Cipla has been awarded a public sector vaccine tender, reaffirming the company’s commitment to strengthening South Africa’s immunisation program through the equitable supply of high‑quality, affordable vaccines.
Cipla submitted bids across several critical paediatric and childhood immunisation categories, including Pneumococcal Conjugate Vaccine (PCV‑10), Rotavirus vaccine, Hepatitis B (Paediatric formulation). These vaccines play a vital role in preventing life‑threatening childhood illnesses and reducing the burden on healthcare systems.
CEO of Cipla Africa, Paul Miller, said: “This tender award marks an important milestone for Cipla as we continue to expand our vaccine footprint in support of national immunisation priorities. We can meaningfully contribute to comprehensive immunisation programmes and long‑term disease prevention efforts.
“Our participation across multiple vaccine categories demonstrates our commitment to addressing critical public health needs and strengthening health outcomes for children and communities.”
Cipla’s vaccine portfolio is underpinned by stringent quality standards and a focus on ensuring continuity of supply reliability. Cipla has a long history of partnering with the Department of Health to support equitable access to quality healthcare, including the supply of antiretrovirals and various vaccines.
Cipla South Africa focus will be ensuring reliability of supply, consistency, and responsible partnership with the public health sector, particularly in communities where access to healthcare remains uneven. CEO of Cipla Africa, Paul Miller, said: “This tender reaffirms our ongoing partnership with the state, as part of Cipla’s mission of ensuring access to quality, affordable healthcare.”
As part of our ethos of “Caring for Life”, we strongly believe in the importance of robust routine immunisation programmes that save lives, reduces inequality and delivery lasting benefits for society as a whole. In public health, progress often comes down to getting the basics right – ensuring vaccines are available, delivered on time, and reach every child who needs them.”
Participation in the Expanded Programme on Immunisation (EPI) aligns with Cipla’s broader mandate to support preventative healthcare and long‑term public health sustainability, said Miller.
Cipla South Africa continues to work closely with healthcare partners and has invested in initiatives to strengthen vaccines knowledge and reduce vaccine hesitancy. For more information about vaccines, visit https://medinformer.co.za/?s=vaccines
South Africa is facing an alarming increase in non-communicable diseases and related mortality. According to Statistics South Africa, deaths due to non-communicable diseases such as type 2 diabetes and hypertension increased by over 58% between 1997 and 2018.
The crisis of overweight and obesity in the country adds to the risk of these diseases. Nearly 40% of the adult population is overweight. Although physical activity can help prevent and manage many non-communicable diseases, 47% of adults do not engage in any physical activity. Most people struggle to meet the World Health Organization’s recommended 150-300 minutes of moderate-intensity aerobic physical activity per week.
A significant part of the challenge is that people have adopted an “all or nothing” approach to physical activity. The perception is that one has to participate in structured workouts, such as gym sessions, running, or cycling.
Instead, research has shown that even brief, low-intensity movements can yield measurable physical and mental health benefits. Even everyday tasks count. New evidence shows that short movement bouts of less than five minutes can have positive health implications.
As researchers in exercise science and sports medicine we have observed that physical activity is particularly low in South Africa. Only 19.8% of adults meet the WHO’s guideline, against the global average of 73%.
Our study of 62 office-based workers at the University of the Witwatersrand also showed the short-term health impact of height-adjustable, sit-to-stand desks. Our intervention reduced prolonged sitting and slightly improved indicators such as body mass index and blood pressure. Given South Africa’s high burden of obesity and sedentary lifestyles among office workers, these improvements are encouraging and support global health messaging that even modest increases in daily movement can positively influence health.
These findings were the springboard for the “Mzansi, what’s your move?” campaign at the university. We want to encourage staff and students to move more by showing how simple actions add up to physical activity. The campaign is supported by a series of comics and murals on campuses.
Here, we highlight some of the actions that we used in our campaign to encourage everyone to get moving. These are daily tasks that may seem mundane but count as physical activity, while reflecting people’s realities.
Housework
Many people do not consider housework a form of physical activity. But tasks like sweeping, mopping or vacuuming require sustained movement and engage multiple muscle groups.
Scrubbing floors, washing windows and cleaning bathrooms involve movements such as squatting and stretching. Working in the garden can strengthen muscles too.
As part of our campaign, we’ve developed comic strips that highlight movements that can be done at home and in the community. We emphasise how all family members can move in ways that fit their lifestyles and physical abilities.
Active commuting
Walking or cycling to work or school contribute significantly to daily physical activity. Studies have shown that active commuting is associated with lower body fat, reduced blood pressure, and improved mental well-being.
Including movement into daily travel routines is a practical way to accumulate physical activity without setting time aside. Walking briskly to a train station, cycling a few kilometres to work, or taking a longer walking route to drop off children at school accumulates over time. Even seemingly small changes, such as getting off the bus one stop early or taking the stairs instead of the elevator, produce measurable health benefits over weeks and months.
However, achieving the full benefits of active commuting is complex and it relies on cities building and maintaining road infrastructure. In South Africa, safety is a legitimate concern for all road users. A 2024 Statistics South Africa report shows that more pedestrians than car occupants died in road crashes in 2007, 2013, and 2019. Another safety concern relates to the country’s high crime rates. People may be reluctant to walk, even in their own neighbourhoods.
These challenges are not insurmountable. For starters, people should consider people moving in groups, joining walking and running clubs.
Beyond what individuals can do, municipalities can do something about green spaces. This includes ensuring that parks are safe to walk in and are clean. Broken pavements and bicycle lanes need to be maintained in all neighbourhoods.
