Address by President Cyril Ramaphosa at the 2nd Presidential Health Summit, Birchwood Hotel in Boksburg, Gauteng

Programme Director,
Minister of Health, Dr. Joe Phaahla,
Deputy Minister of Health, Dr. Sibongiseni Dhlomo,
Premier of Gauteng, Mr. Panyaza Lesufi,
MEC’s of Health,
Traditional leaders present,
Representatives of the healthcare fraternity,
Representatives of academia and the scientific community,
Representatives of the World Health Organization and other international health bodies,
Representatives of business, labour and civil society,
Delegates, including those joining us virtually,
Guests,
Ladies and gentlemen,

Good afternoon, it is a pleasure to be here. Thank you for the warm welcome.

It has been four years since the Presidential Health Compact was signed at the inaugural Presidential Health Summit. 

The summit brought together government, business,  labour, civil society, health professionals, unions, service users, statutory councils, academia, and researchers to develop short and long-term solutions to challenges facing South Africa’s healthcare system.

As we know too well, it was not that long after the summit took place that COVID-19 broke out.

In the words of the World Health Organisation, it was the most severe health emergency the agency has ever declared. 

Beyond its toll on human health worldwide, the COVID-19 pandemic also triggered the most serious economic crisis since the Second World War. 

It was a time in which countries and national economies had to take sharp detours when it came to funding and resource allocation decisions. 

With financial and other resources being diverted to fighting the pandemic, a lot of other health priorities had to be put on the back burner. 

There are ample studies showing the impact of COVID-19 on routine immunization, reproductive healthcare, non-communicable disease management, maternal and child healthcare, and other services. 

With the pandemic now in abeyance, it is a case of playing catch-up for many countries, including our own. 

Even though countries like South Africa were particularly negatively affected by COVID-19, our health systems have proven to be remarkably resilient.  

The pandemic disrupted implementation of the nine pillars of the Compact. 

We have had mixed results, including with the apex issue of National Health Insurance and establishing a National Public Health Institute for South Africa.

But work did not grind to a halt. To the contrary, it continued despite the difficult terrain we were navigating at the time.

To use the old adage, every cloud has a silver lining. 

Having a Health Compact in place actually gave us a launch-pad from which to build a coherent and highly effective pandemic response that was acclaimed around the world.  

We were also fortunate in that we put the legislative wheels for NHI in motion before the pandemic struck. 

The National Health Insurance Bill was introduced in Parliament in August 2019 and has been processed through the parliamentary programme since then.  The Bill is expected to be debated in the National Assembly by June 2023 and then considered in the National Council of Provinces.

Implementing the pillars of the Compact are key if our country’s health system is to be prepared for NHI.
 
At the same time, we recognise the need for agility and adaptability in response to both prevailing conditions and lessons learned.

For this reason, stakeholders have called for a stocktake of our COVID-19 response and its learnings as we resume the pathway towards NHI.

Also on the issue of agility, the world and the AU region are negotiating pandemic prevention, preparedness, response and recovery mechanisms to ensure a far more pre-emptive and protective approach to future outbreaks, epidemics and pandemics.  

We have therefore resolved to add a tenth pillar to the health compact: Pandemic Prevention, Preparedness, Response and Recovery. 

I have had the opportunity to go through the robust summit programme and have had sight of some of the presentations and discussions that have taken place over the past two days. 

I have also received the mid-term review report.

Though there has been progress, there is a lot of work ahead of us.

We have to reassess and redefine our country’s health priorities to align them with firstly, the attainment of the Sustainable Development Goals by 2030; and secondly, the African Union’s New Public Health Order announced ahead of the 77th UN General Assembly last year.

The AU’s New Public Health Order is a continental health security policy anchored by five pillars.

These are, respectively; strengthened public health institutions; increased domestic financing of health; attaining biotech sovereignty through local pharmaceutical manufacturing; building a capable health workforce; and fostering respectful, action-orientated partnerships.  

South Africa is a signatory to the UN’s Agenda 2030 for Sustainable Development, and is striving to implement the Sustainable Development Goals. 

Achieving Universal Health Coverage falls under SDG 3, namely Good Health and Wellbeing. 

The aim is to ensure that everyone can access quality health services without incurring financial hardship.  

The aim furthermore is to promote health equity and reduce health disparities by providing essential health services to all individuals, regardless of their socio-economic status or geographic location.  

To achieve this, health systems need to be strengthened, health coverage needs to be expanded, and out-of-pocket expenses for health services need to be reduced.
 
