WATCH | Bhekisisa: Former health ombudsman Malegapuru Makgoba reflects on healthcare sector

Malegapuru Makgoba, the former health ombud, has seen the country’s health system grow, change and sometimes falter under six health ministers over the past 30 years.

Mia Malan asked him what lessons we have learnt in this Health Beat show, Bhekisisa’s monthly TV programme.

Will the National Health Insurance (NHI) scheme fix South Africa’s unfair health system, a legacy from the transition to democracy 30 years ago when a disjointed structure had to merge to serve a new nation?  

Universal health coverage, which government wants to achieve with the NHI, is one of the hottest issues political parties use in their election campaigns to garner votes in the run-up to voting day this month, our analysis of parties’ manifestos shows.

But politics and science is a bad mix, said esteemed academic, immunologist and health ombud Makgoba. 

Over the past three decades he’s seen the confluence, and often conflict, of politics and science, and has spoken out against it. For him, the idea that politics has the power to take over scientific thought, as he saw during the Aids denialism era, is “a disaster”, he told Malan in an interview in April for  Health Beat.

In the late 1990s and early in the first decade of the 2000s, the Thabo Mbeki government denied South Africans free HIV treatment because of ill-advised counsel and political agendas. Estimates are 330,000 lives could have been saved if reason had prevailed. 

Yet we don’t seem to learn.

“The dynamics between politics, science and medicine continue,”  Makgoba said as he reflected on the Life Esidimeni tragedy. His investigation, as health ombud, concluded  a “high-level decision” to terminate the Gauteng health department’s existing contract with the appointed healthcare provider was taken “precipitously” and with “disastrous” consequences: 144 people died, 1,418 faced torture, trauma and poor care, and 44 lives are unaccounted for. 

As we gear up to vote later this month, drawing on Makgoba’s experiences and insights helps us understand where things went awry and what can be done better.

Despite having seen many things in the health system going wrong, “I don't feel I should lose hope”, he said. 

Here’s more of his insights on what South Africans should expect from the leaders they vote into power because it can become the difference between life and death.

This story was produced by the Bhekisisa Centre for Health Journalism. Sign up for the newsletter.