Incidental movements
Incidental movements refer to small bouts of activity that occur throughout the day. Integrating these movements into everyday life can yield significant health benefits, especially in office contexts, where many people sit for extended periods. Employers can try nudging staff, for example to use the stairs instead of elevators, with simple posters or painted footprints. Another way to encourage physical activity is to centralise shared equipment (printers, bins, water stations) so that staff walk short distances.
Micro-breaks also provide opportunities for informal movements. Stretching during meetings or after long sitting periods, standing discussions instead of seated ones, and walking meetings for small groups all contribute to the physical activity of employees.
In 2024, we investigated the short-term impact of physical activity interventions such as high-intensity interval training and moderate-intensity continuous training on 43 labourers at the University of the Witwatersrand. The number of participants in this study was small, but the findings show that our intervention reduced indicators such as waist circumference, body mass index, blood glucose and blood pressure, and improved physical fitness.
Way forward
People don’t need a gym membership or a strict workout schedule to get moving. Simple, everyday activities all add up to meaningful physical activity. Small movements help to reduce the risks of chronic diseases, strengthen muscles, boost mental wellbeing, and counteract the harmful effects of prolonged sitting.
These “movement snacks” make exercise accessible, manageable and sustainable, particularly for people who find structured workouts intimidating or time-consuming.
Around 3.8 million people in South Africa developed depression in 2024, researchers estimate in a major modelling study. Photo from Pixabay CC0
By Gauta Mashego
Substance abuse is both a symptom and a consequence of untreated mental illness, and government needs to urgently step in to confront this dangerous overlap, argues Gauta Mashego of SECTION27.
Mental health globally has been in crisis for years. The strain on mental health was especially visible when the world stood still during the COVID-19 pandemic. The prevalence of anxiety and depression increased by 25% in the first year of the global outbreak of the SARS-CoV-2 virus, according to the World Health Organization. However, as the pandemic eased and life returned to the usual, open conversations around mental health also tapered off.
In South Africa, as in many low-and-middle income countries, people struggle with mental health disorders such as anxiety and depression. Around 3.8 million people in South Africa developed depression in 2024, estimate researchers in a major modelling study published as a preprint in March on medRxiv.
Mental health is shaped by many factors
Several studies worldwide report a high prevalence of substance use among people with mental illness compared to the general population.
Researchers have found that patients who suffer from psychotic disorders, such as schizophrenia and bipolar mood disorder, were more likely to abuse alcohol and illegal substances. Indeed, findings from a community survey highlighted a substantial burden of co-occurring mental disorders and alcohol use among men in three provinces in South Africa.
What also makes our society vulnerable to both mental health conditions and increased use of drugs and the development of substance use disorders, is our historical context of apartheid as well as socio-economic factors such as poverty, unemployment, and violence. Researchers have argued that mental health problems are related directly to poverty, while others also make the case that the poor are at greater risk than the rich to suffer from mental illness. At the same time, those living with mental illness are more likely to remain trapped in poverty due to high treatment costs, reduced productivity, and stigma around mental illness.
The kids are not alright
Underage drinking further complicates an already complex problem.
Up-to-date statistics of underage drinking in South Africa are limited, however the matter was thrust into the spotlight on Christmas day in 2025 when a disturbing video circulated on social media showing children between the ages of 6 and 12 consuming alcohol in the presence of adults.
Providing insights into the drinking behaviours of adolescents aged between 11 and 18, a 2019 Human Sciences Research Council study in townships across three provinces found that most had their first drink at the age of 13 or 14 years.
Highlighting the extent of underage drinking among Grade 8–11 learners from public schools in all nine provinces, the 2011 South African Youth Risk Behaviour Survey recorded that around 17% of 13-year-olds and 18% of 14-year-olds had engaged in drinking five or more drinks within a few hours on one or more days in the preceding month.
Mental disorders that commonly co-occur with alcohol use disorders in adolescents include antisocial disorders, mood disorders, and anxiety disorders.
Young people’s drinking habits are often linked to factors such as social norms, and the accessibility and affordability of alcohol. Added to this, since young people are often prolific consumers of media, they are frequently exposed to alcohol advertising and marketing, which encourages the consumption of alcohol.
But there is some hope.
The Liquor Amendment Bill aims to amend the Liquor Act of 2003 to prohibit the advertising, promotion or product placement of liquor in all forms of media. The Amendment Bill is at a very early stage in the legislative process, and it is likely to take time before we see any changes to the law (and longer before we see its implementation).
Other legislative changes debated include raising the legal drinking age from 18 to 21 and keeping schools alcohol-free, and more generally to place a moratorium on new liquor licences and stronger enforcement against Liquor Act violations.
South Africa also has a National Drug Master Plan 2019-2024. It was released by the Department of Social Development, and importantly, it recognises addiction as a chronic disease affecting the brain and behaviour.
However, experts say that while it is a great document, the Central Drug Authority which is tasked with implementing the plan, needs more power and resources to implement the plan’s recommendations.
South Africa also has a National Mental Health Policy Framework and Strategic Plan (2023-2030), that was introduced by the Department of Health. Similarly to its previous iteration, the latest plan envisions the integration of mental healthcare into primary healthcare. A key objective of the new plan is to ensure that mental healthcare users have access to care near their places of work. Another aim is to strengthen collaboration between government departments like education and social development to ensure that mental health is incorporated in planning and service development.
However, as it stands, many public healthcare facilities lack mental health professionals, with rural and underserved communities having little to no access to care. Only about 50% of public hospitals offering mental health services have a psychiatrist, while the country has less than one psychologist for every 100 000 people.
