, while acute ischaemic heart disease dominates circulatory conditions.
The Exploitation Factor
Gap insurance is increasingly becoming a target for exploitation. Healthcare providers now routinely ask patients upfront about gap coverage before determining charges, creating a troubling paradox where a R700 monthly gap policy might pay R130,000 for an orthopaedic surgery shortfall, while the medical scheme with an R8,000 monthly premium pays just R30,000. This exploitation threatens the sustainability of gap insurance itself. If current trends continue, gap insurance premiums will inevitably rise, making this crucial protection unaffordable for many South Africans.
The Critical Importance of Gap Cover
Despite these challenges, gap cover remains essential, irrespective of medical scheme option. Most medical schemes have deductibles, co-payments, and reimbursement limits that can leave members significantly out of pocket. The gap between scheme payments and specialist charges can be substantial – often 200% to 500% above scheme tariffs and this isn’t limited to basic hospital cover options. Even comprehensive, top-tier medical scheme benefits leave members facing substantial tariff shortfalls for in-hospital procedures.
The Economics of Healthcare Financial Protection
When you consider the potential financial quantum of a shortfall on your medical scheme benefits, and that a gap cover premium is around R700 per month for a family (2025 Sirago Ultimate Gap), and each family member is covered for up to a maximum of R213 000 per annum, it is clear that Gap Cover is a non-negotiable part of your healthcare financing strategy. A single gap claim of R63k, Sirago’s average large loss claim, would be the equivalent of almost 9 years of premium payments at current premium rates.
Sirago’s mega claims data reveals a private healthcare funding system under severe strain. As medical schemes transfer more financial risk to members through tariff shortfalls, co-payments, and exclusions, gap insurance becomes not just “a-nice-to-have” insurance policy, but essential for financial protection.
However, the sustainability of this model depends on addressing the root causes: unregulated provider pricing, systematic benefit erosion, and the exploitation of gap insurance by unscrupulous providers. Without intervention, South Africa’s healthcare funding crisis will continue to deepen, leaving patients to bear an ever-increasing financial burden.
For consumers, the message is clear: always negotiate pricing for planned surgeries and request formal quotes from all medical role players. In a system where healthcare providers are price makers and medical schemes and gap providers are price-takers, informed patient advocacy becomes crucial for financial survival and your continued access to quality private healthcare.
(Claims statistics drawn from Sirago’s Large Loss Claims Analysis, 2020-2025)
Sirago Underwriting Managers (Pty) Ltd is an Authorised Financial Services Provider (FSP: 4710) underwritten by GENRIC Insurance Company Limited (FSP: 43638). GENRIC is an authorised Financial Services Provider and licensed non-life Insurer and a member of the Old Mutual Group.
Note: The content of this article does not constitute financial advice. Sirago Gap cover is subject to terms and conditions and premiums are reviewed annually. For more information go to www.sirago.co.za (Ts & Cs apply).
South Africa is facing a major health transition. While the average life expectancy has nearly doubled over the past century, the quality of those additional years, commonly referred to as one’s ‘healthspan,’ remains under threat from non-communicable diseases (NCDs). This threat calls for a renewed national focus on prevention and early intervention to address the rapidly growing challenge.
The Healthspan Imperative
According to health data presented at the 2025 Momentum Healthcare Insights Summit, NCDs such as heart disease, cancer, diabetes and neurodegenerative disorders now account for 51% of all deaths in South Africa. In contrast, communicable diseases make up around 40% and non-natural causes (like accidents and violence) account for a mere 9%. This shift reflects a global trend, although some challenges remain; infectious diseases become more manageable, while chronic conditions associated with lifestyle and ageing take centre stage.
Damian McHugh, Chief Marketing Officer at Momentum Health
“Medical advances have added years to our lives, but not necessarily life to our years. More and more, there is growing evidence to support the fact that prevention offers the greatest potential to reduce the burden as well as cost of chronic disease and improve quality of life,” says Damian McHugh, Chief Marketing Officer at Momentum Health.
Prevention Outperforms Treatment
The summit highlighted compelling evidence that prevention is more effective than treatment for advanced disease. For example, research from the American Cancer Society shows that tobacco control measures, such as smoking bans and taxes, have prevented 3.8 million lung cancer deaths in the United States since 1970. The most effective way to save lives from late-stage lung cancer has not been through treatment, but through reducing or eliminating smoking altogether.
The same principle applies to other chronic diseases. Managing risk factors such as high blood pressure, obesity, high blood glucose, and abnormal cholesterol can actively prevent or delay the onset of disease. These factors are strongly influenced by behaviours such as a lack of physical activity, poor nutrition, unmanaged stress levels, and even excessive alcohol use or smoking.
