Digitalisation in the Health Sector: A South African Public Law Perspective




digital health, privacy protection, regulation, risk, surveillance, technology, South Africa


The landscape of the health sector in South Africa as seen from a regulatory perspective is rapidly changing under the disruptive impact of digitalisation. Drawing on a paradigm of "strong rights" protection, particularly a robust privacy law fit for the digital age and sourced in the nation's Constitution, the operationalisation and application of health privacy regulation in post-apartheid society is briefly described. The note then enumerates and assesses a number of specific digital health technologies currently in use in interventions in South Africa. To do so, we adopt the international World Health Organisation (WHO) classification of digital health interventions. We also cover the recent South African response to the COVID-19 pandemic, noting the establishment in South Africa of the COVID-19 Tracing Database and subsequent technological interventions aimed at enhancing contact tracing and other responses to the pandemic. The establishment of the initial database was a development at the interface of the law enforcement and health sectors, which raised concerns regarding its risks to privacy, but it also raised hopes regarding its potential rewards in protecting public health.


Download data is not yet available.


Metrics Loading ...

Author Biography

Jonathan Klaaren, University of the Witwatersrand

Professor of Law

Faculty of Law




Andanda P and Govender S "Regulation of Biobanks in South Africa" 2015 Journal of Law, Medicine and Ethics 787-800 DOI:

Appadurai A and Alexander N Failure (Polity Cambridge 2019)

Barron P et al "Mobile Health Messaging Service and Helpdesk for South African Mothers (MomConnect): History, Successes and Challenges" 2018 BMJ Global Health 1-6 DOI: DOI:

Botes M, Olckers A and Slabbert ML "Data Commercialisation in the South African Health Care Context" 2021 PELJ 1-35 DOI:

Carstens P and Pearmain D "The Regulatory Framework of the South African Health System: Comparative Health Systems Reform" 2009 Medicine and Law 91-124

Clarke R "Privacy Impact Assessment: Its Origins and Development" 2009 CLS Rev 123-135 DOI:

Els F and Cilliers L "A Privacy Management Framework for Personal Electronic Health Records" 2018 African Journal of Science, Technology, Innovation and Development 725-734 DOI:

Frey CB The Technology Trap: Capital, Labor and Power in the Age of Automation (Princeton University Press Princeton 2019) DOI:

Klaaren J "Regulatory Politics in South Africa 25 Years After Apartheid" 2020 Journal of Asian and African Studies 79-91 DOI:

Klaaren J and Ray B "South Africa's Technologies Enhancing Contact Tracing for Covid-19: A Human Rights and Techno-Politics Assessment" 2022 SAJHR 1-23 DOI:

Klaaren J et al "South Africa's COVID-19 Tracing Database: Risks and Rewards of Which Doctors Should Be Aware" 2020 SAMJ 1-4 DOI:

Mathews S et al "Digital Health: A Path to Validation" 2019 Npj Digital Medicine 1-9 DOI: DOI:

Mozorov E "Digital Socialism: The Calculation Debate in the Age of Big Data" 2019 New Left Review 33-67

Pillay Y and Motsoaledi PA "Digital Health in South Africa: Innovating to Improve Health" 2018 BMJ Global Health 1-3 DOI: DOI:

Staunton C et al "Safeguarding the Future of Genomic Research in South Africa: Broad Consent and the Protection of Personal Information Act No 4 of 2013" 2019 SAMJ 468-470 DOI:

Staunton C et al "Protection of Personal Information Act 2013 and Data Protection for Health Research in South Africa" 2020 IDPL 160-179 DOI:

Stevenson S (ed) The National Health Act Guide 3rd ed (Siber Ink Cape Town 2019)

Unger R The Knowledge Economy (Verso Brooklyn 2019)

Veliz C Privacy is Power: Why and How You Should Take Back Control Over Your Data (Penguin London 2020)

Van Niekerk M "Providing Claimants with Access to Information: A Comparative Analysis of the POPIA, PAIA and HPCSA Guidelines" 2019 South African Journal of Bioethics and Law 32-37 DOI:

Wachter S and Mittelstadt B "A Right to Reasonable Inferences: Re-thinking Data Protection Law in the Age of Big Data and AI Survey: Privacy, Data, and Business" 2019 Colum Bus L Rev 494-620 DOI:

Wright D and Raab C "Privacy Principles, Risks and Harms" 2014 IRLCT 277-298 DOI:

Case law

AmaBhungane Centre for Investigative Journalism NPC v Minister of Justice and Correctional Services; Minister of Police v AmaBhungane Centre for Investigative Journalism NPC 2021 3 SA 246 (CC)

Discovery Ltd v Liberty Group Ltd 2020 4 SA 160 (GJ)


Constitution of the Republic of South Africa, 1996

International Health Regulations Act 28 of 1974

National Health Act 61 of 2003

Promotion of Access to Information Act 2 of 2000

Protection of Personal Information Act 4 of 2013

Government publications

GN 1383 in GG 42110 of 14 December 2018

Internet sources

Abrahams L and Burke M 2022 Report on the South African Experience in Open Digital Governance accessed 24 August 2022

BCX 2020 BCX and the Department of Health partner to launch COVIDConnect accessed 19 January 2022

Cachalia F and Klaaren J 2021 Digitalisation, the "Fourth Industrial Revolution" and the Constitutional Law of Privacy in South Africa: Towards a Public Law Perspective on Constitutional Privacy in the Era of Digitalisation accessed 9 September 2022 DOI:

Carvalho T 2021 What We Have Learnt About the Limits of Science accessed 26 September 2022

Cohen AB et al "Direct-to-Consumer Digital Health" 2020 The Lancet DOI: DOI:

Department of Planning, Monitoring and Evaluation 2019 Towards a 25 Year Review: 1994-2019

document/201911/towards25yearreview.pdf accessed 19 January 2022

HPCSA 2016


Professional_Practice/Conduct%20%26%20Ethics/Booklet%209%20Keeping%20of%20Patient%20Records%20September%20%202016.pdf accessed 24 August 2022

Information Regulator 2020 Guidance Note on the Processing of Personal Information in the Management and Containment of Covid-19 Pandemic in Terms of the Protection of Personal Information Act 4 of 2013 (POPIA) accessed 24 August 2022

Mabelane K 2020 Report into Medical Aid Schemes' Racial Profiling Yet to Be Released accessed 19 January 2022

National Department of Health 2020 Download the App – Every COVID Alert SA App Download Means More Lives Saved in SA accessed 19 January 2022

Tomlinson C 2020 The Tangled Web of Medical Device Regulation in SA accessed 19 January 2022

Voigt E 2020 The Trial and Error of Covid-19 Digital Contact Tracing in South Africa accessed 19 January 2022

World Health Organisation 2018 Classification of Digital Health Interventions v1.0

/WHO-RHR-18.06-eng.pdf accessed 19 January 2022



How to Cite

Cachalia, F., & Klaaren, J. (2021). Digitalisation in the Health Sector: A South African Public Law Perspective: . Potchefstroom Electronic Law Journal, 25, (Published 17 November 2022) pp 1 – 24.




Most read articles by the same author(s)

Similar Articles

1 2 3 4 5 6 7 8 9 10 > >> 

You may also start an advanced similarity search for this article.