Shortages of mental health professionals mean patients often wait months for appointments. For an adolescent or a child who experiences anxiety, depression or suicidal thoughts, these delays can feel unbearable and it is quite possible that they may give up before receiving help. Currently, only one in ten children diagnosed with treatable mental conditions will have access to care.
While South Africa developed extensive legislative and policy frameworks to give effect to the constitutional right to healthcare, including mental healthcare, constitutional promises must make a difference in the lives of people. Unfortunately, millions of people in the country face barriers to mental healthcare, exposing the persistent gap between constitutional promises and lived reality.
When families lack access to counselling, community-based mental health services and early intervention programmes, harmful coping mechanisms continue to be passed down rather than prevented. To achieve the objectives of the Mental Health Policy Framework by 2030 and to catch up with the National Drug Master Plan that lapsed in 2024, stronger political will and meaningful action are urgently required. This is a crisis South Africa can’t evade.
*Mashego is a candidate attorney with SECTION27.
Note: Spotlight is published by SECTION27, but is editorially independent – an independence that the editors guard jealously. 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.
While South Africa was among the first countries to introduce mandatory salt reduction targets in processed foods, health experts warn that hypertension remains a major public health concern. The reason is increasingly clear, the problem is no longer only what is manufactured, but how people eat every day.
As World Salt and Hypertension Awareness Week (4–29 May) approaches, the focus should shift from reformulated products to daily behaviour change. High salt intake causes the body to retain excess fluid, which increases the volume of blood in the system and places greater pressure on the artery walls, directly leading to the development of hypertension.
“While the policy has successfully reduced hidden salt in many staple foods, it has not yet shifted South African taste preferences.,” says Lizeth Kruger, Clinic Executive at Dis-Chem. “We are still reaching for the shaker out of habit, and that’s where the real danger lies.”
Hypertension remains one of South Africa’s leading risk factors for heart disease and stroke, often progressing silently until complications arise. According to the Heart and Stroke Foundation South Africa, more than one in three adults lives with high blood pressure, a ‘silent killer’ that accounts for roughly half of all strokes and 40% of heart attacks in the country.
Kruger says a shift in everyday eating habits could reduce excess salt intake
1. Automatic salt shake
Many people add salt before tasting their food, even when meals have already been seasoned during cooking or processing.
2. Hidden salt in everyday staples
Stock cubes, processed meats, margarine and sauces remain significant sodium sources, especially when used frequently in daily cooking.
3. Convenience meals and takeaways
Ultra-processed foods and fast meals are often high in sodium, with a single serving sometimes approaching or exceeding the recommended daily limit.
4. A conditioned taste for salt
Long-term high-salt diets have shaped taste preferences, making fresh, whole foods seem bland and reinforcing reliance on added seasoning.
5. Unnoticed snack intake
Savoury snacks, biltong and crackers contribute meaningful sodium but are often not counted in daily intake.
Small changes, meaningful impact
Kruger says reducing salt intake is less about strict diets and more about changing repeat behaviours.
“Small, consistent adjustments can make a real difference over time,” she explains.
Tasting food before adding salt is a simple first step, as many meals are already seasoned. Rinsing canned foods such as beans or corn can also reduce sodium content.
Flavour can be enhanced using alternatives such as garlic, lemon juice, herbs and black pepper, while checking labels for lower-sodium options helps guide better choices.
A shared responsibility
“Regulation has laid the foundation, but the final step is ours,” Kruger advises. “By becoming more aware of everyday habits, we can reduce the risk of hypertension, stroke and heart disease in our homes.”
By Gale Shabangu, Chairperson, Hospital Association of South Africa (HASA)
Recently, President Cyril Ramaphosa made an important decision: to pause the promulgation of the National Health Insurance (NHI) Act until the Constitutional Court has ruled on the pending challenges to Parliament’s role in passing the Act. In doing so, he affirmed that due process must guide reform.
It is a reminder that healthcare reform is not a race to the finish line, but a journey that requires careful pacing, broad consultation and respect for the voices of South Africans. Reform at this scale is like tending a vast garden: every seed must be planted with foresight, every path cleared with care, so that the harvest nourishes all.
Families already feel the strain of rising costs – electricity, food, borrowing – and medical contributions that climb steadily. Yet even in this pressure, there is resilience. South Africans have always found ways to adapt, to share, to build together. Healthcare reform must honour that spirit, ensuring affordability is not a privilege but a shared foundation.
The private healthcare system is a necessary and valuable part of the scaffolding of our healthcare system, sustaining capacity that millions rely on. Unfinished reforms, such as risk equalisation, mandatory membership, and base benefit packages, remain like bridges half‑built. Completing them would stabilise participation and strengthen the entire ecosystem.
If private participation declines, demand does not vanish – it shifts. Public hospitals, already carrying immense responsibility, would feel the weight. Yet here lies the opportunity: to recognise that public and private healthcare are not adversaries but allies. The public sector anchors universal access; the private sector provides funded capacity that absorbs demand and sustains innovation. Together, they form a single ecosystem, each part vital to the whole.
Healthcare reform is about weaving our systems together into a fabric strong enough to carry us all.
As the President recently noted, readiness is central to bringing legislation into effect. Readiness is not bureaucracy – it is the heartbeat of reform. It signals that change must be feasible, not forced; sustainable, not symbolic. That is a hopeful message, because it means reform will be paced by practicality, not politics.
