A number of problems in the de facto healthcare system highlight the deep systemic failures that have led the healthcare system of South Ossetia to an acute crisis.

Since February 2025, there have been repeated reports of acute shortages of essential medical supplies, including rabies vaccines and life-saving medicines. There have been alarming reports of the poor medical infrastructure. In addition, only one ambulance is reportedly operating in Akhalgori and it is out of order. The crisis was further exacerbated by the ineffective administration of the system by former health minister Thomas Jigkaev, who was accused of inaction and neglect of critical medical issues.

In August, nurses at the Tskhinvali regional hospital held a protest against the problems in the health system. They demanded a promised salary increase, but instead of dialogue, the de facto government used a policy of intimidation. Some of the nurses were intimidated with threats of criminal prosecution, and others with unexpected recertification. In addition to the announced certification, according to the prosecutor general's office, by decision of the Tskhinvali city court, the head of the hospital's intensive care unit and middle-level medical staff, whom the prosecutor general's office considered suspicious of negligence in the registration and storage of narcotic drugs, have been suspended from work until the completion of investigation. These processes fully served intimidation and demoralization of medical personnel.

The dismissal of Thomas Jigkaev in June 2025 left the de facto ministry of health without a head. Soslan Naniev was appointed the new head of the ministry on September 16, 2025, who had already resigned from the post of minister in 2022 after the election of Alan Gagloev as president, due to disagreements with him on certain issues. After leaving office, he continued his professional activities in Russia. According to reports, in exchange for accepting the position, Naniev demanded a complete overhaul of the ministry's leadership. If he is appointed, these demands for healthcare reform would be a recognition that the current problems are not just the result of financial constraints, but are deeply rooted in a corrupt and inefficient system.