Investing in regular health check-ups and preventative care can mitigate the risk of serious health problems, ultimately reducing the incidence of costly, advanced illnesses. Simple lifestyle changes, such as prioritising rest and recovery, making time to connect with loved ones, maintaining balanced nutrition, practicing mindfulness, and engaging in regular exercise not only promotes physical and mental health, but can also translate into significant long-term savings in healthcare costs.
“Making quality healthcare more accessible, while enabling and rewarding healthy, preventative habits can lead to complete physical and mental health and wellbeing. Investing in access and wellbeing is a powerful pathway to realising more wealth and more health for more South Africans,” says McHugh.
Measuring and Managing Healthspan within the South African Context
Momentum Health’s data reveals that many South Africans are living longer, but the average age of medical scheme beneficiaries has increased by nearly three years over the past decade, and the proportion of pensioners in medical schemes is rising. Without proactive measures, our nation’s ailing healthcare system will face increasing claims and costs as the population ages and chronic diseases become more prevalent.
Momentum Health believes that the solution lies in taking measures to improve access to both quality medical care and reliable health information and empowering individuals to take responsibility for their own health.
South Africa’s rising NCD burden is not inevitable. With early detection, healthy lifestyle choices, and consistent engagement with preventative healthcare, individuals can not only extend their lifespan but also improve the years lived in good health.
“Prevention isn’t just a personal choice; it’s a public health imperative. By investing in wellness now, we can reduce the future burden on our healthcare system and help more South Africans enjoy longer, healthier lives,” concludes McHugh.
He speaks in measured tones – calm, reflective, deliberate. But when Dr Dumisani Bomela describes the future he envisions, the words carry power. For the CEO of the Hospital Association of South Africa (HASA), healthcare is not just a profession. It is a promise rooted in dignity, equity and access to every South African.
Q: Dr Bomela, what drew you to medicine and what keeps you committed to healthcare in South Africa? A: I have always seen healthcare as an act of service. As a doctor, you learn to see beyond symptoms, to understand the person behind the diagnosis. As a leader at HASA, I take that same approach. Our work is about people. About making sure that every South African can get quality care when they need it.
Q: HASA represents South Africa’s private hospital sector. Why is this sector important to the country’s overall health system? A: Private hospitals are a cornerstone of healthcare in South Africa. We treat millions of patients each year. More than that, HASA members invest heavily in medical training, advanced technology and infrastructure. We are strategic partners in the national system, that makes our sector a vital national asset.
Q: How does HASA contribute to economic development beyond just healthcare? A: Healthcare is a growth engine. HASA members are major employers, from doctors and nurses to technicians and support staff. We support local communities and stimulate investment. When healthcare systems are strong, economies thrive – and so do people.
Q: What is HASA’s stance on universal health coverage? A: We believe every person has the right to choose their provider and to receive high-quality care. That is why we support reforms that strengthen the system and build equity. HASA members are ready to work side by side with the government to make that vision a reality. Our hospital groups bring deep experience, including in some cases from geographies where universal healthcare systems operate, and strong infrastructure to the table.
Q: What kind of leadership do you believe is needed in South African healthcare today? A: We need leaders who listen. Who understand not just policy, but people. Leadership in healthcare must be grounded in compassion and collaboration. At HASA, we strive to lead by example, building trust, fostering partnerships, and always remembering that every system ultimately affects human lives.
Q: How do HASA hospitals stay at the forefront of medical technology and innovation? A: By investing intentionally. Our members understand that modern medicine is not static, it is constantly evolving. We equip our hospitals with advanced diagnostic and treatment tools. But technology alone is not enough. We also invest in people – training nurses, specialists and support teams to lead with excellence.
Q: In a country facing complex health challenges, how do you stay hopeful? A: Hope grows where there is action. Across our hospitals, I see incredible work being done every day – surgeons saving lives, nurses comforting families, teams innovating to improve care. We are proving, together, that with collaboration and commitment, South Africa’s health system can be strong, inclusive and world-class.
Q: What gives you the greatest sense of pride in your work with HASA? A: Honestly, it is seeing the impact private hospitals have. When families walk out of our hospitals healed. When professionals grow into health leaders. When communities feel their well-being is supported. These outcomes remind us why the work matters. My pride does not come from titles; it comes from knowing we are making a real, human difference every single day.
As healthcare reform gains momentum in South Africa, value-based care is becoming a hot topic – but meaningful progress has yet to take hold. The biggest hurdle? How care is purchased. Despite clear signs of stagnation, most funders remain committed to the same failed approach and have yet to drive the change that is needed.
“It’s encouraging to see a move away from fee-for-service thinking and a growing focus on value-based care. But to turn that interest into action will require real system reform – starting with strategic approaches to purchasing care that support system reengineering,” says Lungile Kasapato, CEO of PPO Serve, a healthcare management company that has been implementing value-based care in South Africa for more than a decade.