The path forward is clear and promising: complete outstanding reforms in medical schemes, strengthen risk pooling, invest in primary care and prevention, and sequence structural changes responsibly. These steps are not obstacles – they are stepping stones toward a healthier, more equitable South Africa.
Healthcare reform is a national undertaking and a shared responsibility. Government, funders, providers, employers and civil society are all custodians of this commitment. What matters now is how we act, with realism, collaboration and a clear focus on strengthening what already works.
Equitable access to quality healthcare is our shared goal. Achieving it requires evidence, readiness, and respect for complementarity. With stability, sustainability and collaboration as our compass, South Africa can build a healthcare system that is workable and inspiring – a system that reflects the resilience, dignity and hope of its people.
Healthcare requires stewardship. With stability, sustainability, and collaboration guiding reform, South Africa can build a system that works for everyone. And with optimism guiding reform, I believe we can build a system that works for everyone – today, tomorrow and for generations to come.
More than 33 000 healthcare workers helped patients more than 20 million times in the Western Cape in the last financial year. (Photo: QuickNews)
21st April 2026
By Christina Pitt
The Western Cape health department is ramping up its workforce with 800 new frontline posts. After years of austerity and with long lists of vacancies, questions now turn to how soon the new posts will translate into staff on the ground.
The Western Cape health department is adding more than 800 staff to frontline and support services in a bid to strengthen a health system in which hiring has been stifled by years of austerity.
Health MEC Mireille Wenger announced a recruitment drive, which includes 316 nurses, 124 doctors and 80 emergency medical personnel. For medical workers to have more time at their patients’ bedsides, she said this plan also targets 38 allied health professionals, such as physiotherapists and dieticians, alongside 278 administrative and management staff.
As it stands, more than 33 000 staff in the province helped patients more than 20 million times in the last year, according to Wenger. For public hospitals and clinics, the news of the new jobs offers some hope that the constant pressure on staff capacity will be relieved.
One example of where the new jobs may make a difference is with surgical backlogs in the province. Of the nearly 100 000 people waiting for surgery in 2025, 87 975 have been waiting for more than a year, while 20 027 have been on the list for more than 60 months. Some of these people entered the system during the height of the Covid-19 pandemic and have been left in limbo through years of budget cycles and hiring freezes.
The budget paradox
While governance has been poor in most of South Africa’s nine provincial health departments, with corruption and looting in Gauteng being a particular concern, the Western Cape health department has received seven consecutive clean audits, maintained stable leadership and largely avoided controversy.
As part of a total R106.8 billion package over three years, the Western Cape health department’s 2026/27 budget is R34.47 billion, which is a 6.25% increase from last year.
When adjusted for inflation, provincial health budgets have been falling for most of the last decade. This has contributed to constrained hiring budgets and exacerbated staff shortages. The tide finally turned with above-inflation increases in the 2025 and 2026 budgets – although belts remain very tight.
Professor Alex van den Heever, Chair of Social Security Systems Administration and Management Studies at the University of the Witwatersrand, said that the Western Cape’s health department is a relatively well-run machine yet is dogged by underfunding.
Understanding this requires a look at how provincial health departments are funded.
While provincial health departments get some funds via sources such as provincial revenue and conditional grants, most of their funding flows from the province’s slice of the national budget. For the 2026/27 financial year, the country’s nine provinces was allocated R810.5 billion.
How much each province gets is determined by the provincial equitable share formula, which has been under review since 2015. The provincial equitable share formula considers factors, such as the size of the school-aged population and the number of people living in poverty. Its health component considers factors like the population without medical aid, adjusted for health risk, medical aid membership, and clinic and hospital visits.
Provinces decide how they divide their share of the budget between their provincial departments.
There are however some issues with the provincial equitable share formula. Firstly, it makes use of certain data from the South African census, which means that the information does not reflect current demographic and service realities, said Van den Heever (the census is conducted only every 10 years). Secondly, the usefulness of the results from the latest census of 2022 is in question because certain data sets, such as income, mortality, fertility, and employment figures, were missing.
As a result, National Treasury has been unable to fully update its calculations to factor in the census 2022 data, contributing to a lag in how population changes are reflected in budget formulas. As far as we can tell, National Treasury has relied on datasets updated at different times in the year, such as Stats SA’s mid-year population estimates, allowing it to phase in changes gradually rather than introduce sudden adjustments.
Broadly, Van den Heever said the result is a system forced to pick up the tab for a population the national budget hasn’t yet acknowledged. Citing an example linked to health, he says the formula ignores patients who travel from other provinces to access specialist care at tertiary hubs like Groote Schuur Hospital in Cape Town.
The claw-back
Some of the vacancies in the Western Cape health department reflect periods when the government cut funding due to broader economic challenges, Doctor Saadiq Kariem, the department’s Chief Operating Officer, told Spotlight.
Indeed, between 2021 and 2024, the province absorbed an R8.4 billion reduction in its budget allocation.
This has forced leadership to make some tough calls, including vacancies for frontline services like health. Kariem explained: “It was a process of consciously delaying the filling of those posts so that we could make up for the loss in funding. Sometimes we, along with local managers, decided to shift posts from a vacancy to another part of the service platform based on service needs and pressures.”
“You know, these are heart wrenching choices because all of those posts are absolutely essential and I know that not filling them will have an impact on the service provision and result in poorer health outcomes. So yes, the austerity measures had a significant impact on the post filling rate,” he added.
According to the health department’s annual report, 3 737 people left the department’s employment in the 2024/2025 financial year. By the end of March 2025, 2 772 funded posts remained vacant.
