Another thing to consider about South Africa is that wealth inequality is insanely high; it seems very plausible to me that most money is spent on like the rich

Another thing to consider about South Africa is that wealth inequality is insanely high; it seems very plausible to me that most money is spent on like the rich 30% of population, and the majority of the country is basically on Namibian levels of care. Public healthcare expenditure is also likely to be wasteful; governmental corruption and languishing infrastructure is a comparatively big problem there (compare power infrastructure, rail network, postal service), so the pure dollar value spent on healthcare is systematically off. Thanks for the link btw-- I would not have expected such a clear trend in this, especially given how noisy metrics like life expectancy are; very interesting.