At its core, value-based care flips the script on how private healthcare is purchased in South Africa. Instead of rewarding volume, it prioritises prevention, puts patients at the centre, and ties payment to measurable outcomes. This stands in stark contrast to the dominant fee-for-service model, where doctors and hospitals are incentivised to provide more services rather than focus on delivering effective care.
A leading example of value-based care in practice is The Value Care Team, operationally supported by PPO Serve. This GP-led multidisciplinary programme broadens access while keeping costs in check. Teams are paid a risk-adjusted global fee to provide holistic patient care, along with substantial incentives tied to improved outcomes. The result is a model that aligns payment with patient outcomes – not the volume of services delivered.
To put it simply, Kasapato explains; “With value-based care, you don’t pay for every kilometre run, you pay to cross the finish line. And that finish line means improved health outcomes, prevention, and system efficiency.” For patients, primary healthcare under The Value Care Team looks and feels completely different. With no scheme benefit limits to navigate, patients are supported by a dedicated care coordinator who guides them through decisions made by their nominated GP and allied professionals. Each clinical team member has a complete picture of the patient’s health, working collaboratively rather than competitively to share accountability for delivering better outcomes.
This new approach to delivering primary care in the private sector isn’t just an isolated test run – it’s being developed and refined in real time. “We’re not just talking about value-based care, we’re implementing it,” says Kasapato. “At PPO Serve, we partner with practices to navigate day-to-day challenges, while working with medical schemes to design payment models that enable strategic purchasing. The Value Care Team is proof that value-based contracting isn’t just possible – it’s already happening in South Africa’s healthcare system.”
For this approach to take root and scale, medical schemes and state funders must take the lead by creating the market incentives that encourage providers and hospitals to adopt new ways of working. The Competition Commission’s 2019 Health Market Inquiry warned that without bold reform, South Africa’s private healthcare sector could face collapse – a warning that remains just as relevant today. But there is still an opportunity to change course. By embracing a strategic purchasing role, funders can help drive the system-wide transformation that’s urgently needed.
The Value Care Team is already leading by example, with a presence across Gauteng and KwaZulu-Natal, as well as in Bloemfontein and Gqeberha. Recognised by the World Health Organisation and featured in international peer-reviewed research as a breakthrough case study in emerging markets, the programme is actively driving real change – improving care coordination, cutting waste, and reducing unnecessary hospital admissions. Even so, Kasapato points out, the journey is far from over; “There is still a lot to learn from and with others as we move from talking about value to actually implementing it.”
By Matimba Ngobeni, Country Head: Value & Access, Novartis South Africa
28 July 2025, Johannesburg South Africa – South Africa’s healthcare system stands at a crossroads. Despite the promise of progress outlined in the Budget Speech and the Presidential Health Compact, the reality on the ground reveals persistent and growing barriers to accessing innovative medicines.
Economic pressures, funding constraints, and infrastructure gaps continue to undermine equitable healthcare delivery, particularly for vulnerable communities. What’s more, recent international developments—such as U.S. President Donald Trump’s cuts to funding that supported healthcare initiatives in South Africa—threaten to exacerbate these challenges, potentially limiting access to life-saving advanced therapies.[1]
Economic pressures
The cost of advanced therapies remains out of reach, and the structural inequalities in our healthcare system persist. While top-tier medical plans still provide access to advanced medicines, we are seeing a shift. Patients are moving to lower-tier plans or into the public system, simply because they cannot afford more. And with that shift, their access to advanced therapies disappears. [2]This is not a uniquely South African problem.
Globally, we see the same story repeat: private healthcare becomes a fortress that only those who can pay the toll may enter. Everyone else is left to rely on an overburdened public system, strained by funding shortfalls, infrastructure gaps, and critical workforce shortages. The public healthcare system, already overburdened, struggles to absorb this increased demand. Rising healthcare costs combined with limited household budgets create a perfect storm where affordability becomes the biggest barrier to accessing cutting-edge treatments.
Funding constraints and infrastructure challenges
Both private and public sectors face severe funding constraints. Innovative medicines, especially advanced therapies, come with high price tags that strain budgets and limit availability. At the same time, infrastructure and skills gaps hinder the effective delivery of these treatments. Investments in healthcare infrastructure, workforce training, and data management are urgently needed to support the growing demand for advanced therapies.
While it may seem like all hope is lost, the Presidential Health Compact offers a promising framework aimed at transforming South Africa’s healthcare landscape through infrastructure development and improved data surveillance[3]. However, it stops short of directly addressing access to innovative medicines. This gap underscores the need for stronger collaboration between public and private stakeholders to ensure that patients do not bear the financial burden alone.