Nationally, vacancies among nursing staff are particularly acute. As of 2023, across enrolled, auxiliary, community service, professional, primary healthcare and specialist nurses, there were about 14 000 vacant posts across the country.
Sabelo Ntshanga, Western Cape provincial secretary of the Democratic Nursing Organisation of South Africa, said burnout caused by workload is the main driver of attrition.
“The reality is that it’s not being filled quickly. It takes up to a year sometimes while the demand in the communities remains high,” he said. “Burnout is underreported and when the nurses get sick from burnout, that’s another burden on top of the shortage of staff.”
Overall, while the 800 new posts represent a step in the right direction, it appears to be more about holding the line than an actual growth spurt. As Kariem says, it represents an effort to “claw back” towards a stable staffing baseline while attempting to invest in future service capacity.
The red tape
Things won’t change overnight though. Wenger noted in her speech that “it will take time to fill these posts”.
Kariem explained that recruitment follows a multi-stage process as vacancies are advertised, followed by shortlisting and interviews. Final appointments then require approval at different levels of the system, depending on the seniority and specialty of the role. “We see delays throughout the process,” he said. “Once there is the ability to advertise a post, we have to give sufficient time for an advert to run… then for interviews and for permissions to follow.”
This means that even funded posts can remain unfilled for extended periods as they move through administrative and approval processes.
Adding further delays to an already complex process, the National Treasury and the Department of Public Service and Administration (DPSA) advised cost-containment measures in October 2023, which was extended until March 2025. It required additional approvals before recruitment could proceed.
Wenger bemoaned these regulations when it was rolled out. “The DPSA’s recent regulations, intended to slow down recruitment, are doing real harm to large service delivery departments like Health. Staff retire or move on, and yet our system lacks the agility to replace them fast enough. This leaves remaining healthcare workers overburdened, and services strained,” she said.
At the same time, not all vacancies can be filled due to shortages of suitably qualified candidates, particularly specialist nurses. Kariem explained that this in part reflects longer-term gaps in investment in postgraduate training. He said the department is using recent budget increases to strengthen human resources information systems to better identify skills gaps and fill vacancies.
These staffing pressures also affect training and retention. Ntshanga said they limit the system’s ability to release nurses for professional development, constraining career progression and contributing to low morale.
At Groote Schuur Hospital, the department noted that nursing staff shortages have affected multiple units across the hospital in 2024/25, contributing to reduced service capacity.
For Ntshanga, the new posts are a small drop in a very large bucket. “As much as it is a good deed from the department, it doesn’t come close to what we need on the shop floor,” he said.
This African Vaccination WeekSanofi South Africareaffirms its commitment to vaccine awareness, access and public health partnerships to close the immunisation gap
Photo by Mufid Majnun on Unsplash
Johannesburg, 20 April 2026 – Marked each year from 24 to 30 April, African Vaccination Week focuses on the need for equitable access to lifesaving vaccines across the continent.
It’s also a timely reminder that while vaccination remains one of the most effective tools in public health, gaps in coverage are a real concern, in South Africa and globally. UNICEF says immunisation prevents an estimated 4.4 million deaths every year,1 yet WHO reported that 14.3 million children worldwide missed out on all routine vaccines in 2024.2 Global coverage for the third dose of DTP-containing vaccine stood at 85% in 2024, while first-dose measles coverage was 84%.2
“Vaccination remains one of the smartest and most effective investments in public health,” says Jean-Baptiste Bregeon, Country Lead and Head of Vaccines, Sanofi South Africa. “Improving coverage is not only about having vaccines available. It’s about building trust, strengthening health systems, supporting healthcare workers and making sure people have the information they need to act. African Vaccination Week is a reminder that protecting lives takes sustained effort and strong partnerships, and Sanofi remains committed to playing its part in South Africa.”
In South Africa, the need is clear. The National Department of Health reported in 2024 that 80% of children in the country had received all their vaccinations by the age of one.3 That is progress, but it also means one in five children had missed one or more doses and was not fully protected. UNICEF South Africa has separately highlighted the urgency of reaching children who have missed routine immunisation entirely. There were 58,000 more zero dose children in 2024 and 278,000 without vaccination, leaving them vulnerable to vaccine preventable diseases.4 Measles vaccination coverage, for example, declined from 80% in 2023 to 76% in 2024.4
Recurring outbreaks of measles, cholera, polio and diphtheria have added pressure to the health system, while disruption to routine immunisation has left more children vulnerable to vaccine-preventable diseases and increased the risk of further outbreaks.5
This year’s campaign aims to intensify vaccination and surveillance activities in districts with high numbers of under-vaccinated and unvaccinated children. Vaccines included in South Africa’s national immunisation schedule are available free of charge at primary healthcare facilities.
Sanofi says its focus in South Africa over the next two to three years will be to continue supporting the Department of Health to improve vaccine coverage across the country, with a focus on access, availability, education and awareness.
“Improving vaccine uptake requires a practical, local approach that recognises the realities of South Africa’s healthcare system, including uneven coverage, pressure on frontline services, and the challenge of reaching communities across both urban and rural settings,” says Bregeon.
That’s why partnership matters, he adds. “Improving immunisation outcomes takes coordinated action across government, healthcare providers, communities and industry. Strong supply is important, but so is public confidence, clear communication and consistent follow-through at clinic level.”
This African Vaccination Week, Sanofi calls on all South Africans to ensure their vaccinations are up to date and encourages healthcare providers to continue championing immunisation as a cornerstone of preventive health.”
To limit the damage from the US research cuts, the SAMRC mobilised a rescue fund of about R600 million.
