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South Africa is a dynamic and complex country.  A middle-income nation that has dedicated substantial resources to health and human capital investments, South Africa has a progressive Constitution that guarantees the right to health care and vibrant civil society.  National Health Insurance (NHI) is the central means by which the government aims to achieve universal coverage, under the principles of social solidarity and equity elaborated in the National Development Plan. To implement NHI, the government is revitalizing service delivery, changing the way that health services are financed, ensuring the provision of primary care, improving access to qualified human resources for health, and ensuring the availability of quality assured medical products.

Life expectancy has increased due to innovations and rapid scale-up of HIV/AIDs and Tuberculosis (TB) treatment and care, and expanded access to immunizations.  Life expectancy increased from 54 years in 2005 to 60 years in 2011. HIV incidence among youth (15-24 years) is 1.49 %, and incidence in the general population is 1.07% (2012). Two in three TB patients also have HIV. South Africa has one of the highest TB incidence rates in the world (1 per 100 population).  Susceptible TB Treatment Success Rates is 80%. South Africa also contributes about 17% of the global burden of reported Multi-drug Resistant Tuberculosis (MDR-TB).  National roll-out of rapid molecular diagnostics (GeneExpert) ensures early detection of drug resistant cases, National DR-TB Survey is ongoing to ascertain the burden of DR-TB. Diagnosis and management of drug resistant cases account for nearly half of the TB budget, and treatment success rates are 40% for MDR-TB and 18% for XDR-TB. 

Progress in maternal and child health has been hindered by the HIV and tuberculosis epidemics, and the performance of the health system.  Efforts to accelerate prevention interventions are underway, including the prevention of maternal to child transmission of HIV. Important reductions have occurred in under-five and infant mortality (42 and 30 per 1000 live births by 2011), although these rates are higher in comparison with other countries of similar socioeconomic status. Maternal mortality ratios remain high, at 333 deaths per 100,000 live births. Immunization remains critical to improving child health. The government currently has eleven antigens on its national immunization schedule, including rotavirus and Pneumococcal Conjugate Vaccine, which has markedly reduced child morbidity and mortality. A national HPV campaign was launched in March 2014. 

Approximately two in five deaths are attributable to non-communicable diseases. Some 40% of mortality from non-communicable conditions among men occurred before the age of 60 years - and is therefore considered premature. Second to non-communicable conditions is the burden of mortality and disability from violence and injuries. In particular, a rapid increase in motor vehicles has led to increases in road traffic accidents that now account for more than one-quarter of deaths due to injuries. 

For nearly two decades, tobacco use declined as a result of strong legislation and policies to control tobacco consumption. The WHO FCTC was ratified in 2005. However, smoking rates are among the highest in the continent (16.2%).  Harmful alcohol consumption is the third most important risk factor contributing to non-communicable diseases, injuries, and communicable diseases.  Alcohol use is a major underlying factor in injuries and road traffic accidents.  Patterns of harmful use exist among those who drink.  Harmful and excessive alcohol consumption also contributes to non-communicable conditions, and can also accelerate the progression of infectious diseases. Overweight and obesity pose major nutritional challenges.  More than seven in ten women above 35 years old are overweight. A contributing factor is the rapidly increasing consumption of packaged foods high in calories, saturated fats, animal proteins, sugars, and salt.  In addition, physical activity levels are low.  Approximately half of adults are physically inactive, and two in five schoolchildren do not participate in sufficient physical activity.

Improvement in the sustainable development sector has resulted in improved quality of life. Access to improved water sources is nearly universal. However, coal is used as a cheap source of energy for industry, and thus South Africa ranks as the highest greenhouse gas emitter in the continent. Climate change is one of the key priorities of Government, who views mitigation as a means to ensure an internationally competitive lower carbon economy.