Healthcare in South Africa – Opportunities for Italian companies

Africa, home to a population of 1.4 billion, is still underserved with regards to healthcare in most of the continent. According to the WHO, the continent carries 25% of the world’s disease burden, but the share of global health expenditures is less than 1%. This will be further affected by the fact that Africa’s population is growing and is expected to nearly double to reach 2.5 billion people from 2021 to 2050. Simultaneously, the number of people aged 60 years and older is projected to reach 67 million by 2025 and 163 million by 2050. Thus, an increasing number of people are living with chronic diseases and disability, increasing the demand for a variety of health services, reported by VEDP.

Africa’s burden of disease has historically been related to communicable diseases, which account for two thirds of the total disease burden. However, non-communicable diseases are rising around Africa. A World Bank report estimates that by 2030 non-communicable diseases will cause more deaths in Africa than communicable diseases.

Due to population growth, the changing nature of burden of disease, and the need to decrease the gap between demand for and access to quality healthcare for all, the market is growing and enforced by the African Continental Free Trade Agreement (AfCFTA). The AfCFTA has been put into force on January 1, 2021 forming the continent into one common market, presents a long view on standardization toward health in trade policies and programs and will lead to an increase in integration between African nations and eventually will create a more sustainable business ecosystem to serve the great population.

Estimated by Zurcom and VEDP, by 2030, Africa will present 14% of health and wellbeing business opportunities, only second to North America holding 21% of the opportunities. The African market provides opportunities in various subsectors, ranging from pharmaceuticals and medical devices, digital health, health services, infrastructure including hospital architecture and management systems, as well as skills development and training.

The African healthcare market will be worth $259 billion and South Africa will remain one of the biggest healthcare markets in Africa. Currently, South Africa has around 522 public pharmacies and 2206 retail & courier pharmacies as well as 700+ public and private hospitals.


The total healthcare market is projected to reach a value of US$37bn by 2022 and US$47.1bn by 2027, Fitch Solutions reported. Total healthcare spending in South Africa was about USD 51.1 billion in 2019. Despite this level of spending, access to quality healthcare is limited.

In south Africa, the public sector provides healthcare for 80% of the population and accounts for approx. 48% of total health care spending. The private sector provides healthcare for 20% of the population and accounts for approx. 50% of total healthcare spending, while the remaining 2% is provided by non-governmental organizations.

The private sector delivers high quality healthcare but is also some of the most expensive in the world. There are around 314 private hospitals and day clinics which have over 34,000 beds in South Africa.


South Africa remains the largest pharmaceutical market in Sub-Saharan Africa. Its prescription drug market is valued at approximately $3.0 billion (Fitch Solutions), which equates to 88.7% of the total market in value terms but will drop in value due to prevailing market conditions. Domestic production meets around 60% of pharmaceutical demand. The bulk of domestic production involves the finishing of imported raw materials and semi-finished drugs. Local producers are used as a base for distribution to most of Sub-Saharan Africa. The multinational companies either import their products or they sign agreements with manufacturers within South Africa using their relatively modern manufacturing facilities to formulate and package products for them. Drugs are mostly imported with main supply from India, Germany, United States, and France.


Consumables: This sector includes bandages and dressings, suturing materials, syringes, needles, catheters, etc. estimated at $240 million in 2019 by Fitch Solutions. There is some local manufacturing, but over 90% is imported. Major suppliers are the United States, China, India and Mexico.

Diagnostic Imaging: Valued at an estimated $192 million (Fitch Solutions), Germany and the United States are the leading suppliers in this market (20% market share each). Other players include Japan, China, Netherlands, and the UK.

Orthopedics and Prosthetics: Valued at $ 164 million (Fitch Solutions), practically all products in this sector are imported, mainly from the United States (40%) and Switzerland.

Dental: Projected growth in this market will be muted, 2.9% in dollar terms from 2019 – 2024. The dental market is currently valued at around $37 million (Fitch Solutions). Over 90% of products in this market are imported, mainly from the United States and Germany (30% each). Smaller suppliers include Switzerland and China. There are some local manufacturers that supply dental instruments, supplies and implants.

Patient Aids: Worth approximately $163 million in 2019 (Fitch Solutions), this category includes portable aids, such as hearing aids and pacemakers, and therapeutic appliances like respiratory apparatus and mechanotherapy. More than 95% of this market is imported. The United States supplies around 25% and other main suppliers include China, Germany, and Switzerland. Growth will be dampened by current economic conditions.


With a public and rapidly growing private healthcare sector, South Africa has one of the most dynamic health sectors in the world. This generates many opportunities for Italian companies, where they can offer innovative technologies to meet healthcare needs.

In the public sector, despite the underdeveloped nature of Diagnostic Imaging market, there is great need for MRI and PET scanners, radiotherapy products, and other diagnostic imaging products.

The private healthcare sector presents more opportunities for high-tech healthcare products and services. There is a growing market Surgical technology, particularly in the private sector, for advancements in surgical technology, such as robotic-assisted surgery, that positively impact surgical outcomes.

In addition, around 15% of the South Africans are either diabetic or pre-diabetic. This is a significant health issue and diabetes is the second most common cause of death in the country. That is, Diabetes Technology, equipment and medication are in high demand and the market offers opportunities to explore.

All in all, expected economic and demographic growth means that African countries provide an ideal environment for healthcare exporters of goods and services to forge strategic partnerships. In South Africa, healthcare is faced by serious challenges presenting an opportunity for constructive engagement by companies delivering healthcare products and services.



Ailar Jabbari

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