I did not expect flu research to become this.
We built Her-Zone™ to answer one question: who in South Africa can get to a pharmacy, and how far do they have to travel? That question pulled us further than we planned. A million records later, we are looking at something much bigger than pharmacy access.
This article explains what we built, what the data shows, and where we know we are incomplete. It is an honest account. We are sharing it because the intelligence only improves when more people engage with it.
What Her-Zone™ Maps
Her-Zone™ currently maps more than 1,000 South African zones. The database holds more than a million records and grows every week. Each zone carries multiple data layers, all sourced from public South African and international data sets.
Corporate Pharmacy Locations
SAPC-registered retail pharmacy outlets, including chain and independent community pharmacies. Current data covers approximately 2,260 locations, roughly 56% of all registered pharmacies.
Dispensing Licence Holders
Health professionals holding SAPC dispensing licences, typically in areas where no pharmacy operates within a defined radius. These practitioners supply medicines directly to their own patients.
Medical Aid Coverage
Medical scheme beneficiary rates by zone, sourced from Council for Medical Schemes (CMS) data. The most direct proxy for pharmaceutical purchasing power and branded medicine demand in each zone.
Age Demographics
Elderly population (60+) and young children (0-4) by zone, from Statistics South Africa Census 2022. Both groups face disproportionate clinical risk from influenza.
School Quintile Data
Every public school in South Africa mapped to its zone with the Department of Basic Education quintile rating. A community wealth and socioeconomic vulnerability proxy.
HIV Prevalence
Zone-level HIV prevalence from the HSRC SABSSM VI national household survey (2022-2023). A critical comorbidity risk multiplier for flu outcomes in South Africa.
Healthcare Facility Access
Drive times to the nearest clinic, hospital, and corporate pharmacy by zone. Actual access, not just proximity on a flat map.
Climate Suitability
Zone-level influenza climate suitability scoring using the Shaman-Kohn Influenza Vapour Theory model, derived from Open-Meteo climate data.
Eight layers per zone. More than a million records. That is what a question about pharmacy access looks like when you refuse to stop asking it.
Nine Seasons of Flu Timing
The first thing we learned surprised us.
We took nine complete flu seasons. 2014 to 2024. We excluded 2020 and 2021: COVID lockdowns suppressed flu transmission in 2020 entirely, and the 2021 season did not arrive until Week 44, when restrictions lifted. Neither year tells us anything about normal flu timing.
That left us with 566 weekly WHO FluNet surveillance records across nine clean seasons.
| Season | Onset | Peak | Duration | Peak Positivity | Dominant Strain |
|---|---|---|---|---|---|
| 2014 | W20 | W31 | 19 weeks | 37.7% | A/H3N2 |
| 2015 | W19 | W26 | 23 weeks | 45.0% | A/H1N1pdm09 |
| 2016 | W20 | W35 | 19 weeks | 36.7% | A/H3N2 |
| 2017 | W22 | W27 | 21 weeks | 39.0% | A/H3N2 |
| 2018 | W17 | W24 | 30 weeks | 37.4% | A/H1N1pdm09 |
| 2019 | W17 | W24 | 18 weeks | 52.8% | A/H3N2 |
| 2022 | W19 | W31 | 24 weeks | 36.4% | A/H1N1pdm09 |
| 2023 | W17 | W22 | 34 weeks | 46.1% | A/H3N2 |
| 2024 | W17 | W22 | 27 weeks | 41.1% | A/H1N1pdm09 |
The nine-season mean onset is Week 19. That is early May. Most supply chains in South Africa plan around early May. The mean gives a false sense of security.
Four of the last five seasons started at Week 17. That is late April. Two weeks before the mean.
The mean says Week 19. The recent pattern says Week 17. A supply chain calibrated for early May may be two weeks late in four out of five years. The season does not wait for the plan.
The WHO Moving Epidemic Method (MEM), applied to nine reference seasons, produces a national epidemic threshold of 12.92%. This is a retrospective confirmation tool, not a forecast. When weekly positivity crosses 12.92%, the season has formally started. It crossed that line at Week 17 in four of the last five seasons.
2025 was the most striking example yet. The season arrived at Week 13. The earliest onset since 2010. H3N2 dominated at 96.8% of detections. While the rest of the Southern Hemisphere saw an H1N1-first season, South Africa ran against the hemispheric trend. The strain story is not predictable. The timing trend increasingly is.
One strain has disappeared altogether. Influenza B/Yamagata was last detected globally in early 2020, consistent with WHO global surveillance data. The WHO has removed it from recommended vaccine composition. One fewer variable for surveillance. The planning reality remains the same.
