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 Today, that silence has been replaced by honest conversations about beauty, confidence, ageing, empowerment, and personal choice, as South Africans openly embrace a wide range of aesthetic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.”
By Damian McHugh, Chief Marketing Officer, Momentum Health
In his 2025 Budget Speech on 21 May, Finance Minister Enoch Godongwana reaffirmed government’s commitment to strengthening South Africa’s healthcare system, announcing a R20.8 billion boost to provincial health budgets. This includes hiring 800 post-community service doctors, addressing shortages of essential goods and services, and settling unpaid obligations.
While this is a welcome step toward easing pressure on healthcare workers, especially in underserved areas, it also presents a vital opportunity for public-private collaboration. The question now is whether this investment will be enough to tackle the deeper, systemic challenges facing our healthcare workforce and infrastructure.
In the ever-evolving landscape of healthcare in South Africa, the rising demand for healthcare services, coupled with a shortage of skilled workers, creates a complex challenge. There is an urgent need to not only support but also empower healthcare workers across the country.
According to the World Health Organisation (WHO), the shortage of skilled health professionals in South Africa is projected to be 97 000 by 20251. This challenge not only disrupts the delivery of quality care but also impacts the overall wellbeing of communities. As advocates for more accessible healthcare for more South Africans, we believe that innovative solutions are key to closing the gap, valuing and retaining current talent, and by doing so, edging us closer towards a healthier nation.
The growing need for healthcare workers is largely driven by factors such as our aging population, increased prevalence of chronic disease, and an uneven distribution of healthcare workers across provinces, with rural areas being particularly underserved2 . In these areas, patients often experience long wait times and reduced access to specialised care. Additionally, healthcare professionals across provinces often face burnout and job dissatisfaction due to excessive workloads and inadequate support. Together, these challenges add pressure to an already strained system.
Embracing Greater Collaboration and Innovation
To address local needs and support healthcare professionals in delivering quality services, a multi-faceted approach is necessary. The first step is greater collaboration between the public and private sectors. These partnerships can address systemic challenges and drive meaningful improvements, thus strengthening infrastructure and expanding affordable health insurance.
In recent years, technology has emerged with strong promise to bridge various divides. We’ve seen first-hand through our Hello Doctor offering and Momentum App how technologies such as telemedicine and emerging technology can enhance care delivery, efficiency and accessibility. These technologies can bridge geographical barriers, enabling healthcare professionals to provide remote consultations, monitor patient progress and access critical health information in real-time.
Building on the promise of technology, emerging technologies like AI can play a significant role in aiding healthcare professionals with decision-making, diagnostics, and patient management. AI-powered solutions can analyse vast amounts of data quickly, identify patterns, and provide recommendations to support evidence-based care. This can lead to more accurate diagnoses, personalised treatment plans, and improved patient outcomes.
Building a Sustainable Workforce
South Africa’s healthcare sector is one of the most stressful in the world, with the public sector particularly under severe strain. Staffing shortages exacerbate this stress, and so supporting healthcare professionals in their roles is just as important as implementing innovative technologies. Fostering a positive work environment and ensuring job satisfaction are key focus areas to improving care delivery. A supportive workplace culture not only enhances employee retention but also promotes better patient outcomes.
Prioritising Mental Health and Wellness
In addition to structural and technological improvements, we must also recognise the critical role of mental health and wellness in sustaining our healthcare workforce. Chronic stress, emotional fatigue, and trauma exposure are daily realities for many healthcare workers. Without adequate mental health support, these pressures lead to burnout, absenteeism, and crippling fatigue.
In recent years, it has become clear that wellness extends beyond physical health. As a result, a visible shift has occurred across the healthcare sector to provide wellness solutions that offer counselling services, resilience training, and mindfulness programmes tailored to the unique challenges faced by healthcare professionals. By embedding mental wellness into the core of workforce support strategies, we not only protect the individuals who care for our nation but also enhance the quality and consistency of the care they provide.
Retaining healthcare professionals is not only critical to the future of healthcare delivery in South Africa, but also to the future health of its people. Healthcare institutions must implement proactive strategies that prioritise the wellbeing of their staff.
Bridging the healthcare workforce gap in South Africa requires investing in innovation, training, and supportive work environments. Building a sustainable healthcare workforce capable of meeting the needs of our nation will take our collective effort to support and empower the sector. Together, we can create a healthier South Africa for generations to come.
Minister of Health Dr Aaron Motsoaledi. Source: GCIS
By Anna Grimsrud and Sibongile Tshabalala-Madhlala
Minister of Health Dr Aaron Motsoaledi’s recent claim that over half a million people have been newly started on HIV treatment in less than six months has raised eyebrows in health circles. In this open letter, Anna Grimsrud and Sibongile Tshabalala-Madhlala, associated with CHANGE – South Africa, ask the Minister to explain numbers that, on the face of it, seem contradictory.
Dear Minister Motsoaledi,
We write to you in response to your 15 May 2025 press statement and subsequent remarks in Parliament on the current status of the national HIV, AIDS, and TB campaign.