Spotlight Editors
It has been a bruising year or so for medical researchers in South Africa with the US pausing, cancelling, and then resuming some grants. But as bad as things were, what played out wasn’t the worst case scenario, and momentum is now building toward recovery.
For decades, the United States government has been the world’s top funder of medical research. When it started cutting research funding last year, South Africa was caught in the firing line. This is because the US administration decided to specifically target South Africa, but also because South Africa was uniquely exposed due to the sheer volume of US-funded research here.
Over recent decades, South Africa built an impressive network of research groups and infrastructure to support high quality research – all underpinned by a strong regulatory environment, several good universities, and many productive partnerships with research groups from across the world. All this, plus the fact that we have large TB and HIV epidemics, means that South Africa was, and still is, one of the best places in the world to conduct research on these two diseases.
But a weakness of South Africa’s impressive research infrastructure was its overreliance on US funding.
To be clear, this was not an overreliance on aid or charity. South African researchers won grants from the US by coming out on top in rigorous and highly competitive selection processes. Much of the research done here benefited people around the world, including in the US.
Instead, the thing that we overly relied upon was that the US would continue to make medical research grants in a way that is rational and in our common interest.
There was much chaos and uncertainty last year with the pausing, cancellation, and resuming of grants. One small positive is that bad as things were, what played out wasn’t the worst case scenario we seemed to be heading for. At least some projects got their funding flows restored. You can read more about that in this Spotlight article.
But there is no doubt that the situation remains very bleak. While some studies that were already underway will be completed, it seems very unlikely that the US will fund any new studies in South Africa in the coming years. Given the historic scale of US investment here, the total volume of clinical trials conducted in South Africa will almost certainly fall precipitously.
Charting a new course
One ray of light in all this has been the response from the South African Medical Research Council (SAMRC) – probably the best run of all the entities linked to the Department of Health.
To limit the damage from the US research cuts, the SAMRC mobilised a rescue fund of about R600 million. This includes major contributions from National Treasury, the Gates Foundation, the Wellcome Trust and the ELMA Foundation.
Some of this funding has already helped sustain dozens of research projects and protect vital expertise during a period of instability. The current funding supports work in HIV, TB, newborn and child health, as well as non-communicable and other infectious diseases.
One example is a cutting-edge HIV vaccine clinical trial that began in January at the Desmond Tutu Health Foundation’s clinical research site at Groote Schuur Hospital in Cape Town. While still in its early stages, the study aims to help piece together what an effective HIV vaccine might look like.
Beyond the SAMRC’s efforts, universities and research institutions have also stepped in, raising funds to safeguard projects and retain skilled staff whose jobs were at risk.
Even so, we are still facing a massive net loss to money for medical research in South Africa.
What to do?
Funding from international partners will remain vital in South Africa. For now, the US government still invests substantial funds in South Africa, as does several philanthropies and the European Union, through the European & Developing Countries Clinical Trials Partnership. There are also new partnerships such as one we recently reported on between South African and Korean researchers.
Such partnerships are not just about money – science thrives where there is collaboration across national borders. In fact, almost all of the most important TB and HIV clinical trials conducted in South Africa in the last two decades were collaborations between researchers from multiple countries. No matter how you slice it, collaboration with international partners will remain an essential foundation of the medical research landscape in South Africa.
The problem was never that South African researchers took too much money from the US or other donors, or worked too closely with researchers based in other countries. One might quibble on details here and there, but on the whole, US-South African research collaboration in recent decades has been a resounding success.
Rather, the problem was that we invested so little of our own funds that we became overly vulnerable to changes in external funding.
Professor Ntobeko Ntusi, president and CEO of the SAMRC, previously told Spotlight that the SAMRC receives in the region of R2 billion from government per year, including funds from both the Department of Health and the Department of Science and Innovation.
Unlike so many parts of our government, the SAMRC is a well-run entity that got clean audits in each of the last five years. This strongly suggests that money allocated to it won’t be wasted or looted. If we understand recent messaging from the Finance Minister and National Treasury, this is precisely the kind of clean government spending that should be rewarded in future budgets.
Relative to health budgets more generally and to what government has historically spent on entities such as South African Airways, the SAMRC’s budget is tiny. As far as we can tell, the current funding level is largely a product of history – apart from the still widespread atmosphere of austerity, there really isn’t any other reason why the budget shouldn’t be scaled up over the next three years to be double what it is now.
The SAMRC supports a sector in which South Africa has truly world-class capacity – capacity that as we speak remains under threat. More than just the research studies and the jobs for young scientists, what is at stake here is the idea of South Africa as a place where we can do world-class medical research. Allowing funding cuts to extinguish this bright spark, would feel like a victory for Afro-pessimism.
The reality is that if President Cyril Ramaphosa and National Treasury seizes the opportunity, the shock of the US funding cuts could be turned into a bright new beginning for medical research in South Africa – all at a price that in relative terms is very low. Let’s hope they have the vision and ambition to seize the day.
Disclosure: The Gates Foundation is mentioned in this article. Spotlight receives funding from the Gates Foundation, but is editorially independent – an independence that the editors guard jealously. Spotlight is a member of the South African Press Council.
Dr Maria du Toit takes a close-up look at vocal cords, capturing high-resolution images and video using widely available mobile technology. Traditionally, this type of examination requires expensive equipment and specialist doctors, making it difficult to access in many parts of South Africa
Ahead of World Voice Day on 16 April, researchers at the University of Pretoria (UP) are inviting the public to take part in free voice checks using a new, locally developed device that could significantly expand access to vocal health services across South Africa.
