NHI Silent on Covering Natural Healthcare
By Anthony Rees – National Chairman (TNHA)
SUMMARY
This report addresses the current exclusion of complementary and traditional African medicine from South Africa’s newly enacted National Health Insurance (NHI) Act, which aims to provide universal healthcare in South Africa. Despite the widespread use of these practices, they are not currently covered under the NHI framework. TNHA emphasizes the need for these practices to be included in the public healthcare system, citing their potential benefits, regulatory challenges, and the need for policy inclusion, collaboration, and financial support to ensure comprehensive healthcare delivery.
The current approach to healthcare, which predominantly focuses on treating illnesses while paying lip service to prevention, is unsustainable. This trend not only drains the health budget but also fails to address the root causes of poor health. To reverse this trend, there is an urgent need to invest in measures that support healthy living, enhance nutritional status, and promote disease prevention. Studies demonstrate that primary care is likely the best setting to integrate CAM and Traditional African Medicine into the NHI, because of their holistic approaches, focus on self-care, and strong therapeutic relationships.
The difficulty in witnessing a historic event as it happens lies not in recognizing it – that part is easy. The real challenge is in grasping its significance for the future, which is the true essence of historic events.
The South African government, led by the ANC, has started what they call an important mission. On the 14th of May, President Ramaphosa signed the National Health Insurance (“NHI”) Bill into law, just two weeks prior to the national elections. This new Act aims to reduce the big differences in healthcare quality by introducing the NHI.
ALLIED HEALTH PROFESSIONS (COMPLEMENTARY & ALTERNATIVE MEDICINE PRACTITIONERS)
TRADITIONAL HEALTH PRACTITIONERS (TRADITIONAL HEALERS)
The World Health Organization (WHO) defines traditional medicine (TM) as “health practices, approaches, knowledge, and beliefs incorporating plant, animal and mineral based medicines, spiritual therapies, manual techniques and exercises, applied singular or in combination, to treat, diagnose and prevent illnesses or maintain well-being”.
According to the Minister of Health, there are an estimated 150,000 to 200,000 herbalists, diviners, and traditional birth attendants classified as Traditional Health Practitioners still awaiting the opening of the professional registers of the Traditional Health Practitioners Council, despite seventeen years having past since the passing of the Traditional Health Practitioners Act (Act No. 22 of 2007) into law. Up until 2007 the ANC-led government made good on its promises to incorporate this sector into the national health system however this process has hobbled along at a snail’s pace.
Despite their widespread use by an estimated 60 – 80% of our indigenous black population on a regular basis, and the important role they play in a primary healthcare setting, traditional health practitioners are not officially recognized or funded by the state or private medical insurance schemes. It must be noted that other African countries such as Ghana, Uganda and Nigeria etc, are all still grappling with how to integrate traditional health practitioners into their formal national health insurance schemes, despite being many years ahead of South Africa in achieving universal healthcare coverage.
The international People’s Charter for Health is a statement of shared vision, goals, principles and action and is the most widely endorsed consensus document on health since the Alma Ata Declaration singed by South Africa in 1978. The People’s Charter calls for the provision of universal and comprehensive primary health care, irrespective of people’s ability to pay. It calls on people of the world to support, recognise and promote CAM and Traditional Medicine systems and practitioners and their integration into Primary Health Care.
The topic of Traditional African Medicine was escalated to the national health agenda by the African National Congress Health Plan of 1994 where it was stated that “traditional healing will become an integral and recognised part of health care in South Africa. Consumers will be allowed to choose whom to consult for their health care, and legislation will be changed to facilitate controlled use of traditional practitioners”. The plan contained a powerful statement as the basis for policy which noted, “people have the right of access to traditional practitioners as part of their cultural heritage and belief system”. This came after the active suppression of traditional healers by the colonial and apartheid governments respectively.
Later, the ANC’s progressive National Drug Policy (NDP) of 1996 pledged our governments support of integrating Traditional African Medicine into our national healthcare system. Our government further refined and expanded upon this objective in its National Policy on Traditional Medicine in South Africa in 2008.
More recently the World Health Organization, in its Traditional Medicine Strategy for 2014-2023 report, emphasised the need for using traditional medicine to achieve increased healthcare. In May 2022 South Africa pledged to integrate Traditional African Medicine into our healthcare system at the BRICS High-level Forum on Traditional Medicine, and later President Ramaphosa reiterated this pledge at the BRICS Summit in August last year.
MOVING FORWARD