To respond to the call to end AIDS by 2030, Dr Yogan Pillay argues it is firstly critical to agree on what we mean by ending AIDS. Secondly, he suggests it is important to have accurate and granular data that can inform a more targeted approach to reaching those people that the health system typically does not reach.
Around 13% of South Africa’s population are living with HIV and the country has the world’s largest HIV treatment programme. The country’s finances are however under huge pressure and significant cuts were recently announced to government’s HIV budget. Catherine Tomlinson unpacks what a new HIV Investment Case can tell us about the possible paths forward.
In the context of weak economic growth, lower-than-expected tax revenues, and the implementation of measures to reduce public spending, there is a “rising panic” ahead of this year’s Medium Term Budget Policy Statement. The concern for health care provision is palpable as anticipated budget cuts threaten the country’s already fragile and understaffed public healthcare system, write Matshidiso Lencoasa and Dominic Brown.
In June, the Gauteng government launched a major employment drive called Nasi iSpani. Thabo Molelekwa spoke to stakeholders in the public health sector about what this may mean for the province’s chronic healthcare worker shortages.
Though budget cuts impact the health system’s ability to provide quality services to the 85% of people in South Africa estimated to rely on public healthcare, women are doubly burdened by these cuts owing to their unequal reliance on public health services. Women have a disproportionate risk and prevalence of HIV/AIDS and more differentiated health needs, including those for reproductive and maternal health. This Women’s Month is an opportune moment to reflect on how much we spend on healthcare and the quality of that spending which can be powerful measures to help create a public healthcare system that narrows the gender gap, writes Matshidiso Lencoasa.
There are over 100 clinics in Mpumalanga without visiting doctors, hundreds waiting on surgeries in hospitals due to a lack of surgeons and other specialists, and only 60 working ambulances meant to service a population of over four million healthcare users. Nthusang Lefafa unpacks these challenges and asks the province’s health department about its plans.
South Africa’s new National Strategic Plan for HIV, TB, and STIs 2023-2028 and the country’s TB Recovery Plan necessitate a sharp increase in TB testing and increased enrolment into care, which will require additional spending on testing and medicines. Sihle Mahonga Ndawonde argues that a joint committee should be set up to review and interrogate provincial departments’ resource allocation decisions for the next three years.
Already bogged down by loadshedding, operations at various health facilities in Gauteng and a few other provinces have also been disrupted due to cable theft, creating another layer of risk for patients and healthcare workers. This is despite millions being paid for security at these health facilities. Thabo Molelekwa reports.
Investment in public health facilities is crucial as the country weathers storms on various fronts – from drought (water shortages) and flooding putting strain on health infrastructure to a harsh economic climate that makes private healthcare unaffordable to more and more people. Mbali Baduza and Matshidiso Lencoasa assess the investments in infrastructure in the budget and what it means for the planned National Health Insurance system.
Spending on public sector infrastructure over the 2023 medium-term expenditure framework (MTEF) is estimated at R903 billion and the health sector accounts for 5% of this. The well-documented poor maintenance and oversight of projects, also in the health sector, will require close monitoring of trends across the public sector, particularly where procurement and contracting is concerned, writes Zukiswa Kota.
Budgets, while important, are not the right mechanism to drive the structural change needed to improve the responsiveness of our public health system in meeting the needs of the population. But, argues Russel Rensburg, we can reorient the health system towards meeting the health needs of the population and then let the budget bolster the reforms. Here he provides some suggestions on how to go about it and contrasts that with the budget announced by Minister of Finance Enoch Godongwana this week.
Health budgets have the power to advance access to healthcare for millions of people in South Africa. This year, however, as the health sector and the economy recovered from the worst of the COVID-19 pandemic and a volatile global environment, the South African government missed opportunities to provide the financial resources to protect access to healthcare for the most vulnerable. Matshidiso Lencoasa unpacks how the past year’s budget choices will affect key public health services.