National Data, Provincial Reality
WHO FluNet captures laboratory-confirmed influenza at NICD sentinel surveillance sites. It tells you when the season starts nationally. It does not tell you where. A season that begins at Week 17 in Gauteng may not reach the Eastern Cape until Week 20. Provincial onset timing, strain distribution, and healthcare capacity vary significantly across South Africa’s nine provinces.
Who Is at Risk: Age and Community
Flu is not equally dangerous across all populations. Two groups carry the highest clinical risk.
People over 60 face higher rates of hospitalisation and death from influenza complications. Children under five face higher rates of severe acute respiratory illness. Both groups are disproportionately concentrated in South Africa’s rural and peri-urban zones.
Her-Zone™ maps the population age profile for every zone using Statistics South Africa Census 2022 data. We know where the elderly are concentrated. We know where the youngest children live. When flu season arrives at Week 17 instead of Week 19, the burden falls on these zones first.
The school quintile layer adds a dimension that most flu planning ignores entirely.
What a School Quintile Tells You About a Zone
South Africa’s Department of Basic Education assigns every school a quintile from 1 to 5. Quintile 1 schools serve the poorest communities. Quintile 5 schools serve the wealthiest. When you map more than 20,000 schools to their zones and record their quintile, you have a powerful proxy for household income, health-seeking behaviour, and the ability to afford medicine without subsidy. A zone with predominantly Quintile 1 schools is not just an education signal. It is a healthcare access and affordability signal.
We have mapped every public school in South Africa. More than 20,000 of them. Each assigned its DBE quintile and attached to its zone. The combination of age demographics, school quintile, and pharmacy access creates a vulnerability signature for each zone that no single data layer can produce on its own.
Medicine Access: Three Layers, Not One
When we say “medicine access” in South Africa, we need to be specific about what we mean. There are three distinct channels. Most analysis addresses only one.
| Aspect | Standard Pharmacy Map | Her-Zone Access Model |
|---|---|---|
| Pharmacy Coverage | Shows where pharmacies exist. No coverage disclosure. | Corporate pharmacies only. 2,260 locations. 56% of registered outlets. Source stated. Coverage gap acknowledged. |
| Dispensing Access | Not captured. Not visible. | SAPC dispensing licence holders mapped. Health professionals authorised to supply medicines to their own patients in low-pharmacy zones. |
| Purchasing Power | Not available. | Medical aid coverage rate per zone from Council for Medical Schemes data. Branded medicine demand visibility. |
| Population Profile | Unknown. A pin on a map. | Age, density, school quintile, HIV prevalence per zone. The patient behind the data point. |
| Data Gaps | Rarely disclosed. | Explicitly acknowledged in every analysis. 44% of pharmacies not yet in dataset. Public sector coverage limited. |
Corporate pharmacies are SAPC-registered retail pharmacy outlets. The chain and independent community pharmacies that form South Africa’s formal private pharmacy footprint. Our dataset captures approximately 2,260 outlets. Roughly 56% of registered pharmacies. We are working to close the gap. We name it because it matters to anyone using our data.
Dispensing licence holders are a different access channel entirely. These are registered health professionals, primarily medical practitioners, authorised by the South African Pharmacy Council to supply Schedule 1 to 4 medicines directly to their own patients. They typically operate in areas where no pharmacy exists within a defined radius under the Medicines and Related Substances Act. They cannot serve the general public the way a pharmacy can. But in zones with no corporate pharmacy, they are often the only formal medicine access point available.
Medical aid coverage is the third layer. And it changes how you interpret everything else.
Medical Aid Coverage: The Purchasing Power Map
Approximately 9.17 million South Africans are medical scheme beneficiaries. That is 15.7% of the national population, according to the Council for Medical Schemes Annual Report 2024/25.
That number sounds small. What it hides is the geographic concentration.
Medical aid coverage is not evenly distributed across South Africa’s 1,000+ zones. In Johannesburg’s northern suburbs and Cape Town’s urban corridors, scheme membership can approach 50 to 60% of the local population. In rural Free State, Northern Cape, or Limpopo zones, coverage can drop below 5%.
Medical aid coverage is a map of pharmaceutical purchasing power. Where medical aid penetration is high, branded prescription medicine demand is real. Patients can access private healthcare and afford out-of-pocket costs at a corporate pharmacy. Where medical aid penetration is near zero, medicines on the public sector Essential Medicines List are often the only accessible option.
Her-Zone™ maps medical aid coverage by zone. That means for each zone, we can see the intersection of: corporate pharmacy density, dispensing licence holder presence, medical aid coverage rate, age profile, and school quintile. These five layers together show what no single layer can.
