Nearly two decades after South Africa passed legislation intended to regulate traditional health practitioners, the country is still grappling with a major oversight crisis that has forced hundreds of thousands of practitioners to operate outside a fully functional legal framework. Members of South Africa's parliamentary portfolio committee on health have warned that a prolonged failure to enforce key provisions of the Traditional Health Practitioners Act 2007 poses serious risks to public safety, weakens accountability, and delays the integration of traditional medicine into the broader health care system.
According to lawmakers, approximately 300,000 traditional health practitioners remain effectively unregulated because the Interim Traditional Health Practitioners Council of South Africa is not fully operational. Officials say persistent delays have created a legal vacuum that has persisted for years despite repeated promises to improve reform and oversight.
This issue has become increasingly controversial as communities throughout South Africa rely heavily on traditional healers for health care, spiritual guidance, herbal medicine and cultural practices. In many rural and economically disadvantaged areas, traditional healers are often the first point of contact for people seeking medical help. However, without a functioning national regulatory system, officials say there is currently no reliable mechanism to verify practitioners' qualifications, monitor standards, or protect the public from fraudulent and potentially dangerous activities.
Portfolio Committee chair Faith Muthambi sharply criticized the delay and argued that the government had failed to implement legislation approved nearly twenty years ago. He said Parliament established a statutory council in 2014, yet key provisions of the law have not been largely implemented even after more than a decade.
Muthambi stressed that accountability cannot be postponed as long as communities remain exposed to unregulated practices. He also rejected attempts to place blame on the previous administration or former officials, stating that appointees to public institutions inherit both their responsibilities and the consequences of earlier failures.
Lawmakers expressed concern that the absence of a comprehensive practitioner register effectively crippled the Council's ability to fulfill its primary mandate. Without an official national database, health authorities are unable to confirm whether practitioners are appropriately accredited, whether complaints have been filed against them, or whether they meet minimum professional standards.
Members of Parliament warned that this situation opened the door to fraudulent activities, including issuing fake medical certificates and misrepresenting themselves as qualified practitioners. Officials said the enforcement mechanism remains weak as there is no effective way to differentiate registered practitioners from unregistered operators.
The Committee also raised broader concerns about the Council's institutional weaknesses and the lack of measurable progress since its creation. Despite overseeing a sector encompassing approximately 300,000 practitioners, the council reportedly continues to operate with a relatively small budget of approximately R6.7 million for 2024. Projections suggest funding will remain below R10 million in the coming years, with lawmakers arguing that this amount is inadequate to regulate such a large and complex sector.
MPs criticized the current funding model, which assumes the council can sustain itself primarily through practitioner registration fees. According to committee members, this approach fails to take into account the economic realities faced by many traditional healers, particularly those working in poor rural communities where income levels are low and health services are limited.
Critics say the lack of adequate funding has directly contributed to staff shortages, administrative inefficiencies, and delays in developing important regulations. As a result, the Council has struggled to establish appropriate governance structures, disciplinary procedures and nationwide registration systems.
Another major concern highlighted during parliamentary discussions involves the protection of indigenous knowledge systems. Traditional medicine plays an important cultural and historical role in South African society, yet lawmakers warn that the absence of a strong regulatory framework leaves indigenous practices vulnerable to exploitation, abuse and intellectual property theft.
The committee said little progress has been made in integrating traditional medicine into South Africa's broader health reforms, including the country's planned national health insurance framework. Officials said there is currently no dedicated budget for scientific research, product development, or intellectual property protection related to traditional medical practices and herbal medicine.
Health experts have long argued that appropriately regulated traditional medicine can complement traditional health services, especially in underserved areas where access to doctors and hospitals is limited. However, they also emphasize that integration requires clear standards, oversight mechanisms, and evidence-based safeguards to ensure patient safety.
Representatives of the Health Department and the Interim Council defended themselves before lawmakers by pointing to a number of operational difficulties. Officials cited regulatory backlogs, procurement delays, staff shortages and widespread capacity constraints as reasons for the slow implementation process. He also confirmed that an amendment bill to formalize the Council and expand its mandate is currently being processed.
Despite these clarifications, Members of Parliament appeared highly dissatisfied with the pace of reform. The Portfolio Committee rejected many of the justifications as inadequate and sought detailed written submissions from both the Department of Health and the Council. MPs requested updated financial statements, implementation timelines, regulatory progress reports and a concrete strategy for establishing a fully functional oversight authority.
Observers say the controversy reflects broader governance challenges within South Africa's public institutions, where delays in enforcing laws have often undermined policy goals and weakened public trust. In this case, the long-term interim status of the Traditional Health Practitioners Council has become a symbol of institutional stagnation and ineffective governance.
The debate also highlights the delicate balance that South Africa faces in regulating traditional medicine without undermining cultural traditions that are deeply important to millions of citizens. Traditional healers maintain significant influence in many communities, providing services ranging from herbal remedies to spiritual counseling and ancestral rituals.
Proponents of stronger regulation argue that the purpose of formal oversight is not to eliminate traditional practices, but to protect both practitioners and patients. He believes that a transparent registration system, ethical standards, and proper disciplinary procedures can help professionalize the field while preserving its cultural value.
As pressure mounts on the government, lawmakers are now demanding immediate action to end years of delays and establish meaningful regulation for one of the country's largest informal healthcare sectors. Whether officials can finally turn long-promised reforms into reality could determine the future credibility of South Africa's efforts to modernize and preserve traditional health care practices.
Jennifer Hicks is a columnist and political commentator who writes on a wide range of topics.