The groundbreaking, low-cost, smartphone-compatible device, which is currently being tested as part of ongoing research, enables clinicians and trained users to take a close-up look at the voice user’s vocal cords by capturing high-resolution images and video using widely available mobile technology. Traditionally, this type of examination – known as laryngoscopy – requires expensive equipment and specialist doctors, making it difficult to access in many parts of South Africa.
“Your voice is something you use every day – whether for work, social interactions, or simply being heard. Yet many people ignore early warning signs of vocal problems,” says Professor Jeannie van der Linde, who is leading the research team and is Head of UP’s Department of Speech-Language Pathology and Audiology in the Faculty of Humanities.
Voice disorders are more common than many people realise. Prof Van der Linde adds: “International estimates suggest that up to one in five people will experience a voice problem at some point in their lives, with higher risk for those who rely heavily on their voices for work, such as teachers, healthcare workers and call centre agents. Despite this, access to specialised diagnostic services remains limited, particularly outside major urban centres.”
The research and device are part of a broader effort to rethink how vocal health services are delivered in South Africa. “Our aim was to develop a solution that is more portable, more affordable and easier to integrate into different healthcare contexts,” says Dr Maria du Toit, a Lecturer in Speech-Language Pathology and member of the research team.
“Many people ignore early signs like hoarseness or vocal fatigue, often because they don’t have easy access to assessment services,” Dr Du Toit says. “If we can identify these issues earlier, we can intervene sooner and potentially prevent more significant problems from developing.
The development of the device forms part of ongoing efforts within the department to explore how mobile anddigital technologies can be used to increase the availability of vocal health assessment and care.
Dr Roxanne Malan, a postdoctoral fellow, speech therapist and research team member, highlights the importance of designing technology that balances functionality with affordability and ease of use. “We wanted to ensure that the device is not only clinically useful but also practical in a range of settings, including those withlimited resources,” she says. “The goal is to make vocal health screening more widely available without compromising on quality.”
The technology, which has not been named yet, is being developed at UP and is currently undergoing testing to compare its performance with gold-standard laryngoscopy. “We started feasibility testing in June 2025 and preliminary tests have been very positive, demonstrating that the device is usable and produces high-quality images of the relevant structures,” Dr Malan says. “It consists of a low-cost, off-the-shelf borescope – typically used industrially – adapted with a 3D-printed handle to ensure optimal placement of the scope in the patient’s mouth, as well as the correct angle for visualisation. We have also assessed its safety for human use and its ability to be properly disinfected.”
In addition to testing the device, the World Voice Day initiative seeks to increase general awareness about theimportance of vocal health. “Your voice is central to how you communicate, work and engage with others,” Dr DuToit says. “Taking care of it should be seen as an essential part of overall health, not something to think aboutonly when there is a problem.”
Dr Malan says the team’s vision is for the scope to be readily available as a screening device in public hospitalsand clinics all over South Africa and other low- and middle-income countries. “But we still foresee numerousphases of testing to ensure that it can be used by a range of healthcare professionals, and that it makes asignificant difference in the target healthcare sectors. We will name and launch it at a stage when this has beendone.”
Dr Du Toit says members of the public can support the research by booking their free voice health check. “Byattending, you’re not only taking care of your own vocal health – you’re helping researchers develop solutionsthat could make voice care more easily available to thousands of people who currently don’t have access tothese services.”
Event details: Members of the public are invited to take part in free voice checks on World Voice Day, 16 April 2026, at the Department of Speech-Language Pathology and Audiology at the University of Pretoria’s Hatfield Campus.
Participants will have the opportunity to learn more about their vocal health and contribute to research that aims to make voice care more accessible across South Africa.
Who should consider a voice check?
This free check is especially recommended for:
● Teachers and lecturers
● Singers and performers
● Healthcare workers
● Clergy and public speakers
● Call centre workers
● Anyone who uses their voice extensively
You should also consider attending if you:
● frequently experience hoarseness or voice changes;
● feel your voice tires easily;
● have ongoing throat discomfort when speaking; and/or
● simply want reassurance that your voice is healthy.
Despite South Africa’s laws and policies, access to healthcare remains an issue, particularly for non-citizens. Photo by Hush Naidoo on Unsplash
By Teri Brown and Thembi Mahlathi
The media has reported several incidents where people were turned away at public healthcare facilities because they did not possess South African identity documents. As related cases slowly grind through the courts, Teri Brown and Thembi Mahlathi of SECTION27 connect the dots between what the law says and what people are experiencing.
Over the years, many migrants and undocumented people have reached out to SECTION27, where we both work, for assistance. These were often pregnant women, lactating mothers and children under six years, who were denied access to healthcare facilities.
Initially, it was easy to simply write a letter to hospital and clinic personnel where our clients were being denied access. But as time went on, the situation got significantly worse and more migrants were being denied access to public healthcare facilities. Writing letters and asking for meetings clearly wasn’t enough anymore.
We went to court and in April 2023 got an order in which the South Gauteng High Court held that important sections of the National Health Act applies to all pregnant women, lactating women and children under the age of six years, irrespective of their documentation status. This affirmed that in South Africa, they have the right to access free healthcare services at all public health establishments, including hospitals and clinics.
Public sector hospitals and clinics are required to assess the status of migrants and then apply a lawful means test to determine the healthcare services that can be offered to them. However, this does not appear to be done routinely. Instead, particular focus is often placed on South African identity documents, while other forms of documentation held by migrants are disregarded.
