Impacts of COVID-19 Understanding the impact of COVID on health inequality -South Africa


At the time of writing, the COVID-19 outbreak in South Africa is yet to reach its peak despite having recorded over 450 000 confirmed cases, the highest in Africa, by 28 July 2020 (Information About COVID-19 in South Africa, 2020). The current trajectory indicates that South Africa will be severely affected by the COVID-19 pandemic and it has been consistently ranking amongst the top 5 countries worldwide in terms of COVID-19 cases, despite having a comparatively small population cf. Russia, Brazil and India. Our greatest concern in this regard is the impact on the most vulnerable in society. Survey evidence in the UK, US and Germany suggests that the pandemic exacerbates existing inequalities (Adams-Prassl et al. 2020; BlackDemographics, 2020; Yaya et al., 2020). South Africa continues to struggle with entrenched chronic poverty and inequality, which also manifests in its unequal and polarised health system and it is feared that the pandemic will further amplify these existing inequalities. Early evidence shows that the most vulnerable have been disproportionally affected, i.e. the poor, those with less education, and informal settlement residents. An overwhelmingly large share of the hotspots where COVID-19 is spreading fast, are informal settlements. And due to more severe testing bottlenecks in the public health system, current statistics may underrepresent this inequity in the burden of the disease. Although four in five people in South Africa are reliant on the public health care system, an approximately equal share of COVID-19 tests have been used in the private and public system. Additionally, public sector laboratories have substantially longer processing times of up to 12 days (NICD, 2020), compared to a current 3 day turnaround time for private sector laboratories (Lancet Laboratories, 2020). These long processing times for public sector testing has presented a major challenge for containing the disease.


Project leader: Ronelle Burger

Project researchers:

Scientific mentors: John Cockburn

Journal publication

No journal publications.

Working Papers

Title Modified Size Comments Recommendations
Anticipating the Impact of the COVID-19 Pandemic on Health Inequality in South Africa: Early Evidence on Direct and Indirect Influences 2021-06-18 1.14MB 0 0

Policy Briefs

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Final report

No final reports.


No proposals.

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