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The South African Communist Party (SACP) has learned with great disappointment the decision of President Cyril Ramaphosa to suspend the implementation of the National Health Insurance (NHI).

As reported on Friday, this decision is framed as a consequence of legal challenges currently being pursued by right-wingers in the courts against the NHI and its implementation. This is hardly a justification that can be accepted by any reasonable progressive person and as the SACP we reject it outrightly as not only opportunistic and irrational, but also as blatantly reactionary.

May 2026, two months from now, will be two full years since the NHI was signed into law and since then the government has provided numerous justifications to explain its clear unwillingness to implement the NHI.

The SACP always anticipated such attacks against the NHI, however. The fact that the NHI was even signed into law is not as a result of the benevolence of the government or its wisdom but a victory of popular working-class struggles that put pressure on the African National Congress (ANC) and the government’s political apparatus to realise this strategic objective of the national transformation.

If the wishes of the political forces of reaction were completely in force, the very conversation of universal health coverage and ending of a two-tier health system would not be a policy discussion on the table, let alone the existence of a signed perpetually delayed National Health Insurance. To that end, the failure of the government to implement the NHI is a political choice of the president and his government and not a random circumstance forced upon him by court proceedings against the scheme.

The SACP is not unsighted to the fact that the president’s political choice occurs within a political ecosystem of the GNU with obvious ideological implications for a policy as redistributive and thoroughly transformative as the NHI. As such, the president’s decision conforms to the general neoliberal tangent of the government and aligns with its austerity policies.

This neoliberal direction is not unavoidable, or perfectly logical, as bourgeois intellectuals and advocates repeatedly claim. It is one of several options in the social and economic policy continuum that the ANC and its leadership have chosen on the grounds of its alignment with class interests and the ideological persuasion of the dominant classes within its elite.

This halting of the implementation of NHI is tantamount to a reversal of a key important transformative policy. An important era of a new public health policy has been reversed before it is born in reality. At the point of the signing of the NHI Act, as the SACP we said that the NHI era must represent a decisive rupture with the present “unequal two-tiered healthcare regime” which is underpinned by income and wealth inequalities. This reversal, which we condemn, undermines that vision. 

The principles of the NHI remain valid and we will continue to defend them. As the SACP, we reiterate the centrality of progressive redistribution from the economic surplus appropriated by capitalists to deliver quality universal healthcare coverage for the whole of society and the working class in particular.

In our rejection of the reversal of the NHI, we call on all progressive forces across the board to resist this latest move by the government. We call upon workers in healthcare specifically and workers across the country to join us in rejecting this abhorrent decision. The struggle for an equitable healthcare system continues. The unity of the working class is pivotal in this struggle.

Issued by the South African Communist Party