You stated that since the launch of the Close the Gap campaign, 520 700 people have been initiated on HIV treatment, reaching “more than 50% of the target”. You also stated that 5.9 million people are currently on antiretroviral therapy (ART). However, at the campaign’s launch on 25 February 2025, you reported the same number on HIV treatment — 5.9 million. This raises a critical question: if over half a million people have started or restarted treatment, why has the total number of people on treatment not increased?
If both figures are accurate, this would mean that approximately 520 000 people have been lost from care over the past few months — a deeply concerning and unprecedented level of attrition. We respectfully request that you provide the underlying data and clarify the current total number of people remaining on HIV treatment.
There are several reasons why we are concerned:
Static treatment numbers: As noted, the number on treatment was reported as 5.9 million in both February and May 2025. If 520 700 people have been initiated or re-initiated during this period, the same number must have exited care — a scenario that requires urgent explanation.
Slow growth in the number of people on treatment: According to official statements, the total number of people on HIV treatment increased by only 100 000 between March and December 2023 — from over 5.7 million to 5.8 million. The claim that the cohort has now grown by over 500 000 in a matter of months contradicts recent trends.
Declining lab numbers: National Health Laboratory Service data reported by the Daily Maverick and Reuters, show notable declines in viral load testing and early infant diagnosis in March and April 2025 compared to the same months in 2024. These indicators should increase alongside meaningful growth in treatment uptake — not decrease.
In light of these concerns, we believe it is essential that you provide a transparent accounting of the current number of people on treatment and the metrics being used to assess progress under the Close the Gap campaign. Specifically, we request data demonstrating that the programme is on track to meet its stated goal: increasing the number of people on treatment from 5.9 million to 7 million.
We share your commitment to a strong and effective HIV response, especially in this period of financial and operational strain. Like you, we believe it is vital that accurate and complete information is shared with the public and Parliament at this critical moment.
*Anna Grimsrud is an epidemiologist with a PhD in Public Health and writes in her personal capacity. Sibongile Tshabalala-Madhlala is openly living with HIV and currently serves as the National Chairperson of the Treatment Action Campaign (TAC).” CHANGE is a coalition of more than 1 500 people from civil society organizations in South Africa and around the work — people living with HIV, activists, community health workers, researchers, programme members, epidemiologists, clinicians, economists, and others. CHANGE stands for Community Health & HIV Advocate Navigating Global Emergencies.
Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.
Republished from Spotlight under a Creative Commons licence. Views expressed in the original article are not necessarily shared by Quicknews.
Kris Jenner’s “new face” has everyone talking – and it’s widely speculated to be the result of a deep plane facelift, a procedure now dubbed the gold standard in facial rejuvenation. Let’s not even get into how Khanyi Mbau’s face broke the internet. The demand for natural-looking, sophisticated facial transformations has reached an all-time high, both globally and here in South Africa.
A global weight loss boom, fuelled by miracle diabetes drugs, has led to an unexpected side effect: the ‘O weight loss face’, marked by hollowed cheeks, sagging jowls, and prematurely aged skin. In turn, this phenomenon has sparked a significant rise in demand for advanced facial rejuvenation, and particularly the deep plane facelift – what experts term ‘the facelift that lifts where it matters most’.
“One of the most common complaints I hear from patients is, ‘I finally have the body I wanted, but my face looks 10 years older,’” says Professor Chrysis Sofianos, one of South Africa’s leading plastic surgeons and experts in deep plane facelifts.
The Gauteng-based specialist notes that he has seen a meteoric increase in consultations from patients seeking to reverse the facial deflation and laxity caused by rapid weight loss.
“This is just one instance where the deep plane facelift truly shines, as it restores natural facial harmony by lifting and repositioning deep tissues, not just tightening the skin. By addressing the deeper structural changes caused by significant weight loss, this approach delivers far more natural outcomes and a timeless look.
The Facelift No One Can See
What sets the deep plane facelift apart? Unlike traditional facelifts that only address the skin’s surface, the deep plane technique lifts beneath the superficial musculoaponeurotic system (SMAS) layer of tissue to reposition and support the foundational structures of the face. This approach not only rejuvenates the face more effectively than other techniques, but also avoids the tell-tale ‘pulled’ look, offering a more subtle, organic-looking transformation.
Professor Sofianos further enhances his results with the Vertical Restore method, lifting facial tissues vertically – in harmony with the way gravity naturally impacts the face over time. This technique provides holistic rejuvenation of the midface, jawline, neck, and brow, with results that restore youthful contours and expressions.
“Only a handful of surgeons currently offer this breakthrough procedure, and I can confidently state that the deep plane facelift is the gold standard for natural, long-lasting revitalisation.”
According to Professor Sofianos, deep plane facelifts offer several major advantages compared to conventional facelifts:
Superior, long-lasting results: By repositioning deeper facial structures rather than merely tightening the skin, the deep plane facelift offers longer-lasting, more authentic outcomes.
Natural look and movement: The technique avoids excessive skin tension, ensuring the face remains expressive and vibrant – even in motion.
