By Dr Ruth Lancaster — Essential Drugs Programme, National Department of Health
Imagine visiting your doctor for high blood pressure. Whether you’re treated at a public clinic or by a private doctor, you probably expect to receive medicine that is safe, effective and supported by the latest medical evidence. You may not realise that national treatment guidelines also play an important role in determining which medicines are available and, in some cases, what your medical scheme will pay for.
These national guidelines are called the Standard Treatment Guidelines (STGs) and the Essential Medicines List (EML). Together, they help healthcare professionals choose the most appropriate treatments for medical conditions commonly found in South Africa.
The EML identifies medicines that meet the country’s most important healthcare needs, while the STGs explain when and how those medicines should be used. Their goal is simple: to help ensure that patients receive high-quality, evidence-based care while making the best use of South Africa’s healthcare resources.
Developing these guidelines is a careful and transparent process. Teams of doctors, pharmacists, nurses, health economists and other healthcare experts from across South Africa regularly review the latest medical research. They also consider local health challenges, medicine safety, availability and affordability. They also try to take the patient’s preferences into consideration.
The experts also monitor changing disease patterns, including antimicrobial resistance. This is when antibiotics no longer work as well against bacteria, making infections more difficult to treat. Keeping the guidelines up to date helps ensure that recommended treatments continue to be effective.
Importantly, the STGs and EML are not fixed documents. As new medicines become available, new research is published, or health needs change, the recommendations are reviewed and updated so that patients continue to benefit from the best available evidence.
Even if you have private medical cover, these guidelines still matter. They form the clinical basis for many Prescribed Minimum Benefits (PMBs), which are conditions that medical schemes are legally required to cover. For example, if someone with high blood pressure or diabetes receives treatment that follows the national guidelines, the scheme is generally expected to fund the prescribed care without additional co-payments for those PMB benefits, provided the scheme’s rules and PMB requirements are met. Understanding these guidelines can therefore help patients better understand their treatment options and their healthcare costs.
For healthcare professionals, the STGs provide practical, evidence-based recommendations that support good clinical decision-making. For patients, they offer reassurance that treatment recommendations are based on careful scientific review.
This article is the first in a series exploring South Africa’s STGs and EML. Future articles will explain how the guidelines are developed, who contributes to the decision-making process, how medical evidence is evaluated, and where both healthcare professionals and members of the public can find reliable information. Whether you are a clinician, a patient or simply interested in how healthcare decisions are made, understanding the STGs and EML offers valuable insight into one of the foundations of healthcare in South Africa.