South Africa: Building Health and Universal Healthcare in South Africa

President Cyril Ramaphosa receives PPEs (file photo).

Wittingly or unwittingly, the proposal for National Health Insurance has created two camps: pro-NHI and anti-NHI. But there is much more to improving health and healthcare in South Africa than the NHI.

In 1939, Dr Salvador Allende, then minister of health in Chile, contended that without improved housing, nutrition and employment for the majority, increased healthcare services would do little to reduce mortality and morbidity rates in Chile.

This view has much to offer in thinking about health in South Africa today, which, according to the Indigo Wellness Index figures, is the most unhealthy nation in the world.

Drawing the links between socioeconomics and health, Hoosen Coovadia and co-authors, trace four epidemics and one social problem as key to premature death, and high rates of illness and injury in South Africa. Three of the epidemics are "diseases of poverty": infectious diseases, maternal death and malnutrition. The fourth is non-communicable diseases (NCDs) like diabetes and hypertension. Violence rooted in toxic masculinity is identified as the social problem contributing to high mortality and morbidity.

While many health analysts and researchers cite the high or quadruple burden of disease in South Africa, few reflect on the historical roots elaborated by Coovadia and co-authors....

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