Towards equitable access: Collaboration is imperative
Another way forward is through a robust, transparent Health Technology Assessment (HTA) process, where medicines are evaluated not only on their cost but on their ability to save lives, improve quality of life, and reduce the long-term burden on the health system.
Inclusive HTAs, where payers and pharmaceutical companies work together, are essential for reimagining access to advanced therapies. If we only look at the upfront cost of innovation, we miss the bigger picture of societal value.
Globally, risk-sharing models and outcome-based pricing agreements are helping bridge the affordability gap[4]. South Africa could benefit from more flexible legislation to enable these models, ensuring that innovation doesn’t remain locked behind prohibitive price tags.
South Africa’s healthcare future depends on what we choose to prioritise: short-term financial gains or long-term societal wellbeing. Too often, systems have been designed around protecting profits rather than protecting lives. Healthcare should never be a luxury. Yet in South Africa, and across much of the world, the reality is stark: exclusion is the norm, not the exception.
If we want a future where access to life-saving medicines is a reality for all, we need to break down the barriers of affordability, infrastructure, and policy inertia. And we need to do it together — governments, healthcare companies, funders, and civil society — because lives are at stake.
All hope is not lost. But we cannot wait for crisis to be our catalyst. The time for bold, collaborative action is now.
**About Novartis:**
Novartis is an innovative medicines company. Every day, we work to reimagine medicine to improve and extend people’s lives so that patients, healthcare professionals and societies are empowered in the face of serious disease. Our medicines reach more than 250 million people worldwide.
Novartis South Africa (Pty) Ltd, Magwa Crescent West, Waterfall City, Jukskei View, 2090. Co. Reg. No. 1946/020671/07. Tel. No. +27 (0) 11 347 6600.
Disclaimer: The presentation may include data on formulations, products, indications, and dosages not yet approved by the South African Health Products Regulatory Authority. This information is not intended to be promoting nor recommending any formulation, indication, dosage, or other claim not covered in the approved Professional Information. Novartis South Africa (Pty) Ltd recommends the use of their products in accordance with the locally approved Professional Information. Views and opinions of speakers do not necessarily reflect those of Novartis.
COVID-19 has largely dropped out of the headlines, but the virus that causes it is still circulating. We ask what we should know about a new variant of SARS-CoV-2, the state of the COVID-19 pandemic in 2025, and the lack of access to updated vaccines in South Africa.
In the leafy Johannesburg suburb of Sandringham, the National Institute for Communicable Diseases (NICD) bears a deceptive facade. Do not be fooled by its sleepy campus, clustered face brick buildings and shade-cloth parking, this government facility is home to state-of-the-art biosafety laboratories and some of South Africa’s top virologists, microbiologists and epidemiologists. Here, 71 scientists are tasked daily with laboratory-based disease surveillance to protect the country from pathogen outbreak events.
On 5 March 2020, then health minister Dr Zweli Mkhize announced South Africa’s first COVID‑19 infection at an NICD press briefing. At the time, the NICD was an obscure acronym for many – but that quickly changed as the institution became central to the country’s pandemic response.
While the COVID-19 pandemic may have waned, the NICD hasn’t stopped monitoring.
That is because there remains a global public health risk associated with COVID-19. The World Health Organization (WHO) states: “There has been evidence of decreasing impact on human health throughout 2023 and 2024 compared to 2020-2023, driven mainly by: 1) high levels of population immunity, achieved through infection, vaccination, or both; 2) similar virulence of currently circulating JN.1 sublineages of the SARS-CoV-2 virus as compared with previously circulating Omicron sublineages; and 3) the availability of diagnostic tests and improved clinical case management. SARS-CoV-2 circulation nevertheless continues at considerable levels in many areas, as indicated in regional trends, without any established seasonality and with unpredictable evolutionary patterns.”
Thus, while SARS-CoV-2 is still circulating, it is clearly not making remotely as many people ill or claiming nearly as many lives as it did four years ago. Asked about this, Foster Mohale, spokesperson for the National Department of Health, says “there are no reports of people getting severely sick and dying due to COVID-19 in South Africa at the current moment”.
‘Variant under monitoring’
As SARS-CoV-2 circulates, it continues to mutate. The WHO recently designated variant NB.1.8.1 as a new variant under monitoring. There is however no reason for alarm. Professor Anne von Gottberg, laboratory head at the NICD’s Centre for Respiratory Diseases and Meningitis, tells Spotlight that NB.1.8.1 is not a cause for panic, particularly not in South Africa.
Von Gottberg says no cases of the new variant has been detected in South Africa. She refers to her unit’s latest surveillance of respiratory pathogens report for the week of 2 to 8 June 2025. It states that out of 189 samples tested, 41 (21.7%) cases were influenza, another 41 (21.7%) cases were respiratory syncytial virus (RSV), and three (1.6%) cases were earlier strains of SARS-CoV-2.