A zone in the Northern Cape has no corporate pharmacy within 30km. On a standard pharmacy map, it appears to have no formal medicine access. Her-Zone shows something different: several registered dispensing licence holders active in that zone, a school quintile average below 2, a medical aid coverage rate below 8%, and an elderly population concentration above the national average. This is not a zone with no medicine access. It is a zone with limited, practitioner-mediated medicine access, serving a vulnerable, low-income, elderly population with almost no private sector pharmaceutical purchasing power. The planning implications are completely different from what the pharmacy map suggests.
The Comorbidity Layer: South Africa’s Flu Risk Profile
South Africa carries a disease burden that makes flu more dangerous here than in most countries where flu planning models originate.
HIV and tuberculosis are not background noise. They are risk multipliers. Published research from South African hospital surveillance quantifies this with precision.
HIV-positive individuals face 7.9 to 20.4 times higher flu mortality risk than HIV-negative people. TB patients hospitalised with confirmed influenza face 5.2 times higher mortality risk than those admitted without influenza co-infection. These are observed findings from South African hospital data, not modelled estimates.
Her-Zone™ holds HIV prevalence data for every zone, sourced from the Human Sciences Research Council’s SABSSM VI, the South African National HIV Prevalence, Incidence, Behaviour and Communication Survey conducted in 2022 and 2023. South Africa’s gold-standard population-level HIV data.
When you overlay HIV prevalence against school quintile, age profile, medical aid coverage, corporate pharmacy density, and dispensing licence holder distribution, you are not looking at separate data points. You are looking at compounding risk. The zones where risk compounds are often not the zones where medicine supply concentrates.
Her-Zone™ scores every zone across 11 independently sourced vulnerability factors:
Eleven factors per zone. Each independently sourced. Each producing a different dimension of the same question: where in South Africa is flu most dangerous when it arrives, and how ready is that zone to respond?
Where We Are Incomplete
We want to be direct about our limitations. We state them in every analysis we publish.
Known Data Gaps — Stated Explicitly
Our corporate pharmacy data covers approximately 56% of registered outlets. Nearly half of registered pharmacies are not yet in our dataset. Any analysis relying on pharmacy density from Her-Zone should be understood as a partial picture. We are actively working to close this gap.
Our dataset does not map the public sector comprehensively. South Africa’s public healthcare system serves approximately 84% of the population through government clinics, district hospitals, and community health workers. This is the dominant healthcare channel for most South Africans and it is underrepresented in our current data. A zone-level analysis that does not account for public sector access makes implicit assumptions about who uses private healthcare. We name that assumption.
Dispensing licence holder data represents a point-in-time snapshot. Licences are issued, renewed, and lapsed. Our data is not a live register.
The school quintile system is a socioeconomic proxy. It is a strong one, well-grounded in the research literature on health access inequality in South Africa. But it is not a direct measure of health access. We use it carefully and with stated caveats in every analysis.
These limitations do not make the intelligence less useful. Incomplete data that is honest about its incompleteness is more useful than complete-looking data that hides its assumptions.
Why This Matters for Pharmaceutical Planning
Every medicine that reaches a patient in South Africa travels through a supply chain calibrated against assumptions about timing, population, and access.
When those assumptions are wrong, the consequences cluster. Stockouts do not happen evenly. They happen in specific zones, at specific times, for specific populations. Understanding where and when requires a different kind of map.
Her-Zone™ does not tell you what your strategy should be. That is not our role. What we can provide is zone-level intelligence that informs better decisions:
Supply Chain Timing
Nine seasons of flu onset data. The W17 pattern. The two-week gap that exists between when most supply chains load and when the season has arrived in four of the last five years.
Market Access Segmentation
Corporate pharmacy density, dispensing licence holder coverage, and medical aid beneficiary rates per zone. Where branded prescription demand is real, and where the market is effectively public-sector only.
Vulnerability-Based Prioritisation
11-factor vulnerability scoring across 1,000+ zones. Where elderly populations, high HIV burden, low pharmacy density, and low medical aid coverage converge. The zones that need supply when it matters most.
Socioeconomic Zone Profiling
School quintile segmentation for 20,000+ schools across every zone. Quintile 1 zones are not just underserved in education. They are where healthcare access, affordability, and compounding vulnerability intersect.
This intelligence was built from South African public data, for South African conditions, with South Africa’s specific disease burden in mind. It does not exist anywhere else in this form.
An Invitation
We think we have built something useful. We are not finished.
You have data we do not. Distribution coverage. Outlet-level trends. Rep call density. Tender penetration by zone. We have data you may not. Zone-level HIV burden. School quintile profiles. Medical aid coverage rates. Nine seasons of flu timing. Neither dataset alone answers the question. Together they might.
