Overview of CSI spend on health in 2024

National context of health in South Africa

• The national health budget increased from R259 billion for 2023/24 to R271.9 billion for 2024/25, constituting 11.5% of consolidated government expenditure of R2.37 trillion for the financial year. 
• According to Stats SA’s mid-year population estimates for 2024, the life expectancy at birth in South Africa is 66.5 years, a significant increase from 53.6 years in 2005. The rise in life expectancy can be attributed to three key trends: the antiretroviral treatment programme leading to a reduction in Aids-related deaths from 284 249 in 2005 (42% of all deaths) to 68 406 in 2024 (12% of all deaths); uptake of vaccinations and treatments for Covid-19 infections; and the decrease in the infant mortality rate from an estimated 57 infant deaths per 1 000 live births in 2002 to 22 per 1 000 live births in 2024.  
• According to Stats SA, the total number of people living with HIV is approximately 8 million in 2024. For adults aged 15–49 years, an estimated 16.7% of the population is HIV positive.  
• According to the World Health Organization (WHO), an estimated 55 000 individuals in South Africa died from tuberculosis (TB) in 2023, while around 280 000 were infected with the disease.  
• The Mental State of the World in 2023 Report ranked South Africa as the country with the highest percentage (35.8%) of its population being distressed and struggling with mental health.  
• On 15 May 2024, President Cyril Ramaphosa signed the National Health Insurance Bill (NHI) into law in an effort towards achieving universal health coverage in South Africa. Over 60 million people, and over 3 000 clinics and 34 hospitals are registered on the NHI database.  
• According to Statista, in 2023, South Africa had the highest healthcare index score in Africa, taking into account factors such as the overall quality of the healthcare system, healthcare professionals, equipment, staff, doctors and cost.  
• From 1 January to 3 September 2024, a total of 24 940 suspected cases, 5 432 confirmed cases and 639 deaths of Mpox were reported from 14 African countries, with the Democratic Republic of Congo worst affected. The total number of cases in South Africa was 25. WHO declared a public health emergency of international concern and the Africa Centres for Disease Control and Prevention declared a public health emergency of continental security for the first time. 

Overview of CSI spend  

Health was supported by 36% of companies and received 9% of average CSI expenditure. 

Level of heathcare

Average % CSI healthcare spend 2024 n=21

73% Primary healthcare

3% Secondary healthcare

19% Tertiary healthcare

5% Other

• Primary healthcare (clinics, hospices, home-based care, community health education) continued to receive most CSI spend in the health sector (73%) in 2024, albeit a decrease from 81% in 2023.  
• Tertiary healthcare (specialist care) received 19% of the CSI spend in the sector, a notable increase from only 7% in 2023.  
• Spending on secondary healthcare (district and provincial hospitals) decreased from 8% in 2023 to only 3% in 2024. 

Type of intervention

Average % CSI healthcare spend 2024 n=21

37% Wellbeing initiatives

22%: Healthcare education, training, and capacity building

19%: Infrastructure, facilities, and equipment

6%: HIV/AIDS and related

5%: Non-specific general donations

11%: Other

• Over a third of average healthcare CSI expenditure (37%) in 2024 went to supporting wellbeing initiatives, a substantial increase from 18% in 2023. 
• Healthcare education, training and capacity building received 22% of average healthcare spend, up from 13% in 2023. 
• Infrastructure, facilities and equipment received 19% of average healthcare spend, up from 10% in 2023.  
• The increase in support for these three types of intervention came at the expense of non-specific general donations which fell from 37% in 2023 to just 5% in 2024, when only one company allocated spend to it.