Comprehensive rejuvenation: From sagging jowls and hollow cheeks to neck laxity, the deep plane facelift addresses multiple problem areas in one single, unified procedure.
The Ultimate One-Stop Shop for Aesthetic Excellence and Care
Professor Sofianos’s practice is not only a leader in surgical innovation but also a complete one-stop destination for all aesthetic needs. His clinic offers a full suite of surgical and non-surgical procedures – from advanced facial surgeries to injectables, laser treatments, skin rejuvenation, and body contouring. Each treatment is bespoke and delivered with meticulous care to ensure natural, balanced, and long-lasting results.
What truly sets Professor Sofianos apart, however, is his absolute commitment to patient care. Every facelift is supported by a holistic pre- and post-operative care programme, designed to optimise recovery and results.
A signature component of this is the integration of hyperbaric oxygen therapy (HBOT), which is included as standard in his facelift packages. HBOT begins around 7–10 days after surgery, dramatically improving oxygen delivery to tissues, speeding up wound healing, reducing bruising and swelling, and significantly shortening overall healing time.
As a result of these additional post-surgical interventions, the typical recovery period is two to three weeks, with most patients able to resume social activities within a month. With comprehensive aftercare – including HBOT and nutrient therapies – patients benefit from accelerated healing and refined results that continue to improve for several months post-surgery.
“The success of a procedure isn’t just about the surgery itself, but about guiding patients through a complete journey from start to finish,” he explains. “My patients receive comprehensive, full-spectrum care – including pre-operative preparation, expert surgical techniques, post-operative hyperbaric therapy, scar management, and continuous follow-ups. It’s this level of commitment that ensures optimal outcomes, supporting patients through every step of their transformation and helping them feel comfortable and secure throughout.”
A Lasting Solution for Facial Rejuvenation in the Weight Loss Era
As weight loss medications continue to help patients address issues with weight management and obesity, experts predict that the demand for facial rejuvenation will only rise.
“This trend has created both challenges and opportunities for plastic surgeons, and in many ways is reshaping our field in real time. The good news for patients is that we’re at the beginning of a new chapter in aesthetic medicine – where a combination of sophisticated surgical techniques and aftercare procedures are helping people achieve what was once thought impossible: natural-looking transformations that truly turn back the clock.”
For those seeking to restore their youthful appearance with confidence and discretion, the deep plane facelift offers an unmatched, cutting-edge solution – delivered with precision, artistry, and unparalleled care by Professor Chrysis Sofianos and his dedicated team.
Lungile Kasapato, Chief Executive Officer of PPO Serve
The South African commercial health sector is at a critical juncture, grappling with a severe imbalance that threatens its sustainability and the accessibility of quality care. The dominance of the hospital sector and the deficient state of primary care, are creating an unsustainable system that demands urgent reform, says Chief Executive Officer of PPO Serve, Lungile Kasapato, speaking at the Board of Healthcare Funders (BHF) conference, held in Cape Town from 10-14 May.
“Primary care in the South African commercial health sector is underpowered, compared with a dominant hospital sector, that is pulling the system off-kilter, as a consequence,” Kasapato said.
She identifies a weak and disjointed primary care system as a key driver of this imbalance, underfunded by limited out of hospital benefits and exacerbated by the fee-for-service payment model, which incentivises fragmented care and counterproductive competition. This model leads to GPs competing with specialists for limited out-of-hospital benefits, hindering the collaborative approach needed for optimal patient outcomes.
“Incentives exist to deliver high volumes of covered services, rather than those which will produce the best outcomes and value,” she explains, highlighting the misalignment of financial incentives that the patient, and the medical scheme, needs.
The problem is further compounded by managed care models, which Kasapato suggests can inappropriately shift clinical accountability to funders who lack direct patient interaction. She is also wary of the conflicting roles of scheme administrators, who can profit from being both payers and providers, undermining the “not for profit” ethos of medical schemes and stifling innovation.
Kasapato stresses the crucial role of payers in strategically purchasing care from professionals working in multidisciplinary care teams. By doing so, payers foster healthy competition among these teams, with performance measured by outcomes and efficiency. She points to the contracting model between Government Employees Medical Scheme (GEMS) and PPO Serve’s The Value Care Team as an example, which involves a monthly global fee, adjusted for patient risk. Significant additional fees are linked to performance.
The effectiveness of this approach has been demonstrated in a three-year pilot with GEMS, which resulted in a 29.6% reduction in medical admissions and a 7% decrease in patient bed days, along with a 39% increase in flu vaccine uptake amongst at-risk patients. “That’s not just better care – it’s better use of every rand spent,” she said, highlighting the financial benefits of improved care co-ordination.
Kasapato proposes a fundamental shift towards healthy partnerships built around multidisciplinary GP-led teams. This is the approach of The Value Care Team, which emphasises co-ordinated care delivery. In this approach, clinical teams, allied health workers, alternative care facilities, and community-based organisations are integrated, with care co-ordinators guiding patients through the system. This structure aims to reduce waste, minimise unnecessary hospitalisations, and prioritise preventative care.
