Health and Health Care in South Africa, an article from The New England Journal of Medecine
You will understand why number relative to COVID are under-estimated, simply no ressources.
WIDENING DISPARITIES IN HEALTH CARE
Annual per capita expenditure on health ranges from $1,400 in the private sector to approximately $140 in the public sector, and disparities in the provision of health care continue to widen.
3 The national public health sector, staffed by some 30% of the doctors in the country, remains the sole provider of health care for more than 40 million people who are uninsured and who constitute approximately 84% of the national population. Approximately 16% of South Africans (8 million people) have private health insurance that provides access to health care from the remaining 70% of doctors who work full-time in the private sector. Up to 25% of uninsured people pay out of pocket for private-sector care. In recent years, permission for senior full-time staff in the public sector to spend a limited proportion of their time working in the private sector has diluted their public-service activities.
Many of the state hospitals are in a state of crisis,
26 with much of the public health care infrastructure run down and dysfunctional as a result of underfunding, mismanagement, and neglect. This has been most visible in the Eastern Cape province
27 but is also striking in other regions.
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