As Africa’s largest medical technology market, South Africa relies heavily on imports and has limited domestic manufacturing. This was one finding of the Localisation Support Fund’s (LSF) demand-mapping study, independently prepared by HealthValue Consulting and IQVIA, with guidance from a steering committee comprising the Department of Health, the Department of Trade, Industry and Competition (dtic), and the Medical Technology Masterplan project management unit.
According to Stats SA Supply and Use Tables, total supply of medical appliances rose from R57.2bn in 2021 to R67.5bn in 2022.
Over the same period, domestic production grew only from R12.5bn to R12.9bn. As a result, the import share of supply rose from 78.1% to 80.8%, showing that foreign producers are meeting rising demand.
Imports are meeting rising demand.
South Africa imported an estimated R155bn worth of medical technology between 2021 and 2025.
Public-sector procurement of medical technology totalled about R50.3bn over the same period, according to National Treasury payment data.
High on demand, low on local supply
The study, titled Localising MedTech Manufacturing in South Africa, finds that demand is not the binding constraint.
Still, high input costs, the cost and time required for regulatory certification, limited local testing infrastructure, fragmented and price-weighted public tenders, short contract periods, and late payments constrain the ability to convert that demand into local production.
Nearly half of the manufacturers surveyed reported operating at 50% of capacity or less.
The report stresses phased implementation, piloting before scaling, and safeguards for quality, continuity of supply and value for money as it moves from diagnosis to action.
Irshaad Kathrada, CEO of the LSF, said: “The pandemic reminded us that a dependable local supply of medical technology is part of a resilient health system.
“This study gives government, industry and investors a common evidence base for implementing the Medical Technology Masterplan.
“Its central finding is encouraging in a number of product categories: capability already exists, and demand is growing. The task now is to give manufacturers enough certainty to invest.”
Unlocking local manufacturing
The report identified product categories where existing local capability and sustained demand can combine to build manufacturing scale.
These include scaling established production, deepening partially localised categories, moving importers into manufacturing, rapid diagnostic tests, and advanced equipment.
The report recommends a selective, capability-led approach rather than blanket import substitution.
It sets out its main recommendations, including procurement as an industrial lever, regulatory and certification support, skills and quality systems, better market data, and private-sector engagement.
Fundile Gebremedhin, director of medical devices and health technology procurement management at the Department of Health, said improved procurement coordination could help unlock local manufacturing opportunities, building on the report’s findings.
“The study highlights the importance of public-sector procurement in shaping South Africa’s medical technology market, given that government serves approximately 84% of the population.
“However, fragmented procurement and a lack of consolidated utilisation data make it challenging to signal clear demand to local manufacturers. However, it is possible to change this and build on existing best practices.”