“Teams work together to deliver quality, efficient care within local resources, including collaboration with allied health workers, alternative care facilities and community-based organisations,” explains Kasapato.
Looking ahead, Kasapato stresses the urgency of addressing unhealthy competition and rebalancing the system to ensure long-term sustainability and progress towards universal healthcare. She cautions against short-sighted solutions like discounted fee-for-service networks and scheme-led managed care, which offer only temporary relief.
“After decades of imbalance, we’ve found ourselves in a situation where the vast majority of people living in South Africa cannot afford to access our badly structured healthcare resources,” says Kasapato.
Instead of sustaining a flawed system with solutions like isolated telehealth and pharmacy nurse clinics, Kasapato is calling for a fundamental transformation; “Let’s stop propping up a system in need of transformation and focus our efforts on partnerships that strengthen primary care delivery, bringing it into balance with hospital-based care and addressing the major challenges that the commercial sector is facing.”
The international community must protect global responses to HIV, tuberculosis (TB), and malaria to serve humanity’s collective interests, according to an opinion article published May 14, 2025, in the open-access journalPLOS Global Public Health by Gorik Ooms from the Institute of Tropical Medicine, Belgium, and colleagues.
Within days of starting his second term as President, Donald Trump ended most United States (US) contributions to global health. Global responses to HIV, TB and malaria are not the only programs affected but were particularly dependent on US support. The US withdrawal from global health could result in 3 million additional HIV deaths and 10 million additional HIV infections, 107 000 additional malaria deaths and 15 million additional malaria infections, and 2 million additional TB deaths, all in 2025.
HIV, TB and malaria are global health security threats that require international collective action. The Global Fund to fight AIDS, TB and Malaria (Global Fund) entered its replenishment cycle for 2027–2029, with a target of $18 billion. A failure of this replenishment would make it impossible for many countries to compensate for decreasing US funding and decreasing Global Fund support.
The abrupt end of most US funding for global health comes at a crucial moment for the fight against the three epidemics. For HIV, funding cuts are disrupting treatment and prevention, and increasing morbidity, mortality and infections especially among marginalised groups. The transmission of TB remains high due to insufficient access to treatment, urbanisation and undernutrition. Control of malaria remains elusive due to emerging resistance to treatments, and insecticides, gaps in prevention, and limited access to healthcare.
According to the authors, the reduction of US bilateral aid calls for re-prioritisation and enhanced coordination of the global fights against HIV, TB and malaria. Currently, the Global Fund is uniquely positioned to undertake this endeavour, as it financially supports HIV, TB and malaria programs in most, if not all, countries affected by US spending cuts. This requires a successful replenishment, which seems improbable given uncertainty about the US position and considering the aid spending cuts announced by other high-income countries. Low- and middle-income countries need to step in, which necessitates an overhaul of the Global Fund governance.
The authors outline four action points. First, all countries, regardless of income level, should support the current replenishment of the Global Fund. Second, the replenishment mechanism should move toward agreed and fair assessed contributions, such as 0.01% of the annual gross domestic product of all countries. Third, the Global Fund should commit to overhauling its governance structures to promote equal representation among geographical constituencies. Fourth, the Global Fund should commit to adhere to the Lusaka Agenda, which captures consensus around five key shifts for the long-term evolution of global health initiatives and the wider health ecosystem.
As noted by the authors, these four actions would save essential elements of the global responses to HIV, TB and malaria and set a central and collaborative mechanism for global health security on a path toward the principles of global public investment.
Dr Gorik Ooms adds: “Richer countries still view global health cooperation primarily as aid, from them to poorer countries. They do not seem to realise how this cooperation also protects their own interests. We must not only find enough funding to sustain it; but also rethink how we work together. Through genuine international cooperation between equal partners.”
Co-author Dr Raffaella Ravinetto concludes: “It is not only a matter of keeping life-saving programs alive. It is also a matter of building and maintaining a solid ecosystem, encompassing health infrastructure, policies and human resources, to make quality health care feasible everywhere. Through solidarity we can serve common interests.”
Image Caption: A person holds medications. Limited access to diagnostics and medicines will worsen treatment quality, inducing resistance to antiretrovirals and medicines for infections.
Johannesburg, 15 May 2025 – South Africa’s healthcare sector faces mounting pressure as international funding withdrawals threaten critical research and services.
Without the financial support, medical advancements are being jeopardised and access to care for vulnerable communities is limited.
With leading universities bracing for losses exceeding R800 million annually, experts warn of setbacks in disease treatment and public health initiatives. As foreign aid recedes, South Africa must look inward for sustainable solutions to safeguard its healthcare future.
At Adcock Ingram Critical Care (AICC), newly appointed Operations Executive Lucelle Iyer is part of a new wave of industry leaders focused on local solutions. Rather than relying on global models, she is driving efforts to strengthen domestic production and innovation. As public health programmes face uncertainty, the role of private-sector initiatives in sustaining healthcare access is becoming increasingly critical.
