MBABANE – EswatiniMed has been accused of using its dominance to frustrate rival healthcare providers through alleged anti-competitive practices.
The allegations originate from complaints lodged by Paramed Laboratories and the Eswatini Private Doctors Association (EPDA), which accused the medical aid fund of conduct that allegedly disadvantaged healthcare providers competing with its own service providers.
The complaints are being investigated by the Eswatini Competition Commission, which has already dismissed Eswatini Medical Aid Fund’s (EswatiniMed) preliminary objection that it does not fall under the Competition Act No. 8 of 2007.
In a ruling delivered on July 31, 2026, the commission held that the fund’s medical aid activities were subject to the competition law, despite its not-for-profit status.
The commission reasoned that providing medical aid in exchange for contributions from members constituted economic activity. It also considered the fund’s investment and control in Ezulwini Private Hospital (EPH), its participation in the healthcare market and its open-enrolment arrangement.
The ruling followed complaints by Paramed Laboratories and EPDA over alleged practices which they claimed frustrated other healthcare providers.
Paramed alleged that EswatiniMed had refused to issue practice numbers to certain healthcare providers. It further complained that practice numbers previously allocated to some practitioners and facilities had been withdrawn or revoked.
EPDA, on the other hand, accused the fund of employing what it described as a ‘non-price predatory strategy’ to frustrate competitors of healthcare providers associated with the fund.
The association alleged that the conduct was aimed at disadvantaging competitors and potentially eliminating them from the market.
The commission’s Secretariat issued an investigation notice on September 26, 2024, before publishing a public notice on October 9 of the same year. It subsequently requested information on October 24, 2024, as part of the investigation.
However, EswatiniMed objected to the commission’s jurisdiction on November 12, 2024, and sought an oral hearing to argue its preliminary objection. The investigation continued, with the Secretariat issuing its investigation report on February 10, 2025.
In the report, the Secretariat concluded that EswatiniMed held a dominant position in the healthcare cover market and had engaged in anti-competitive trade practices.
It recommended that an administrative penalty equivalent to 4.398 per cent of the fund’s total turnover be imposed. The proposed penalty was to be paid within 90 days of the Board’s decision.
The recommendation was, however, not a fine imposed by the commission. It formed part of the secretariat’s investigation report and was subject to the subsequent determination of the matter.
The final investigation report, dated May 12, 2025, referred the matter to the commission’s Board for determination.
The Board heard arguments on the jurisdictional objection on August 8, 2025, before reserving its decision.
After the tenure of the previous Board expired, a new Board was appointed. The commission subsequently wrote to EswatiniMed on February 17, 2026, asking whether it objected to the new Board determining the matter on the papers or preferred to make fresh oral submissions.
On June 1, the Board decided to determine the matter on the papers.
It delivered its ruling on July 31, dismissing EswatiniMed’s preliminary points of law and referring the matter to the second stage, where the substantive allegations of anti-competitive conduct are to be determined.
The ruling did not finally establish that EswatiniMed had engaged in anti-competitive conduct. It dealt with the preliminary jurisdictional issues and allowed the substantive investigation to proceed to the next stage.
Meanwhile, EswatiniMed has approached the High Court seeking to review and set aside the commission’s ruling.
The fund is challenging the decision that its activities fall within the scope of the Competition Act. The matter is scheduled to be heard on November 20 at 9:30am.
