EDITORIAL: With elections and NHI, this is a big year for healthcare in SA

South Africa is barrelling towards its most consequential and most competitive national and provincial elections since 1994. Spotlight editor Marcus Low asks what is on the line in these elections from a healthcare perspective and argues that the stakes are particularly high when it comes to NHI and the Gauteng and KwaZulu-Natal provincial health departments.

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Health in 2023: A deceptively busy year in fewer than 1 000 words

2023 was a busy year for healthcare in South Africa. We saw several promising policy developments, landmark court cases, important pieces of legislation, and some changes in leadership. Yet, take a step back and at facility level little seems to have changed. Shortages of healthcare workers persist, corruption is still rife, budgets tight, and our health governance crisis remains as acute as ever. Marcus Low looks back at the year in health in fewer than 1 000 words.

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Analysis: Incentives seem to work in private healthcare, why not in public?

Doing ‘the right thing’ for one’s health, be it eating well, exercising, or going for an annual HIV test or blood pressure check, is easier said than done. One way to nudge people to make these ‘right’ decisions is to offer rewards or incentives. Amy Green asks whether aspects of some popular private-sector incentive schemes might be worth copying in South Africa’s public sector.

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HIV in Umkhanyakude: Impressive numbers, but living with HIV difficult amid socio-economic hardship

Premier of KwaZulu-Natal, Sihle Zikhalala praised the Umkhanyakude District recently on its ‘exceptional’ figures in meeting the UNAIDS 90-90-90 targets. Yet, when Spotlight recently visited the Jozini area, we were confronted with a less rosy picture. Some people stopped their HIV treatment because they do not have food to eat, and activists now warn that the progress with the targets can be derailed if poverty, hunger and other social determinants of health are not urgently and comprehensively addressed. Nomfundo Xolo reports.

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Finding the money: The case for raising the Health Promotion Levy

The recent budget policy statement shows South Africa finds itself in a very tight fiscal space where it has to navigate a global pandemic along with other health challenges such as rising rates of non-communicable diseases. Russell Rensburg argues that the Health Promotion Levy should be increased to 20% – which will raise much-needed revenue that will contribute to preventing disease and reducing healthcare costs.

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