These figures suggest much greater circulation of influenza and RSV in South Africa than SARS-CoV-2. Over the past six months, 3 258 samples were tested, revealing 349 (10.7%) cases of influenza, 530 (16.3%) cases of RSV, and 106 (3.3%) cases of SARS-CoV-2. Since most people who become sick because of these viruses are not tested, these figures do not paint the whole picture of what is happening in the country.
As of 23 May 2025, the WHO considered the public health risk of NB.1.8.1 to be “low at the global level”, with 518 iterations of the variant submitted from 22 countries, mainly around Asia and the Pacific islands.
The WHO report states: “NB.1.8.1 exhibits only marginal additional immune evasion over LP.8.1 [first detected in July 2024]. While there are reported increases in cases and hospitalisations in some of the WPR [Western Pacific Region] countries, which has the highest proportion of NB.1.8.1, there are no reports to suggest that the associated disease severity is higher as compared to other circulating variants. The available evidence on NB.1.8.1 does not suggest additional public health risks relative to the other currently circulating Omicron descendent lineages.”
Combating misinformation
Von Gottberg says that the NICD plays a critical public health communication role in combating misinformation and warns against alarmist and inaccurate online depictions of NB.1.8.1, the Omicron-descendent lineage dubbed “Nimbus” by some commentators.
“There’s fake news about NB.1.8.1 going around on social media,” she says. “For example, supposed symptoms. I have been trying to look for articles and have not seen anything from [reliable sources],” she says. “In fact, there is no information about whether there are any differences in symptoms, because there are so few cases and it is not causing more severe disease.”
Von Gottberg implores members of the public to check information sources. “We try hard – and the Department of Health does the same – to put media releases out so that accurate information is shared. What we ask is that all our clients, the public, verify information before they start retweeting or resending.”
COVID-19 vaccines in South Africa
The WHO recommends that countries ensure continued equitable access to and uptake of COVID-19 vaccines. They also note that the currently approved COVID-19 vaccines are expected to remain effective against the new variant. But contrary to WHO advice, newer COVID-19 vaccines are not available in South Africa and continued access to older vaccination seems to have ceased. When Spotlight called two branches of two different major pharmacy retailers in Cape Town asking for available COVID-19 vaccines, the answer at both was that they have none.
Several recently approved COVID-19 vaccines are being used in other countries but are not available in South Africa. These include Moderna’s updated mRNA boosters, approved in the United States and parts of Europe, Novavax’s Nuvaxovid vaccine, approved in the United States, and Arcturus Therapeutics’s self-amplifying mRNA vaccine Zapomeran, approved in Europe. Self-amplifying mRNA vaccines has the additional capacity to induce longer lasting immune responses by replicating the spike-proteins of SARS-CoV-2.
None of these vaccines are under review for registration in South Africa, according to the South African Health Products Regulatory Authority (SAHPRA). Vaccines may not be made available in the country without the green light from SAHPRA. “It may be advisable to contact the owners of the vaccines to obtain clarity on whether they intend to submit for registration,” says SAHPRA spokesperson Yuven Gounden.
Spotlight on Friday sent questions to Moderna, Novavax, and Arcturus, asking whether they plan to submit their vaccines for registration with SAHPRA, and if not, why not. None of the companies responded by the time of publication.
Von Gottberg explains that vaccines can only become available in South Africa if their manufacturers submit them to SAHPRA for approval. “So, if a vaccine provider, a vaccine manufacturer, does not want to sell in our country because they do not see it as a lucrative market, they may not even put it forward for regulation so that it can be made available.”
Professor of Vaccinology at the University of the Witwatersrand, Shabir Madhi, says the major concern with the lack of licensed SARS-CoV-2 vaccines in South Africa is that “high-risk individuals remain susceptible to severe COVID-19, as there is waning of immunity”.
“High-risk individuals should receive a booster dose every 6-12 months, preferably with the vaccine that is updated against current or most recent variants,” he says.
Von Gottberg has similar concerns. “My hope as a public health professional is that these vaccine manufacturers take us seriously as a market in South Africa and in Africa, very importantly, and put these vaccines and products through our regulatory authorities so that they can be made available both in the public and in the private sector for all individuals who are at risk and should be receiving these vaccines,” she says.
Gounden notes that should a public health need arise, “SAHPRA is ready to respond in terms of emergency use approval.”
Concerns over vaccine expert dismissals in the United States
Earlier this month in the United States, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. fired all 17 members of the Advisory Committee on Immunisation Practices (ACIP) – an expert body responsible for recommending vaccines for 60 years. He then appointed eight new members, some known for vaccine skepticism.
Commenting on this, Von Gottberg says: “I am hoping there will be those who will think about what he [Kennedy] is doing and question it. It is an unusual situation in the United States, you cannot call it business as usual.”
