The National Health Insurance (NHI) bill has failed to tackle transformation in the pharmaceutical sector, an industry association for black-owned pharmaceutical businesses told parliament on Tuesday.
Parliament is currently processing the bill, the first piece of enabling legislation for its ambition to implement universal health coverage, which aims to ensure that everyone is provided with health services that are free at the point of delivery.
The far-reaching bill proposes establishing a central NHI fund to buy services from accredited public and private sector providers, and suggests sweeping changes to 11 other acts, including the National Health Act, the Competition Act, and the Medical Schemes Act.
Parliament called for written submissions on the bill in the second half of 2019 and conducted public hearings in all nine provinces, which concluded in early 2020. It began considering oral presentations on May 18 2021.
Black Pharmaceutical Industry Association chairperson Kingsley Tloubatla said the bill is silent on transformation in the R56.4bn pharmaceutical industry.
“This is an opportunity for our country to transform the sector,” he told parliament’s portfolio committee on health.
Under apartheid black individuals were not allowed to own pharmaceutical companies. Now, 27 years after the advent of democracy, black-owned pharmaceutical businesses are still struggling to grow their share of the market, and own less than 1% of it, said the association’s Suhail Gani.
SA’s medicines regulator, the SA Health Products Regulatory Authority (Sahpra), takes up to four years to approve new products. While multinational companies and well-established white-owned SA businesses have large product portfolios and can absorb the opportunity costs of these delays, smaller black-owned players cannot do so, he said.
The Black Pharmaceutical Industry Association told parliament it wants Sahpra to prioritise the review of registration applications submitted by black-owned businesses, to speed up market access. “Under no circumstances should black-owned companies be exempt from the full regulatory assessment of product dossiers to ensure safety and efficacy. We are only advocating for the addition of the Broad-Based BEE certificate in the screening phase of the current regulatory process,” it said in its presentation.
When asked by committee chair Sibongiseni Dhlomo whether the association had raised the issue with the regulator, Gani said Sahpra indicated there is no legal mechanism for it to do so.
The association proposed that the government devise a health-care charter that would compel all health department tenders to include a minimum 30% set aside for black-owned businesses, and similar measures to be put in place for the private sector pharmaceutical trade. “Punitive measures should be applied to corporates that do not pursue trade with black-owned companies in a given year, such as withholding new licences and restricting the renewal of existing licences,” he said.
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