The National Health Insurance Policy Paper (NHI) that was promulgated in 2011, marks the beginning of the South African Department of Health’s journey into delivering a health system that offers universal coverage to all it’s citizens, that is free at the point of contact. (NHI, 2011) The implementation of this new health system faces many challenges such as the impact of HIV/AIDS. This research was conducted to ascertain what this impact would be according to subject matter experts in the field.Twenty interviews with experts from the different stakeholder groups were undertaken.The findings revealed that there is dire a need for a new health system to offer financial risk protection and universal coverage to all South African residents. Health Systems strengthening will form a significant part of the reformation that is needed to get the health system to work efficiently. HIV/AIDS must be monitored and managed carefully to avoid multi-drug resistant strains from emerging. An existing model has been adapted for the purposes of this study that allows focus on the various components of the health system. Each component or building block will need attention and strategic direction to ensure that the entire system can function holistically, seamlessly and efficiently.