There have been incidents where entry to facilities such as Rahima Moosa Mother and Child Hospital in Coronationville and South Rand Hospital in Rosettenville and several clinics across Gauteng have been denied to people, including South African nationals who have the necessary documentation.
Furthermore, we are aware that to avoid being refused healthcare and to demonstrate the urgency of their need for treatment for themselves or their kids, migrants have sometimes been forced to disclose their HIV status – information which they would otherwise have kept private.
In mid-2025, we started receiving a surge of calls from clients complaining about not being able to enter public sector clinics that they were previously assisted at. They informed us that a group of people stationed outside these clinics requested their identity documents, and when they produced their documents confirming either their refugee status or asylum seeker status, they were unlawfully prevented from entering the clinics. These group of people explicitly told them that they should go to a private clinic for treatment or go back to their home country.
Thus, two years after the April 2023 court order, the denial of access to healthcare had worsened, as it was not only women and children who could not access clinics, but anyone who could not provide South African identity documentation. The situation was also exacerbated by the fact that it wasn’t just healthcare staff denying access anymore, but vigilante groups stationed outside healthcare facilities.
Despite the crisis being widely reported, the state failed to address it effectively. We had no choice but to go back to court, and again the court found in our favour.
In December 2025, the South Gauteng High Court ordered the state to take immediate and decisive action to end the obstruction of access to public healthcare facilities in Gauteng. The case was brought by the civil society organisations the Treatment Action Campaign, Doctors Without Borders, and Kopanang Africa Against Xenophobia (the applicants), all represented by SECTION27.
In this landmark judgment, Judge Stuart Wilson concluded that the state entities tasked with upholding the constitutional mandate to safeguard everyone’s right to access healthcare had failed to prevent the obstruction of access to public health facilities. Consequently, this failure was in violation of the constitutional rights of patients seeking care at the Yeoville and Rosettenville clinics.
Despite this court order, our monitoring found ongoing vigilante activity at the two clinics. The applicants then launched an urgent contempt application, heard in March 2026, arguing that the state had failed to fully comply with Judge Wilson’s court order.
Following this, a court ordered settlement agreement was reached with the Gauteng Department of Health and other respondents. Among other things, it required the authorities to take reasonable steps to ensure safe and unhindered access to the Yeoville and Rosettenville clinics, and to report on the implementation by 18 May 2026. It also makes provision to continue legal proceedings if necessary to enforce full compliance with Judge Wilson’s order.
The laws governing healthcare for migrants in South Africa
Taking a step back from this case, and its specific set of facts, it is worth remembering that South African law really does provide extensive protection to migrants who need to access healthcare services.
The right to access healthcare services is guaranteed by section 27 of our Constitution, which states that everyone has the right to have access to healthcare services, and that no one may be refused emergency medical treatment. The term “everyone” is not restricted to South Africans only. It includes everyone within the borders of South Africa, regardless of their nationality.
This right extends to all children living in South Africa under section 28(1)(c) of the Constitution. This guarantees all children access to basic healthcare services dependent on the availability of resources, to which they can never be completely denied.
After the Constitution, the most important piece of healthcare legislation relevant to migrants is the National Health Act (NHA). The NHA assists in giving effect to the constitutional right to basic healthcare services by outlining who can receive services at public clinics free of charge. It obligates the provision of free healthcare services to women who are pregnant or breastfeeding, or children under six. Moreover, the NHA requires that free primary healthcare be provided to those without medical aid. It also makes it clear that those working in healthcare cannot refuse any person emergency medical treatment.
Along similar lines, South Africa’s Refugees Act states that a refugee is entitled to full legal protection, which includes the rights set out in the Bill of Rights, except those reserved for citizens. The Act formally acknowledges that refugees are entitled to the same basic healthcare services and primary education that South African citizens receive. While the Act does not expressly cover undocumented migrants, it is grounded on the principle of non-discrimination, which supports equal access to essential services.
The denial of healthcare services has significant impacts on many aspects of people’s lives. Migrants often become so desperate to receive care that they feel compelled to disclose their HIV status, which infringes on their rights, particularly the constitutional rights to privacy and dignity. It also creates feelings of stigma and discrimination, further marginalising people who are often already vulnerable.
There are also direct health consequences. Denying treatment to a migrant not only negatively impacts that person’s health it can also result in the continued transmission of infectious diseases to both other migrants and South Africans. For example, HIV and TB typically become non-infectious a while after someone starts treatment. Deciding not to treat someone ends up harming everyone. As untreated conditions worsen, it may require emergency medical attention that could have been avoided through early treatment. All of this places extra pressure on an already fragile health system – extra pressure that could be avoided by providing more migrants with healthcare services as soon as they need it.
The failure to provide healthcare services also affects migrants’ livelihoods and well-being. For those who run their own businesses, being unable to access treatment may prevent them from working altogether and could lead to them and other people, possibly South Africans, losing their jobs. Ultimately, this has a ripple effect on the country’s economy, job security, and perpetuates cycles of poverty and vulnerability.
At its heart then, this issue is about who we choose to be as a society. Turning people away at their most vulnerable moments erodes not only their dignity, but also their humanity and ours. In a country built on the values of equality and dignity, we cannot allow this attack on our basic humanity and decency to succeed. We are, and must be, better than that.
*Brown is a legal researcher and Mahlathi is a paralegal with SECTION27. In the court case discussed in this article, SECTION27 represented the Treatment Action Campaign, Médecins Sans Frontiers, and Kopanang Africa Against Xenophobia.
Note: Spotlight is published by SECTION27, but is editorially independent – an independence that the editors guard jealously. 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.