In an article published in the Journal of the American Medical Association, former ACIP members voice grave concerns over the dismissals. “Vaccines are one of the greatest global public health achievements. Vaccine recommendations have been critical to the global eradication of smallpox and the elimination of polio, measles, rubella, and congenital rubella syndrome in the US. They have also dramatically decreased cases of hepatitis, meningitis, mumps, pertussis (whooping cough), pneumonia, tetanus, and varicella (chickenpox), and prevented cancers caused by hepatitis B virus and human papilloma viruses. Recent scientific advancements enabled the accelerated development, production, and evaluation of COVID-19 vaccines…,” they write.
The article also questioned the announcement by Kennedy Jr. on X that he had signed a directive to withdraw the recommendation for COVID-19 vaccination in healthy children and healthy pregnant people.
“[R]ecent changes to COVID-19 vaccine policy, made directly by the HHS secretary and released on social media, appear to have bypassed the standard, transparent and evidence-based review process. Such actions reflect a troubling dis-regard for the scientific integrity that has historically guided US immunisation strategy,” the authors warn.
Von Gottberg adds: “We hope that this anti-vax, the denialism of vaccines and the good they do, won’t come to South Africa.”
In addition, she cautions public healthcare professionals to take heed of this discourse. “We must take seriously that people have questions, and that they want to see us doing things correctly, transparently, always telling people of our conflicts of interest, being very upfront when things are controversial, when it’s difficult to make decisions,” she says. “So I think what this teaches us is not to be complacent in the way we talk and write about vaccines, discuss vaccines, and we must take our clients, the public out there seriously and hear their voices, listen to their questions.”
By James White, Director of Sales and Marketing at Turnberry Management Risk Solutions
Photo by Alex Green on Unsplash
Rising medical costs can be a major burden that negatively affects employees’ health, wellness and productivity. Even with medical aid in place, unexpected shortfalls for hospital stays, surgeries and specialist treatments can run into tens of thousands of Rands – creating financial stress that spills over into the workplace.
Group gap cover offers an affordable, accessible and highly effective way to bridge the growing divide between what medical schemes pay and what private healthcare actually costs. This makes a tangible difference for both employers and their employees.
A practical solution for reducing stress and improving productivity
Medical expense shortfalls can add up to significant amounts of money and can be enough to seriously impact an individual’s financial wellbeing. Employees who cannot afford the co-payments or gaps in cover may delay treatment, manage ongoing pain with temporary measures, or fall back on high-interest loans, all of which can negatively affect their focus and performance at work.
Group gap cover can help to prevent this type of scenario. Cover includes medical expense shortfalls, co-payments, and sub-limits, and some providers also offer value-added benefits like casualty cover, trauma counselling or additional cancer cover, depending on the plan.
This allows employees to access the care they need without having to worry about paying large sums of money out of their own pocket. It helps them get treatment sooner, making it more likely they will recover faster and return to work sooner, as well as offering improved peace of mind. All of this benefits the business as much as the individual.
Empowering brokers to support a broader wellness strategy
Brokers are ideally placed to support employers in designing employee benefits that do more than tick boxes by positioning group gap cover as an essential component of an organisation’s wellness strategy.
It is, however, essential to tailor group gap cover plans to align with the medical aid options that are already in place. The key is to create solutions that fit the needs of the organisation and its employees and add tangible value, taking into account elements like demographics, income bracket, life stage and so on. For brokers, this is an opportunity to drive innovation in employee benefits and demonstrate deeper advisory value.
Affordability that matters in a tough economy
As medical inflation continues to outpace the Consumer Price Index (CPI), comprehensive medical aid has become less attainable for many companies and their employees. Some organisations have been forced to downgrade their medical scheme contributions, leaving employees more exposed to shortfalls. Group gap cover offers a cost-effective way to mitigate that risk.
With preferential premiums, favourable underwriting terms, and often no waiting periods, group gap cover is cost-effective and affordable, especially when compared to the costs of upgrading a comprehensive medical aid plan that will typically also experience certain shortfalls. It is also tax efficient as a payroll deduction and can be implemented with minimal administrative burden.
Attracting and retaining talent in a competitive market
Today’s job seekers are looking for more than a payslip. They want to feel valued and supported. Offering group gap cover as part of a holistic benefits package can set a company apart, especially in sectors where high turnover is common.
Candidates take note when employers show they care about more than just performance metrics. A company that helps its people avoid financial distress during a medical emergency is a company that builds loyalty, trust and long-term engagement. Gap cover is an investment in human capital that pays dividends far beyond the balance sheet.
Genuine benefits build genuine loyalty
Medical costs are rising, and economic pressures are continually increasing. In such an environment, employers need benefits that do more than look good on paper – they need to add real value to the lives of their employees. Group gap cover is one of the most practical, cost-effective ways to support employees’ health and financial wellbeing while also protecting business performance.
