Inhlangano esanda kusungulwa i-Health Tax Alliance (HTA) icela uhulumeni waseNingizimu Afrika ukuthi anyuse intela kagwayi, utshwala neziphuzo ezinoshukela ukuze kwehliswe umthwalo ohlelweni lwezempilo lomphakathi oluvela ezifweni ezifana nesifo sikashukela, umdlavuza kanye nezimo zenhliziyo. I-Rural Health Advocacy Project (RHAP) igqamisa ukuthi ukwelapha lezi zifo kuziqeda kakhulu izinsiza zezempilo zomphakathi. Ukwenza isibonelo nje, ukwelapha isifo sikashukela kukodwa njengamanje kubiza u-R2.7 billion ngonyaka kanti kungase kunyukele ku-R35 billion ngo-2030. .
I-HTA, eyethulwe eKapa, ihlanganisa ndawonye amaqembu ezempilo omphakathi ahlanganisa i-RHAP, i-Treatment Action Campaign, kanye ne-South African Medical Association. Abameli baphikisa ngokuthi ukukhuphula “izintela zesono” kuzonyusa amanani, kunciphise ukusetshenziswa, futhi ekugcineni kwehlise umthwalo wezifo ohlelweni lwezempilo. I-World Health Organization kanye nochwepheshe bezempilo emhlabeni wonke bagunyaza izintela njengamathuluzi asebenzayo okuthuthukisa impilo yomphakathi.
Kodwa-ke, abanye ababambiqhaza bemboni bayasiphikisa lesi siphakamiso, ikakhulukazi emkhakheni kashukela, oweseka abantu abangaba yisigidi sokuziphilisa. Abamele izimboni baphikisa ngokuthi izintela zikashukela zisongela imisebenzi nemali engenayo. Kusukela yethulwa ngo-2018, i-Health Promotion Levy yeziphuzo ezinoshukela kubikwa ukuthi iholele ekulahlekeni kwemisebenzi nokuvalwa kwemboni kashukela. Yize abameli bezempilo behlongoza ukwenyuswa kwentela kashukela ibe ngu-20%, abaholi bezimboni bazwakalisa ukukhathazeka ngomthelela wayo kwezomnotho, okwenza kube nenkulumo-mpikiswano yokulinganisa izidingo zezempilo zomphakathi nokucatshangelwa kwezomnotho.