National expenditure on health research in South Africa: What is the benchmark?

J Paruk, J M Blackburn, I B Friedman, B M Mayosi


The Mexico (2004), Bamako (2008) and Algiers (2008) declarations committed the South African (SA) Ministry of Health to allocate 2% of the national health budget to research, while the National Health Research Policy (2001) proposed that the country budget for health research should be 2% of total public sector health expenditure. The National Health Research Committee has performed an audit to determine whether these goals have been met, judged by: (i) health research expenditure as proportions of gross expenditure on research and development (GERD) and the gross domestic product (GDP); and (ii) the proportion of the national health and Department of Health budgets apportioned to research. We found that total expenditure on health research in SA, aggregated across the public and private sectors, was R3.5 billion in 2009/10, equating to 16.7% of GERD. However, the total government plus science council spend on health research that year was only R729 million, equating to 3.5% of GERD (0.03% of the GDP) or 0.80% of the R91.4 billion consolidated government expenditure on health. We further found that R418 million was spent through the 2009/2010 Health Vote on health research, equating to 0.46% of the consolidated government expenditure on health or 0.9% of the R45.2 billion Health Vote. Data from other recent years were similar. Current SA public sector health research allocations therefore remain well below the aspirational goal of 2% of the national health budget. We recommend that new, realistic, clearly defined targets be adopted and an efficient monitoring mechanism be developed to track future health research expenditure.

Authors' affiliations

J Paruk, Fathima Paruk, PhD, FCOG (SA), Cert Crit Care (SA), is Director of the Cardiothoracic Intensive Care Unit in the Department of Anaesthesiology and Division of Critical Care, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (SA), and a member of the Human Research Ethics Committee at the University of Witwatersrand and of the National Health Research Committee (NHRC), Department of Health (DoH), SA

J M Blackburn, Foundation SA Research Chair in Applied and Chemical Proteomics in the Institute of Infectious Disease and Molecular Medicine and Division of Medical Biochemistry, Faculty of Health Sciences, University of Cape Town, SA, and is a member of the NHRC

I B Friedman, Public Health Physician in the Health Programme, SEED Trust, Durban, SA, a member of the Technical Task Team of the SA Health Products Regulatory Authority, which is linked to the SA DoH, and a former member of the NHRC

B M Mayosi, Head of the Department of Medicine, Groote Schuur Hospital and University of Cape Town, and Chair of the NHRC

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South African Medical Journal 2014;104(7):468-474.

Article History

Date submitted: 2020-02-24
Date published: 2020-02-24

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