By helping people access the treatment they need without incurring crippling debt, it reduces stress, shortens recovery time and fosters loyalty. For businesses looking to attract and retain talent, boost productivity and show genuine care for their people, group gap cover is a benefit that makes a real and lasting difference.
About Turnberry Management Risk Solutions
Founded in 2001, Turnberry is a registered financial services provider (FSP no. 36571) that specialises in Accident and Health Insurance, Travel Insurance, and Funeral Cover.
With extensive experience across healthcare and insurance industries in South Africa, Turnberry offers unsurpassed service to Brokers and clients. Turnberry’s gap cover products are available to clients on all medical aid schemes, as they are independently provided and are therefore transferable in the event of a change in the client’s medical aid scheme.
Turnberry is well represented nationally, with its Head Office based in Bedfordview, Johannesburg with Business Development Managers in Cape Town and Durban. The Turnberry Team’s focus on outstanding client service comes from having extensive knowledge and experience in the financial services sector and is underwritten by Lombard Insurance Company Limited. Lombard Insurance Company Limited is an Authorised Financial Services Provider (FSP 1596) and Insurer conducting non-life insurance business.
The health insurance sector is undergoing significant changes that insurers, healthcare professionals and brokers need to be aware of. For one, healthcare costs have risen above the national inflation rate, forcing individuals and corporate entities to reassess their healthcare management strategies.
The industry is moving towards a more personalised and customer -focused approach, companies are revolutionising traditional insurance processes with digital platforms that offer simplicity, transparency and efficiency. The role of technology and data are driving forces behind these trends. With technological advancements reshaping health insurance, other trends like shifting demographics, an ageing population, and rising chronic diseases add complexity. Navigating this landscape requires specialised knowledge. This is where health insurance brokers become essential partners for companies in need of top-quality healthcare solutions for their workforce.
Shifting patterns in the health insurance market
The health insurance industry is currently experiencing significant changes driven by various factors. Healthcare expenditures and utilisation have increased dramatically in recent years given the prevailing South African economic climate and rising healthcare costs. Organisations are scrutinising their healthcare programmes, including those that provide cover for employees. Many employers are now adopting a hybrid approach that includes both medical scheme membership and health insurance to offer maximum flexibility and choice to their workers.
The healthcare sector is also witnessing an increasing adoption of digital solutions; mobile applications with online portals for accessing benefits and services. Users can take advantage of virtual healthcare solutions, such as telemedicine consultations and online appointment scheduling, which not only reduce costs but also save time. Consequently, brokers are focusing on partnering with insurers who offer technologically advanced and user-friendly digital services.
Challenges faced in the market
The health insurance market is facing several challenges. A significant hurdle is the issue of member education. There is a widespread misconception that health insurance operates in the same manner as medical scheme cover, leading to confusion and disappointment among members. Brokers play a crucial role by clarifying the distinctions between each type of cover, and they conduct annual assessment sessions to keep clients informed about new developments or available improvements. Frequent engagements that elucidate various aspects of their benefits empower clients to make more informed decisions.
The healthcare distribution system introduces another layer of complexity as it plays a critical role in ensuring the safe and efficient delivery of healthcare products to patients and healthcare providers. South Africa’s market comprises both public and private sectors, making it difficult to identify and reach the ideal target audience. The insurance sector is heavily competitive, characterised by numerous insurers, each offering a wide range of products. These challenges are compounded by regulatory bodies, stringent rules and requirements that organisations must navigate while attempting to earn customer trust.
Financial pressures significantly impact clients’ decisions regarding attaining affordable healthcare. Financial limitations forces clients to make difficult choices often prioritising essential expenses and, leading many to opt for cheaper health insurance plans even if they have higher out-of-pocket costs or limited cover. Clients who are struggling financially need guidance and sound advice in exploring their options for affordable solutions. By reviewing their existing healthcare costs and assessing their current cover, brokers and insurers can help recommend a more effective healthcare solution that suits their needs. Clients can also consult with a financial advisor to help create a budget that incorporate healthcare costs that includes an emergency fund to cover unexpected additional medical expenses.
The value of consulting health insurance brokers
Given these complexities, one may question why companies should consult health insurance brokers. The answer lies in their expertise and advocacy. Brokers possess in-depth market knowledge and understand insurance products, enabling them to devise tailored solutions that precisely meet the requirements of both companies and employees. They represent their clients in negotiations, ensuring regulatory compliance and striving to secure the best rates and terms while providing ongoing support.
