The data black hole undermining South Africa's health R&D

South Africa has earned its stripes as a scientific leader in Africa, with groundbreaking research in HIV treatment and tuberculosis that has saved countless lives.

Our researchers are world-renowned, driven by courage and intellect. The South African government has, over the years, invested in health research, development and innovation with support from external funders.

Despite its global reputation for medical innovation, South Africa lacks comprehensive, transparent data on how much is invested in health research specifically and where that money goes. Are we getting returns on these investments? This data blind spot undermines health outcomes, jobs and innovation. Further to this, the recent US funding cuts call for a more robust Health R&D funding data transparency and accountability.

For more than two decades, the Department of Health promised to allocate 2% of its budget to health research. It was a bold pledge, since evidence and innovation are the primary components of a strong health system. South Africa’s annual national R&D survey provides data to analyse government funding of R&D by looking at historic trends in R&D investment.

Government has contributed more funding to R&D activity than the private sector since 2007/08. Yet here we are in 2025, with no clear picture of whether we are anywhere close to that target. A 2019 review by the South African Medical Research Council (SAMRC) revealed that funding was already falling short, and since then, the data trail has gone cold. We are flying blind, and it’s a national risk we cannot afford.

Why this matters

Transparent data isn’t a bureaucratic luxury, but the foundation of accountability, equity and progress. Without it, we are guessing what matters most in our national health priorities.

Are we investing enough in emerging threats such as antimicrobial resistance, or are we neglecting chronic killers like diabetes? Without knowing where the money goes, we risk pouring funds into the wrong battles while leaving others under-resourced.

For citizens, transparency means accountability. When government pledges to spend 2% of its budget on health research, South Africans should be able to track that promise and see results. Right now, we can’t. That opacity opens the door to waste, duplication and declining public trust. If we can’t follow the money, we can’t be sure it isn’t disappearing into bureaucratic black holes.

For scientists and health workers, clarity in funding helps sharpen priorities. Evidence-based budgeting ensures that our brightest minds are working on the most urgent health challenges, not competing for the same limited pots of money without coordination or insight into national goals.

For the economy, health R&D is more than lifesaving – it’s nation-building. Every breakthrough drives patents, jobs and local innovation.

In the 2022 Global Innovation Index, South Africa was considered one of the most technologically advanced countries in Africa and was rated the most innovative region in sub-Saharan Africa. But without reliable data, investors hesitate, and South Africa risks importing overpriced technologies instead of developing our own. Covid-19 showed what happens when fragmented data slows decision-making and leaves researchers working in the dark. The next crisis will not give us time to fix it.

In short, data transparency in health research is not optional, but how we build trust, target our efforts, and unlock the full potential of South Africa’s scientific excellence.

The data mess we’re in

The main issue is that our data is all over the place. For example, South Africa’s Department of Science and Innovation’s survey on research and development (R&D) groups all health research into broad categories, so we don’t know which specific diseases, regions or institutions are actually getting funding.

Private companies like Aspen Pharmacare tend to keep their R&D spending private because there’s no law requiring them to share that information. Major international organisations like Pepfar (the US President’s Emergency Plan for Aids Relief) and the Bill & Melinda Gates Foundation invest billions in our health system, but we don’t have a single system to see where that money goes or how effective it is.

Universities and research organisations produce important scientific work, but their financial data is scattered in hard-to-find reports. Because of this, it’s difficult to see the connection between how much money is spent and the progress made in developing new medicines, tests, or saving lives.

We are spending billions with one eye shut. That’s not just bad management; it’s a betrayal of South Africa’s potential.

What Treasury must do

The National Treasury holds the keys to fixing this. It’s not just about money, it’s about leadership. Here’s what they need to do, and fast:

• Build a national health R&D observatory. Partner with the DSI and SAMRC to create a single, open platform that tracks every rand spent on health research, public, private and donor. The UK’s Clinical Research Collaboration shows it’s possible.
• Force standardised reporting. Any group getting public funds or tax breaks should have to report exactly how much they’re spending on health R&D. No excuses, no loopholes.
• Reward transparency. Offer tax credits or procurement perks to companies that come clean about their R&D budgets. Make openness a competitive advantage, like we’ve done in renewable energy.
• Demand results. Link funding to real outcomes—new treatments, rights, or policies that save lives. Australia has done it; we can too.

The payoff

Some will object that building data systems costs too much.  Transparency is not an expense if we stop wasting money. Research has shown that it cuts duplication and sharpens priorities, and ensures every rand delivers maximum impact. A clear R&D picture will draw investors, initiate innovation, and help us build solutions that don’t come with a foreign price tag.

South Africa has great ambitions: 0.4% of GDP in R&D by 2030 and 2% of health spending on research. But those are just words without data to back them up. We have the scientists, the labs, and the global cred to lead. What we are lacking is the need to demand transparency and the systems to make it real.

The time for vague promises is over. South Africa must follow the money, demand data, and make every rand count for health. DM

Sakhile Khaweka, lead at Strengthening Africa’s Health Technologies Advocacy Coalition (SAHTAC), specialises in public health policy and advocacy, governance, and research accountability. Ncengani Mthethwa, community manager at the South African Medical Research Council (SAMRC), brings expertise in health research systems and stakeholder engagement, while Ruth Kwachenera Dube, SAHTAC member, is a seasoned bioscientist.