South Africa’s ability to bridge healthcare gaps and extend services to underserved communities increasingly depends on local innovation and resourcefulness. As AICC expands its investment in modernising plants and developing local talent through 2025, its initiatives could serve as a model for sustainable pharmaceutical manufacturing in South Africa and potentially across the continent. By focusing on innovation and homegrown expertise, the company is contributing to the broader effort to strengthen self-sufficiency in African healthcare.
The push towards localisation addresses the country’s significant dependence on imported pharmaceutical products and active pharmaceutical ingredients (APIs). In 2024, pharmaceutical imports to South Africa were valued at approximately $2.42 billion USD.1 Even though more than 60% of pharmaceutical products sold in South Africa are formulated locally, approximately 98% of APIs2 used in local formulation are imported.
This reliance exposes the healthcare system to risks like exchange rate fluctuations and supply chain disruptions, highlighting the need for increased local production. “We’ve seen the impact of the fragility of local supply chains on our hospitals, especially in rural and under-resourced areas,” says Iyer. “South Africa needs a manufacturing base that is resilient, scalable, and locally relevant.”
Iyer’s leadership is shaped by a philosophy of resilience, innovation, and strategic execution. As the first woman to lead operations at AICC and one of the youngest professionals to hold such a pivotal role, she has broken barriers in a traditionally male-dominated industry. Her success is driven by a solutions-focused mindset, tackling challenges with a commitment to progress and impact.
Building a future-proof pharma ecosystem
The shift to a local-first strategy is part of a broader sector-wide call for policy support and investment into the domestic pharmaceutical value chain. Experts argue that localisation is not only a health security imperative, but an economic opportunity — capable of generating skilled jobs and retaining healthcare spending within national borders.
“Pharma manufacturing has long been seen as too complex or too costly for the local context,” says Iyer. “But technology has changed that. Smart factories, digital quality control, and automation can make local production competitive.”
AICC’s comprehensive strategy includes:
Digitisation of production and regulatory compliance systems
Building local expertise in pharmacy, engineering, and biotechnology
Collaboration with stakeholders to streamline regulatory frameworks
Incorporating sustainability and circular economy principles into packaging and plastics manufacturing
Leveraging compliance for competitive advantage
AICC also challenges the common perception that regulatory compliance limits innovation. Instead, the company integrates compliance strategically into its digital transformation, embedding quality assurance and regulatory preparedness from the outset.
“When systems are designed with compliance in mind from the beginning, it greatly reduces rework and crisis management, turning quality into a driver of efficiency,” says Iyer, who brings extensive experience in regulatory affairs, quality management, and pharmaco-economics to her role.
A pivotal moment for the industry
South Africa’s pharmaceutical sector stands at a crossroads, with the potential to become a regional hub for essential medicines, medical devices, and biosimilars. Realising this ambition, however, hinges on coordinated efforts across public, private, and academic sectors to drive innovation, expand capacity, and ensure long-term sustainability.
“Our goal isn’t to replicate models from Europe or the US,” says Iyer. “It’s about creating a pharmaceutical ecosystem designed specifically for our unique needs – efficient, ethical, and sustainable.”
Finding a path forward for South Africa’s healthcare workers
Donald McMillan
By Donald McMillan, Managing Director at Allmed Healthcare Professionals
06 May 2025
South Africa’s healthcare system is under serious pressure. The sudden suspension of critical US funding has resulted in the loss of around 15 000 healthcare jobs – many of them linked to HIV/AIDS programmes that served as lifelines for vulnerable communities. Combined with broader public sector budget cuts and a national hiring freeze, the situation threatens to undo decades of progress in healthcare delivery. As public hospitals struggle with fewer staff and shrinking resources, the country is at risk of losing not only jobs, but skills, infrastructure, and hope. But in the face of these challenges, there are still ways to keep services running and people employed. One of them is through Temporary Employment Services (TES), which provides a flexible staffing approach that can help stabilise the system while longer-term solutions are explored.
A healthcare system under pressure
The US aid cut has had an immediate and devastating impact. Programmes focused on HIV, tuberculosis, and reproductive health, many of which were propped up by international donor funding, have been forced to scale back or shut down entirely. Thousands of community healthcare workers, nurses, counsellors, and administrators have found themselves jobless, while patients are left facing longer wait times and reduced access to care.
At the same time, cost-cutting across the public sector has put a freeze on new hires, even in essential departments like health and the impact is already being felt. With public hospitals and clinics stretched thin, they’re unable to take on newly trained doctors and nurses. And while the private sector plays a role, it simply cannot absorb the overflow. This isn’t just a staffing issue, it’s a setback for the entire healthcare system, affecting everything from medical training to frontline care.
Young professionals left in limbo
Every year, South Africa produces thousands of highly trained doctors and healthcare workers, many of whom move into the public health system after completing their compulsory community service. These roles used to be a given but with hiring freezes and shrinking budgets, many young professionals are now finishing their training with nowhere to go. Despite their skills and frontline experience, these workers are left in limbo. This is a double blow as South Africa loses out on the return from its investment in their education, while the risk of a growing skills drain looms large. With countries like the UK, Australia, and Canada actively recruiting healthcare workers, there’s a real chance they may leave and not come back.