Strategic partnerships: selecting the right insurer
Choosing the right insurance partner is crucial, and brokers focus on several key attributes during this selection process. The insurance company must exhibit sound financial health, offer a comprehensive suite of products and services, and maintain effective claims procedures alongside superior customer care. Additionally, brokers seek partners that demonstrate a commitment to technology and innovation as a means of enhancing the customer experience.
Also, in today’s landscape, an insurance company’s reputation is of paramount importance, as policyholders can easily access customer feedback on social media.
Enhancing the South African healthcare system
The South African healthcare system requires careful navigation. With the assistance of informed and professional brokers, companies can tackle prevailing issues, optimise their healthcare expenditure, and deliver valuable benefits to their employees, ultimately resulting in a healthier and more productive workforce. Brokers serve not only as a source for insurance products but also as providers of expertise and trust, acting on behalf of the client in a complex and dynamic environment.
Twenty years ago, cosmetic surgery was still a subject of taboo, whispered about behind closed doors. Today, that silence has been replaced by honest conversations about beauty, confidence, ageing, empowerment, and personal choice, as South Africans openly embrace a wide range of aesthetic enhancements. And what South Africans are choosing might surprise you.
Leading plastic and reconstructive surgeon Professor Chrysis Sofianos shares insights from his own practice, revealing how cosmetic surgery trends are evolving across age and race – and what that means for the future of beauty.
“Cosmetic surgery is no longer about fitting a single mould, but about choosing how we, as individuals, want to age, restore, or refine. Today’s patients are more informed, intentional, and unapologetic about their tastes, and wanting to feel good in their own skin,” he says.
Aesthetic choices by age
Gone are the days where cosmetic procedures were the exclusive domain of patients of a certain age. According to Professor Sofianos, the modern approach views aesthetics as a journey, although age still plays a major role in shaping the types of treatments individuals may seek:
20s: Patients in their twenties are often navigating early self-image issues, driven by social media influences. The most requested procedures include breast augmentations, lip fillers, and occasional rhinoplasties to address long-held insecurities.
30s: Often post-pregnancy or in the midst of career and family life, this group leans toward tummy tucks, mommy makeovers, and the start of anti-ageing injections, cosmetic fillers, and preventative treatments. Restoration without exaggeration is usually the goal.
40s: This is the decade of refinement. Liposuction, eyelid lifts, and more assertive facial rejuvenation procedures become common, as patients seek to stay ahead of midlife volume loss and skin laxity.
50s and beyond: For those who want long-term, natural results, the deep plane facelift, neck lifts, and biostimulators become top of mind. “Our approach is structural, not superficial,” he notes. “It’s about restoring facial harmony without compromising identity.”
“What fascinates me is how differently my patients may define beauty. A 22-year-old influencer and a 55-year-old executive might sit in the same waiting room, but their goals couldn’t be more different. We’re not selling a standard look – we’re facilitating personal choices, and sometimes, those choices may even challenge conventional aesthetic norms.”
Understanding patient preferences: A cultural lens
Perhaps the most significant change is how different communities and racial groups are approaching enhancement in South Africa, reflecting new trends in beauty ideals. For example, African women are increasingly choosing breast reductions, prioritising comfort and opting for a different aesthetic from more traditional beauty standards which often favour a fuller figure or more pronounced curves.
Indian patients are leading the way in tummy tucks and body contouring, while Caucasian patients tend to focus on breast augmentations and high-definition liposuction, particularly around the waistline and abdomen, to refine their silhouette and definition.
“What’s beautiful about this shift is how it reflects our diversity. We’re not seeing patients trying to look like someone else – they’re choosing procedures that enhance their natural features and fit their lifestyles,” says Sofianos. “Critically, there is no one-size-fits-all in aesthetic medicine. The more we understand the nuances of each patient’s background and goals, the better we can serve them.”
Why winter is the most strategic time for surgery
No matter your personal objectives, an insider tip could make a huge difference in your surgical recovery: while people mistakenly tend to plan procedures for December – unaware that most surgeons do not operate after November due to holiday closures and the necessity of post-operative care – smart patients are booking for winter.
Cooler temperatures help to reduce swelling, promote easier healing, and generally mean less downtime. Patients also benefit from increased coverage beneath bulkier clothing, allowing them to recover more discreetly while still going about their daily lives. With fewer social commitments and sunnier distractions, winter becomes the ideal window for surgical recovery.
“If you want to look and feel your best by summer, now is the time to plan,” he advises. “Winter is a strategic opportunity for recovery.”
As aesthetic surgery continues to evolve in South Africa, Professor Sofianos believes that education, access, and authenticity are key pillars moving forward.
“My role is to guide patients through their options, help them make informed choices, and deliver results that are both technically excellent and emotionally empowering. The most rewarding part of my practice isn’t about creating one particular look, but about helping people become more confident versions of themselves. Whether that means a subtle enhancement or a more significant change, the choice is truly personal.”
