The long term growth prospects of the South African pharmaceutical market will be strongly influenced by the ANC government’s policies in regards to the new National Health Insurance (NHI) scheme, the promotion of public-private partnerships to develop and upgrade hospitals, the serious shortage of healthcare personnel and an urgent need to effectively address the AIDS crisis in the country.
The AIDS situation is dire in South Africa. According to projections from the EIU, the population of South Africa will start to decline from 2011, not normal for a country which has a relatively low elderly demographic (estimated 5.7% of the total population in 2011) and one of the highest birth rates in the world (25 live births per thousand population).
In 2008, there were a total 34,687 doctors or medical practitioners registered with the Health Professions Council of South Africa (HPCSA), equal to less than one doctor (0.7) per thousand population. This rate is very low by world standards. The majority of these doctors worked in the private sector, with only 30.7% or 10,653 working in the public sector in 2008. This means the provision rate for doctors in the public sector is just 0.2 per thousand population.
Private hospitals and doctors were unhappy with the government’s proposed National Health Amendment Bill in June 2008, which would have resulted in private hospitals and medical scheme providers having to “negotiate” private healthcare fees. At time of writing, nothing had been finalised.
A key driver of growth is expected to be the public-private partnerships to develop hospitals in South Africa but this could be tempered slightly, by a depreciating rand against the US dollar and the general state of the South African economy.
Further reading - An in-depth analysis of the South African pharmaceutical market, including some background information on the healthcare system, is available from Espicom: The Pharmaceutical Market: South Africa (published June 2009)