A flexible solution in Temporary Employment Services
In response to this crisis, temporary employment solutions have become a practical and effective solution. TES providers offer qualified healthcare professionals short- to medium-term flexible contracts, enabling them to continue working in their field while delivering essential support to overburdened healthcare facilities.
This approach offers a lifeline not just for displaced workers, but for clinics and hospitals struggling with limited resources. TES employees can be rapidly deployed where they are needed most, whether to cover staff shortages, serve remote communities, or support seasonal fluctuations in demand. Unlike permanent hires, they don’t carry long-term costs such as medical aid or pension contributions, making them a more budget-conscious option in uncertain times.
The benefits of the TES model have already been proven. During the COVID-19 pandemic, temporary staff played a key role in scaling up testing, vaccination, and treatment efforts across the sector. That same adaptability is needed now to respond to the healthcare funding crisis.
Rethinking the future of healthcare work
While temporary employment solutions cannot not solve the problem alone, it can provide an important stopgap and potentially a new way of thinking about workforce planning in the healthcare sector. Rather than relying solely on permanent positions, South Africa may need to adopt a more fluid, demand-based deployment model that allows professionals to move between roles, regions, and areas of urgent need.
Shifting to this model calls for a change in mindset. Permanent posts have traditionally been seen as the gold standard in healthcare, valued for their stability and benefits. But in a time of uncertainty, contract and locum roles – especially when managed by trusted TES providers – can offer a practical alternative, combining income, ongoing experience, and flexibility.
Retaining talent, restoring hope
Avoiding long-term damage to South Africa’s healthcare system will require urgent, coordinated action. Government departments must urgently reprioritise spending toward essential services like health and education. At the same time, private healthcare providers and staffing agencies must step up and work together to ensure that skilled professionals are not lost to the system or the country.
Despite the current turbulence, South Africa’s healthcare workers remain among the best trained and most resilient in the world and with the right support structures, including flexible employment options like TES, we can preserve our healthcare capacity and continue to serve those who need it most.
Migraines can severely affect the quality of life for people who suffer from them, making work, social interactions, and even simple tasks unimaginably difficult. With an estimated 15%* of the global population affected, the impact of migraines on daily life and productivity is significant and cannot be underestimated.
“Migraines are more than just headaches — they are complex neurological events that can significantly impact daily life, often leading to missed days of work or school because of the intense pain and other associated symptoms,” says neurologist Dr Michael Huth, President of the South African Headache Society and Executive Board member of the Neurological Association of South Africa, who practises at Netcare Linksfield Hospital.
“The debilitating and wide-ranging symptoms people experience with migraines can reduce productivity. In addition to brain fog and fatigue, some have sensitivity to environmental factors, such as bright lights, strong smells, or loud noises, which can worsen symptoms.
“Furthermore, the emotional distress of dealing with chronic pain from recurring migraines can contribute to anxiety and depression for some individuals who endure them, underlining the importance of proper diagnosis and appropriate management of migraines,” he says.
“While many people think of migraines as intense head pain, there are different types of migraines, each with characteristic symptoms, duration, and triggers. Determining what type of migraine a person is experiencing is key to establishing what can be done to help manage the episodes effectively and, where possible, prevent them.”
Types of migraines generally fall into two broad categories, depending on whether there is a visual or sensory disturbance known as an ‘aura’ before or during the headache phase. “An aura can be described as flashing lights, blind spots, tingling sensations, or difficulty speaking, and a classic migraine includes aura symptoms for 20 minutes to an hour,” Dr Huth explains.
“A migraine without an aura is known as a common migraine. Symptoms include throbbing or pulsating pain often felt on one side of the head, nausea, vomiting, and sensitivity to light and sound.
“These migraines typically last between four and 72 hours without treatment, and frequency varies with some people experiencing occasional attacks, known as episodic migraine, while others may experience repeated migraines many times in a month.
“Chronic migraine is defined as symptoms occurring for 15 days or more per month for at least three months. These migraines are persistent and can be near-daily in severe cases,” he says.
“Hemiplegic migraine, which is often caused by genetic factors, is experienced as temporary weakness or paralysis on one side of the body, lasting anywhere from a few hours to several days at a time. This type of migraine is accompanied by aura symptoms such as confusion, speech difficulties, or dizziness. While the attacks are usually infrequent, some individuals experience hemiplegic migraine multiple times a year.”
In addition to these more widely recognised migraines, Dr Huth warns that some lesser-known types can be just as disruptive.
“Vestibular migraine, also known as migraine-associated vertigo, involves symptoms of dizziness, balance issues, nausea, and sensitivity to movement – sometimes without a headache – lasting from minutes to hours. Lifestyle changes can be helpful in conjunction with vestibular rehabilitation therapy to improve balance and stability and prescribed treatment such as beta-blockers or anti-seizure medication.
“Abdominal migraines, on the other hand, are recurrent episodes of severe stomach pain, nausea, and vomiting, usually seen in children. Often, adjusting lifestyle factors and drinking enough water for good hydration can help to prevent or minimise abdominal migraines, supported with medication where needed,” Dr Huth says.
