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RESUMO
The World Health Assembly passed a resolution on the importance of engaging with the private health sector. However, the reality is that universal health coverage aspirations are particularly challenging when there is a significant private health sector. This sector in South Africa suffers from rapidly increasing costs, inflation and volume of services (unnecessary medical tests or treatments). This commentary draws on the international literature, particularly the Japanese model of healthcare, to illustrate that it is necessary and possible to curtail costs and volume in the private sector in South Africa, and possibly in other low-income and middle-income settings.