The South African Military Health Services struggle to fulfil ordered commitments, retain scarce skills, and renew obsolete equipment. The management of assets and expenditure remains a challenge; so too procurement and contract management. As in 2009/2010, the shortage of health-care practitioners, deteriorating health-care facilities and unsuitable equipment hamper long-term sustainability of military health services. It is reported that the South African Military Health Services (SAHMS) cannot fund renewal projects from its operating budget, while facilities continue to deteriorate.