If you work in pharmaceutical market access, supply chain planning, public health, or healthcare investment in South Africa, you probably see things we cannot. There are datasets we should integrate. Methodologies we should question. Observations from the field that would make this more accurate.
We want to hear from you. Not a sales conversation. An exchange of intelligence. The best maps are built by people who disagree about what is missing.
Collaboration is what moves mountains.
Reach us at dieter@herbstteam.com.
References and Data Sources
Her-Zone™ Intelligence Platform Herbst Group proprietary spatial health intelligence platform. Version 10.x, February 2026. Zone methodology: Geographic units derived from Statistics South Africa Census sub-place boundaries. All data sourced from publicly available South African and international data sets as listed below. Creative Commons licence.
Influenza Surveillance World Health Organisation. FluNet Global Influenza Surveillance Database. Available: https://www.who.int/tools/flunet. Data: 566 weekly records, South Africa, 2014-2024. COVID-affected years (2020-2021) excluded.
Epidemic Threshold Methodology Vega T, Lozano JE, Meerhoff T, et al. Influenza surveillance in Europe: comparing candidate methods for estimating the epidemic threshold of influenza epidemics. Euro Surveill. 2013;18(28):pii=20528. WHO Moving Epidemic Method (MEM) applied to 9 reference seasons. Computed national threshold: 12.92%.
HIV and Influenza Mortality (Peer-Reviewed) Cohen C, Moyes J, Tempia S, et al. Severe influenza-associated respiratory illness in South Africa, 2012-2013. J Infect Dis. 2015;212 Suppl 1:S65-74.
Walaza S, Tempia S, Moyes J, et al. Influenza virus infection is associated with increased risk of death amongst patients hospitalised with confirmed pulmonary tuberculosis in South Africa, 2010-2011. BMC Infect Dis. 2015;15:26. doi:10.1186/s12879-014-0740-2
HIV Prevalence Human Sciences Research Council (HSRC). South African National HIV Prevalence, Incidence, Behaviour and Communication Survey VI (SABSSM VI). Pretoria: HSRC Press, 2023. Available: https://www.hsrc.ac.za
Demographic Data Statistics South Africa. National Census 2022. Available: https://census.statssa.gov.za. Population by age group and sub-place.
School Quintile Classification Department of Basic Education, Republic of South Africa. National Quintile Classification of Public Schools. Updated annually. Available: https://www.education.gov.za. 20,000+ public schools, quintile 1-5, mapped to Her-Zone zones.
Pharmacy Register South African Pharmacy Council (SAPC). Register of Pharmacies. Accessed February 2026. Available: https://www.pharmcouncil.co.za. Corporate pharmacies only. Approximately 2,260 registered outlets in dataset, representing approximately 56% of all registered pharmacies.
Dispensing Licence Holders South African Pharmacy Council (SAPC). Register of Persons Authorised to Dispense. Medicines and Related Substances Act (Act 101 of 1965), as amended. Regulation 10. Available: https://www.pharmcouncil.co.za.
Medical Aid Coverage Council for Medical Schemes (CMS). Annual Report 2024/25. Pretoria: CMS, 2025. Available: https://www.medicalschemes.co.za. National beneficiary statistics. 9.17 million beneficiaries, 15.7% national coverage.
Climate Suitability Model Shaman J, Kohn M. Absolute humidity modulates influenza survival, transmission, and seasonality. Proc Natl Acad Sci USA. 2009;106(9):3243-3248. Implemented using Open-Meteo climate data (open-meteo.com) for zone-level Influenza Vapour Theory calculations.
National Flu Surveillance Authority National Institute for Communicable Diseases (NICD). Influenza Surveillance Programme. Available: https://www.nicd.ac.za. Real-time surveillance, sentinel site methodology, and annual reports. NICD is the authority for current-season surveillance data in South Africa.
Regulatory Authority South African Health Products Regulatory Authority (SAHPRA). South African Package Insert database and scheduling. Available: https://www.sahpra.org.za. SAHPRA replaced the Medicines Control Council (MCC) in 2018.
Her-Zone™ is a planning intelligence platform. Nothing in this article constitutes medical advice, vaccination recommendations, disease forecasting, or clinical guidance. For real-time influenza surveillance, consult the National Institute for Communicable Diseases: www.nicd.ac.za
Data compiled February 2026. Her-Zone™ is under active development. Coverage figures and record counts reflect data available at time of publication. Approximately 56% of registered pharmacies are represented in the current corporate pharmacy dataset.
Her-Zone™ is developed by Herbst Group and made available under a Creative Commons licence.
Written by
Dieter Herbst
CEO & Founder at Herbst Group. Working with pharmaceutical commercial leaders across South Africa, Kenya, and Brazil to transform sales force effectiveness through evidence-based approaches.
Connect on LinkedIn