Pandemic shows SA urgently needs universal health care: Zweli Mkhize

Health minister Dr Zweli Mkhize says one of the glaring lessons highlighted by the deadly Covid-19 pandemic is the urgent need for universal health coverage (UHC) to ensure no-one is left behind.

“The implementation of the National Health Insurance (NHI) is seen as a critical intervention that will assist in restructuring the core components of the health system.

“In turn, this will allow for better use of and access to the capacity available in the health sector with better prioritisation of the vulnerable,” said Mkhize.

Speaking during a commemoration of World Health Day webinar on Wednesday, under the banner “Together for a fairer and healthier South Africa”, Mkhize said: “The reform agenda is based on enshrining the elements of universalism, equity, social solidarity, strategic purchasing, access to quality health-care services and, most importantly, financial risk protection.

“These principles will ensure we attain the objectives of UHC through the phased implementation of the NHI.”

Reflecting on the past year, he said the emergence of the pandemic in late 2019 and its rapid spread in 2020 created the necessity for unprecedented actions and interventions by government and non-government players worldwide.

“Many fellow citizens, especially in our regions, have experienced the acute symptoms of an unprecedented health crisis, job insecurity, food insecurity, income insecurity, social disruption, political tensions and psychological upheaval.”

With SA among the most unequal societies globally, Mkhize said no-one should be left behind in the government’s efforts to stop the spread of the coronavirus.

There are important lessons to draw from the pandemic data, he said.

“If we take these to heart and appropriately contextualise them, we can use them to leverage our health system reform programmes and build more resilient health-care systems capable of absorbing the next public health threat that may come our way while  protecting the people from the devastating outcomes we have seen during the Covid-19 pandemic.”

He said one of the earliest interventions was to create reliable mechanisms for health system governance to ensure the effort was co-ordinated and efficient.

“With this evidence-based approach, our central structure, the national coronavirus command council and ministerial advisory committees created to support government, we were able to foster confidence in the interventions proposed — especially those that required a great deal of social and financial sacrifice by sectors and individuals.”

Mkhize said SA’s health system preparedness approach has strategically focused on:

• mobilising and fairly distributing the available human resources for health;
• assessing the existing hospital bed capacity; and
• creating innovative and sometimes expedited procurement processes to support a proactive response.

“In all these interventions, we have kept our door open for the ongoing involvement and consultation of our private sector stakeholders.”

In addition, he said the government ensured the response remained government-led, with close collaboration across the sectors.

“The role of the private sector was defined in the context of a unified system, and this is a fundamental ethos enshrined in the NHI Bill. Thus our approach has been based on an all-inclusive strategy to draw on the full capacity of the health system.”

As examples, he said the government combined all laboratory efforts and shared resources, combined all beds and moved patients in equal volumes between public and private facilities, “and now, for the first time in history, we have one digital system for capturing and certifying all vaccinated individuals”.

Another lesson learnt is in the field of data management, integration, sharing and reporting.

In the time of the fourth industrial revolution, Mkhize said the government was able to build technology such as the Connect and Covid Alert SA apps to assist with tracing cases and engaging with asymptomatic cases.

“The efficiency of our vaccination programme has been greatly enhanced by the electronic vaccine data system,” he said.

Another lesson learnt is the importance of diversifying procurement strategies.

“In our case, for instance, our diversified approach included bilateral engagements with individual manufacturers, multilateral involvement through the Covax facility and engaging a regional approach through the African Union’s vaccine acquisition task team.”

The minister said at all costs, the country’s vaccine acquisition plan avoided the notion of vaccines nationalism.

“We subscribe to a regime that globally ensures fairness in access and equity in financing and is founded on the principle of social solidarity and equity.”

Inevitably, the consequent slower rollout of vaccines in lower-income countries will negatively impact on economic prosperity and development in those countries. However, Mkhize said, the greatest lesson that vaccine nationalism has taught SA is the critical urgency for Africa to develop, manufacture and distribute its own biotechnology.

The government has also realised there is a huge gap in expertise. “This has created the inclination for continued engagement between the public and private sectors, a clear departure from the past when this type of discourse could not happen without landing in court.”

All of this, he said, lays a strong foundation for the NHI fund provider accreditation and contracting environment.

With the lessons learnt, Mkhize said SA needs to ensure “we use what we learn to inform our broader policy reforms around the phased implementation of UHC”.

TimesLIVE