“Ophthalmic or retinal migraine symptoms include temporary loss of vision or visual disturbances in one eye, followed by or accompanied by a headache. It is important that people experiencing this type of migraine have an eye examination with their ophthalmologist to rule out the possibility of other eye-related conditions that could be contributing to the condition. Identifying and avoiding triggers can be helpful, as well as migraine-specific medications guided by your treating doctor.”
Tips to reduce migraine frequency and severity
“While medication can help manage migraines, the following lifestyle changes can play a crucial role in reducing their frequency and intensity,” he advises.
1. Maintain a consistent routine
Stick to regular sleeping patterns, aiming for seven to nine hours of rest.
Eat balanced meals at the same times each day to prevent blood sugar levels from dropping.
Stay hydrated, as dehydration is a common migraine trigger.
2. Manage stress
Practise relaxation techniques like meditation, deep breathing, or yoga.
Take breaks from screens and limit exposure to bright or flickering lights.
3. Exercise in moderation
Low-impact activities like walking, swimming, or stretching can help.
Avoid overexertion, as intense workouts can sometimes trigger migraines.
4. Watch your diet
Keep a migraine diary to help identify and avoid triggers.
Common food triggers include caffeine, alcohol, aged cheeses, processed meats, and artificial sweeteners.
An elimination diet can help pinpoint specific food triggers.
5. Medication and alternative therapies
Preventive medications may be prescribed for frequent migraines.
Acupuncture and magnesium supplements can provide relief for some sufferers.
“Migraines are complex and vary widely from person to person. Understanding the different types, recognising their symptoms, and implementing lifestyle strategies can make a significant difference in managing them.
“If you or someone you know experiences frequent migraines, there is help available and consulting a doctor for an individualised treatment plan is recommended. Through awareness and prioritising self-care, quality of life can be greatly improved for those suffering from migraines,” Dr Huth concludes.
Finance Minister Enoch Godongwana holding a copy of the 2025 Budget Speech. (Photo: Parliament of RSA via X)
By Charles Parry, Funeka Bango, Tamara Kredo, Wanga Zembe, Michelle Galloway, Renee Street and Caradee Wright
While the 2025 national budget boosts health spending, researchers from the South African Medical Research Council stress the need for strong accountability measures. They also raise concerns about rising VAT and omissions related to US funding cuts and climate change.
The 2025 budget speech by Finance Minister Enoch Godongwana saw a welcome boost to the health budget with an increased allocation from R277 billion in 2024/2025 to R329 billion in 2027/2028. This signals a government that is responding to the dire health needs of the public sector, that serves more than 80% of the South African population.
As researchers at the South African Medical Research Council (SAMRC), we listened with interest and share our reflections on some of the critical areas of spend relevant for health and wellbeing.
We note the increase in investment in human resources for health and allocations for early childhood development and social grants. At the same time, we also raise concern about increasing VAT, with knock-on effects for the most vulnerable in our country. There were also worrying omissions in the speech, such as addressing the impact of the United States federal-funding freeze on healthcare services nationally, and a noticeable absence of comment on government’s climate-change plans.
Health and the link with social development: Recognising the importance of early childhood development
Education and specifically early childhood development (ECD) is known to have critical impacts on children’s health and wellbeing, with longstanding effects into youth and adulthood. In South Africa, eight million children go hungry every day, and more than a third of children are reported to live in households below the food poverty line, that is below the income level to meet basic food requirements, not even covering other basic essentials such as clothes.
While the increase in the number of registered ECDs is laudable, many more ECD centres in low-income areas remain unregistered, which means they do not get support from the government in terms of subsidies and oversight.
Social grants
The increase in social grants is welcomed. However, the marginal increase of the Child Support Grant (CSG) by only R30, from R530 to R560, is too little to impact on the high levels of child hunger and malnutrition. The release of the Child Poverty Review in 2023, which highlighted the eight million children going hungry every day, including CSG recipients, proposed the immediate increase of the CSG to at least the Food Poverty Line (R796 in 2024).
Social relief of distress still too small
The Social Relief of Distress (SRD) Grant is an important source of income for low-income, working-age, unemployed adults. Its continuance in 2025 is welcomed. However, it remains too small at R370 per person per month, and the stringent means-test criteria which disrupt continuous receipt from month-to-month, makes it an unreliable, unpredictable source of income for low-income individuals.
Strengthening the healthcare workforce
The Minister stated that “R28.9 billion is added to the health budget, mainly to keep about 9 300 healthcare workers in our hospitals and clinics”. It will also be used to employ 800 post-community service doctors, and to ensure that our pharmacies do not run out of medicines. The speech highlighted the necessary commitment to strengthening the healthcare system, specifically human resources for health.
Considering the pressures on resources, primarily due to the escalating disease burden and challenges within the health workforce, the proposed budget increase from R179 billion to R194 billion – an increase of 8.2% – to maintain the current workforce and employ additional healthcare workers signifies a positive step forward that will aid in addressing staff shortages.
