The National Health Assembly, held at the University of the Western Cape from 24 – 26 June brought together organisations and individuals from all provinces in South Africa and beyond.^[i]

The NHA participants identified the following issues around health and health care provision in South Africa:

• the need for community participation including health committees;
• the problem of human resources in health;
• problems around management of HIV & TB;
• the need to address key social determinants of health;
• barriers to accessing health care including financial, transport and discrimination;
• failures in Emergency Medical Services;
• lack of quality of care;
• poor leadership and management in the health sector

It was acknowledged that while identifying the problems within the health sector is important, identifying solutions and how to bring about the change we seek is vital. There is no more time for talking. Participants committed to specific local, provincial and national campaigns. The broad themes of the campaigns are:

1. Working collectively makes civil society stronger

The Assembly committed to the establishment of provincial coalitions on health with clear goals and plans.

2. One clinic; one committee; one policy

We need the voices of health care users in the health system. Strong health committees put real people in the driving seat of health facilities to make decisions that improve access, and the use of resources.

3. Treasury is a health provider

The Assembly committed to engaging Treasury on taxation, financing for the health sector and the social determinants of health, and maximizing resources available for key reforms.

4. People make the health system

The Assembly resolved to campaign for more community health workers who are integrated into the health work force and health system in the interests of the health of the population; and for the filling of critical health posts throughout the system, from cleaning staff, to community health workers, to specialists.

5. Health is political

The Assembly committed to developing a manifesto on health and requiring responses from all political parties contesting the August elections. The manifesto will include challenging public officials and other users of the private health care system to use the public health system. It will also require a commitment by ward councilors to improve health in their wards through strengthening health care facilities services to address the social and environmental determinants of health.

6. All eyes on the health system

The Assembly resolved to monitor and report on health rights violations and health systems failures and in particular to “adopt” the NHI pilot districts to focus monitoring and health systems improvements in these districts. The International AIDS Conference, to be held from 18 July 2016 in Durban, is an important opportunity to get eyes on the health system in South Africa.

7. Children’s right to basic health services

Children have an unqualified constitutional right to basic health care services and yet vaccines are frequently out of stock and children use the same failing public health care system as their parents. The Assembly resolved to campaign for health system reforms targeting children to realise their rights.

8. Health beyond the health care system

Our environment, diets, access to water and other social determinants of health continue to make us sick. The Assembly resolved to campaign to link health system improvement with improvements to the social determinants of health.

Finally, the Assembly noted that South African civil society cannot and should not act alone. Civil society is under attack in many parts of the world. In particular, the Assembly recognised the contribution of the Lawyers Collective in India, condemned the attacks on the organisation and resolved to express our support to Lawyers Collective to continue their work on promoting access to health care services.