South Africans who have access to co-ordinated healthcare, preventive screening, and early intervention are living longer, surviving serious diseases at higher rates, and spending more years in good health.
That is one of the central findings emerging from Discovery Health’s new HealthTrend26 report.
But the findings also raise a bigger question.
If these gains are possible for a relatively small insured population, how can similar improvements be achieved for the millions of South Africans who rely on the public healthcare system?
That question surfaced repeatedly during the report’s launch and subsequent panel discussion, where specialists reflected on what the data reveals not only about Discovery members, but about South Africa’s broader healthcare challenges.
The report draws on more than 30 million life years of healthcare data collected from Discovery Health Medical Scheme’s 2.7 million members between 2015 and 2025. The dataset includes more than 570 million healthcare interactions, 7.5 million hospital admissions, and nearly 28 million hospital days.
Among its findings are significant improvements in cancer survival, better outcomes after major cardiovascular events, and evidence that interventions such as smoking cessation, weight management, and preventive screening can add years to people’s lives.
The report also points to a growing role for earlier diagnosis, personalised healthcare, and co-ordinated care pathways in improving long-term health outcomes.
A glimpse of what works
Many of the report’s findings point to the same conclusion: prevention works.
Discovery’s data shows that members who stop smoking can add more than eight years to their lives. Those who maintain healthy cholesterol levels can gain more than six years, while sustained weight management is associated with almost seven additional years of life expectancy.
In oncology, the report found that members diagnosed with cancer are living an average of 7.1 years longer than they did a decade ago. In cardiovascular care, life expectancy has improved by 6.3 years.
The report also highlights the growing role of personalised healthcare, predictive modelling, and targeted interventions that help to identify risks earlier and guide members towards appropriate care.
For Discovery Health chief clinical officer Dr Noluthando Nematswerani, the objective extends beyond simply helping people live longer. The goal, she said, is helping people to live healthier lives with a better quality of life and fewer years spent living with illness.
The challenge beyond medical schemes
The reality, however, is that Discovery’s 2.7 million members represent only a small part of South Africa’s population.
Medical schemes cover roughly nine million South Africans, leaving the vast majority dependent on public healthcare services.
The panel discussion repeatedly returned to that reality.
Cardiologist Dr Dave Jankelow said the healthcare challenges highlighted in the report extend far beyond medical scheme members.
“I’m not just worried about 2.7 million insured Discovery members. I’m worried about 65 million South Africans,” he said.
Jankelow argued that cardiovascular disease has become one of the country’s largest health burdens and that prevention must reach far beyond the insured population.
As an example, he described the South African Heart Association’s Check My Beat initiative, a community-based screening programme that uses artificial intelligence to assess cardiovascular risk among minibus taxi drivers. The programme was designed around a simple reality: many of the country’s estimated 600 000 taxi drivers, who transport millions of South Africans every day, have never undergone a formal heart-health screening.
The project measures cardiovascular risk factors such as obesity, smoking, hypertension, and diabetes, while also collecting population-health data. Participants complete lifestyle questionnaires and receive personalised health information aimed at encouraging healthier behaviours.
Approximately 75% of screened drivers were either overweight or obese, highlighting the scale of modifiable cardiovascular risk factors within the population.
Jankelow said the initiative is about more than screening. The programme also promotes simple, practical interventions such as exercise routines that can be performed at taxi ranks and healthier dietary choices that are realistic within the communities being served.
The project was recently featured in Beats of Change, a BBC StoryWorks documentary series highlighting community-based cardiovascular-health initiatives from around the world.
It offers a practical example of how prevention, behavioural change, and early intervention can be applied beyond the medical scheme environment.
The cancer divide
Perhaps the clearest example of the gap in health outcomes emerged during the discussion on cancer care.
Discovery’s own data shows how dramatically outcomes can improve when cancer is detected early. The HealthTrend26 report found that cancer mortality among Discovery Health Medical Scheme members has fallen by 48% over the past 15 years, while life expectancy for oncology-registered members has increased by an average of 7.1 years. Discovery attributes those gains to earlier detection, advances in treatment, and more co-ordinated care.
The report also found that regular cancer screening increases the likelihood of early-stage diagnosis by 19% and is associated with a 67% reduction in relative mortality risk. Among Discovery members diagnosed with breast cancer, five-year survival is 96% when the disease is detected at an early stage, compared with 61% when diagnosed after it has become metastatic.