Despite the gains in health spending, the proposed increase in VAT raises substantial concerns to partially negate the potential benefits to the health sector. As the World Bank reports that approximately 60% of people living in South Africa live below the poverty line, increases to VAT will likely drive poverty levels higher.
A focus on other forms of taxation may be better, more evidence-based, and less likely to disproportionately affect those at the highest levels of poverty.
On the issue of alcohol taxes, often mischaracterised as “sin taxes” rather than “health taxes”, the Minister has proposed excise duties of 6.75% on most products for 2025/26. This is 2% above consumer inflation, which stands at 4.75%.
Raising alcohol prices through higher excise taxes is globally recognised as an effective way to address alcohol-related harms. National Treasury is to be commended for adjusting alcohol excise tax rates above CPI in the 2025/26 Budget. This is a move in the right direction, but it does not address the current anomalies in tax rates across different products. This failure to address shortcomings in the excise tax regime is expected, given the release of a discussion document on alcohol excise taxes in December 2024 with a February 2025 response date. The earliest we can expect substantial changes in excise tax rates is in February 2026.
From a public-health perspective, it makes sense to link alcohol excise taxes to the absolute alcohol content of the product to standardise across products. Ethanol is ethanol. The current differential in excise tax rates on different alcohol products is indefensible. Specifically, it makes no sense to tax wine and beer so much less than spirits in terms of absolute alcohol content. Wine, especially bag-in-box wine, is the cheapest product on the market in South Africa, and its affordability increases consumption, leading to more societal harm.
Beer is the most consumed product in the country and is increasingly sold in larger, non-resealable containers. A 2015 SAMRC study in Gauteng found the highest level of heavy episodic drinking with beer products, largely due to their affordability, especially in larger, non-resealable containers. Heavy episodic drinking is a major public-health concern in South Africa, with 43.0% of current drinkers engaging in heavy episodic drinking at least monthly, 50.9% of male and 30.3% of female drinkers. Increasing the excise tax on beer is a powerful tool that the state can use to reduce the level of such behaviour.
Additionally, it makes sense to have lower taxes on alcohol products with lower alcohol content, as this could shift consumption to less harmful products. The current excise tax regimen does not account for this within a single product type like beer or wine, as all products are taxed at the same rate regardless of their alcohol content.
During the COVID-19 pandemic, we saw the benefits of decreased access to alcohol: fewer injuries, fewer unnatural deaths, and communities less disrupted by patrons visiting liquor outlets. While no one advocates for total liquor sales bans, increasing excise taxes on wine and beer would decrease alcohol consumption and reduce harms on drinkers, on others around them, and on society more broadly.
Acute risk to lives with knock on effects due to US federal funding cuts
We believe the South African government has a responsibility to step into the gap left by the sudden US federal funding freeze on HIV and TB services. The US President’s Emergency Plan for AIDS Relief (PEPFAR) funds 17% of HIV and TB services in South Africa and covers salaries for thousands of health workers, including the vital services of community health workers.
The implications for people living with HIV and TB and affected by the externally funded services will be devastating. It will also have ripple effects on the health system as we see inevitable increases in demand for health services to address advancing illness, effects on families caring for ill relatives or losing income.
This area needs to be addressed and clear communication from the National Department of Health is urgently awaited. The US funding cuts clearly impact on essential research funding available to institutions like the SAMRC and no indication has been given in the budget of any plans to augment or replace such funding.
National Health Insurance for South Africa’s public sector
The Minister addressed budget allocations for NHI implementation, specifically, the mid-term indirect and direct conditional grants for NHI were R8.5 billion and R1.4 billion respectively. Although these amounts in themselves are minor compared to other health-budget allocations, allocations for infrastructure (R37.4 billion over the mid-term economic framework period) and additionally allocations for digital patient health information systems, chronic medicine dispensing and distribution systems, and medicine stock surveillance systems are vital for healthcare efficiency and improved outcomes.
Least said not soonest mended: climate change – ‘no comment’?
From a climate-crisis perspective, although the budget speech did not explicitly mention climate change or its related health challenges, there seems to be positive steps being taken to address these issues. Initiatives such as clean energy projects and efforts to improve water management have the potential to benefit all sectors of society, while helping to mitigate the health risks associated with climate change.
Promising spend on health, but who will measure the impact?
Ultimately, increasing health spend is a promising step to increase access to quality health services for South Africa’s population. However, this is not enough, government must seize the opportunity to translate the budget increase into improved health outcomes. The effectiveness of the additional funds must be maximised through efficiency, transparency, and sound governance. The government can reinforce the integrity of public-health services by aligning these increases with robust accountability measures.
Government-academic partnerships represent an opportunity to share knowledge, technical skills and resources to support evidence-informed decision-making for national health decision-making and strengthen monitoring and evaluation mechanisms. There are many examples of this working well, and we trust that the SAMRC, along with the network of higher education institutions are well placed to provide the necessary support.
*Parry, Bango, Kredo, Zembe, Galloway, Street and Wright are researchers with the SAMRC.
Note: Spotlight aims to deepen public understanding of important health issues by publishing a variety of views on its opinion pages. The views expressed in this article are not necessarily shared by the Spotlight editors.