Promoting UHC and achieving sustainable development relies on collaboration between governments, civil society organisations, the private sector, and other stakeholders.

As a country we have come a long way towards creating one health system for all, However, disparities between public and private healthcare continue to increase.

Moreover, despite efforts to integrate health departments, quality of healthcare is still largely influenced by where you live. 

The objective of NHI is to provide access to quality healthcare services to all South Africans, regardless of their socio-economic status or geographical location.

It aims to reduce health disparities between different population groups and regions of the country, and to protect individuals and families from the financial burden of healthcare expenses.

The journey towards NHI requires working with key stakeholders to prepare the health system to accommodate the entire population in one system and ensure all can access quality health care. 

Our vision is to create a world-class health system accessible to all citizens regardless of socio-economic status.
 
It is to ensure every citizen can access quality health services and receive the right diagnosis and treatment at the right time for free at the point of care.  

Such a healthcare system should be adequately staffed with well-trained and motivated healthcare professionals supported by effective management and leadership.

To achieve this vision, government must prioritise several key areas. One, funding.

We need a well-funded health system.  Resources will need to be pooled to provide access to quality health care for all, starting with government funding health services that have experienced a massive budget reduction in the past few years. 

We will also need to mobilise resources to address perennial problems such as HIV, TB and other non-communicable diseases.

Two, strong governance and leadership by the Department of Health. This is to ensure that the entire health system, public and private, is well-managed, transparent, and accountable to the public. In this regard we look to partnerships with civil society to improve oversight and accountability. The Department of Health should be at the forefront of highlighting the importance of health for economic development and social well-being. 

Three, stepping up investment in healthcare infrastructure. We have to upgrade existing healthcare facilities, build new ones where necessary, and ensure that they are properly equipped with the latest medical equipment and technologies.  

Four, developing a motivated, capable, compassionate workforce, and working with medical schools, nursing colleges, and other healthcare training institutions in this regard. 

Government must invest more in training programs for healthcare professionals and increase staffing levels to meet the population's needs. 

We have heard from labour at this Summit on the critical issue of increasing human resources in healthcare, and that community healthcare workers have to be integrated into NHI.

Five, ensuring that essential medicines and medical devices are available in all healthcare facilities, including rural areas and points of access closest to the people, like community pharmacies.

Six, advancing the local production of therapeutics, diagnostics, vaccines and other medical countermeasures in South Africa. 

As a country we have an opportunity to leverage public procurement spend to develop our local industries.
 
We have to ensure that a reasonable balance is struck between considerations of pricing, which are naturally important, with supporting localisation, an economic growth imperative. 

Seven, a zero-tolerance approach to corruption in the healthcare sector, with strict measures to ensure that medical supplies and services are procured transparently and efficiently.  

The highly-publicised situation at Tembisa Hospital and many such examples in various provinces, are unacceptable.  We must protect whistle-blowers to ensure we can root out corruption that has become endemic in our health system.  

I applaud the excellent work of the Health Sector Anti-corruption Forum, some of the results having been presented at this Summit by the Special Investigating Unit.  

As the Presidency we will continue to work closely with the Department of Health, health professionals, the labour movement, businesses, service users, civil society, and regulators to ensure everyone is on board with our vision and committed to making it a reality. 

We also aim to step up engagement with communities across the country to make them aware of what NHI is, how it will benefit them, what their rights are, and how to access services. 

The government, private sector, civil society organisations, and individuals should work together to create a society where everyone can access the resources needed for a healthy life.  

This includes implementing policies that address poverty, education, housing, transportation, and environmental factors that impact health outcomes.  

By addressing social determinants of health across sectors, this country could promote health equity, reduce health disparities, and ultimately create a society where everyone can live a healthy life.

At this year’s UN General Assembly in September we hope to attend the UN High-Level Meeting on Universal Health Coverage to confirm our global commitment to achieve UHC by 2030 in line with the Sustainable Development Goals.

It will be an opportune time to share with the world the progress we have made since 2019 towards National Health Insurance. We have been able to learn from the experiences of others as well as adopt best practice in implementing UHC policies and programs.

Ahead of this UN High-Level Meeting we will also converge at the AU mid-year coordinating meeting to ensure that we are aligned as African countries.

Our goal as South Africa is to create a healthcare system that is the world's envy; that is accessible, efficient, and effective in meeting the needs of all citizens.  

By working together and focusing on our shared vision, we can create a brighter future for everyone.

I thank you.