Medical oncologist Dr Keorapetse Tabane said those figures illustrate the importance of what happens before treatment even begins.
In private practice, most patients present with early-stage disease, resulting in better outcomes and higher cure rates. In the public sector, however, patients often present much later.
Tabane highlighted data showing that five-year breast-cancer survival in the state sector is approximately 50%, meaning that half of women diagnosed with breast cancer do not survive beyond five years.
She said the reasons are multifaceted. Public-sector resources are often focused on treating people who are already ill, leaving less capacity for routine screening and early detection. Access to mammograms, pap smears, and other screening tests is more limited, while patients who are diagnosed frequently face longer waits for specialist consultations, surgery, radiotherapy, and other forms of treatment.
“The discussion is not the same,” she said when comparing the insured and uninsured populations.
Lessons that extend beyond private healthcare
One of the most notable themes from the launch was that many of the factors driving better outcomes are not unique to medical-scheme members.
Smoking cessation, weight management, physical activity, healthier diets, and routine screening benefit everyone, regardless of where they receive care.
Nematswerani emphasised that Discovery’s responsibility does not end with its members.
She noted that obesity, smoking, harmful alcohol use, and other modifiable risk factors affect all South Africans, not only those who belong to medical schemes. The organisation therefore uses its findings not only to guide member care but also to educate the broader public.
Many of the interventions highlighted in the report are not dependent on private healthcare. Smoking cessation, healthier diets, physical activity, and routine health checks can improve health outcomes across the population.
“When you say people must stop smoking, you’re not talking only to Discovery Health Medical Scheme members,” Nematswerani said. “When you speak about weight management, we know South Africa has got an issue with overweight and obesity.”
She also pointed to a significant gap in South Africa’s healthcare landscape.
“When we speak about screening, we know we don’t have public health national screening programmes, which is an issue,” she said.
Nematswerani pointed to the World Health Organization’s goal of eliminating cervical cancer as a public-health threat by 2030 as an example of where broader collaboration is needed.
She argued that efforts to improve screening and early detection should not be confined to medical-scheme members.
“We have to do it, not only for scheme members; we have to do it for South Africa,” she said.
From possibility to practice
Discovery Health chief executive Dr Ron Whelan said the report is not only intended to identify healthcare trends, but also to explore how successful interventions can be applied more broadly.
Responding to questions about the wider healthcare system, he said Discovery was committed to working alongside the government and other stakeholders and to sharing insights from its data that could help improve health outcomes more broadly.
Whelan noted that many healthcare professionals working in the private sector were trained in public hospitals and remain committed to improving care across the wider system. He said the challenge was identifying practical opportunities where lessons from prevention, early diagnosis, and co-ordinated care could be applied more broadly.
Whelan said many of the lessons emerging from the report – particularly around prevention, early diagnosis, and co-ordinated care – are relevant beyond the medical-scheme environment.
“When I look through this Health Trends report, I see more possibility than I see problems,” he said.
Similar thinking is already emerging elsewhere in the healthcare sector.
Tabane pointed to a new breast-cancer initiative being launched by the Breast Interest Group of Southern Africa (BIGOSA), which will involve five public-sector breast units across the country. The project aims to standardise care, improve data collection, and create a clearer picture of patient outcomes in the public sector.
According to Tabane, funding has already been secured, and implementation is expected to begin later this year. The initiative will also help to identify gaps in treatment pathways and support efforts to improve access to care for breast-cancer patients treated in state facilities.
The project reflects a growing recognition that better data, earlier diagnosis, and more coordinated care can improve outcomes regardless of where patients receive treatment.
A broader opportunity
At its core, the HealthTrend26 report is about what happens when prevention, early diagnosis, co-ordinated care and patient engagement work together.
The data shows that those interventions can help people to live longer, healthier lives and reduce the burden of serious disease.
Much of that possibility lies in whether the lessons emerging from the data can ultimately benefit more South Africans than the 2.7 million members whose experiences helped shape it.
The report does not attempt to solve South Africa’s healthcare challenges. It does, however, offer a rare longitudinal view of what appears to improve outcomes over time.
In a healthcare system facing growing demand and constrained resources, that evidence is difficult to ignore.
