- Universal health coverage which the (current) government wants to achieve with the National Health Insurance scheme is one of the hottest issues parties use in their election speak to garner votes in the run-up to voting day this month.
- But politics and science is a bad mix, says esteemed academic, immunologist and most recently South Africas health ombud, Malegapuru Makgoba.
- Over the past three decades hes seen the confluence and often conflict of politics and science, and the idea that politics has the power to take over scientific thought as hes seen during the Aids denialism era is a disaster.
- In the April edition of Bhekisisa s monthly TV programme, Health Beat, Mia Malan asks Makgoba what lessons weve learned over the past 30 years and what it means for the future of our healthcare system.
In todays newsletter , Anna-Maria van Niekerk and Linda Pretorius explain why mixing politics and science is a bad idea. Sign up.
Will the National Health Insurance (NHI) scheme fix South Africas 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 the (current) government wants to achieve with the NHI is one of the hottest issues parties use in their election speak 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, says esteemed academic, immunologist and most recently South Africas health ombud, Malegapuru Makgoba.
Over the past three decades hes seen the confluence and often conflict of politics and science, and hes spoken out against it. To him, the idea that politics has the power to take over scientific thought as hes seen during the Aids denialism era is a disaster, he told Mia Malan in an interview in April for Bhekisisa s monthly TV show, Health Beat .
In the late 1990s and early on in the first decade of the 2000s, the Mbeki government denied South Africans free HIV treatment because of ill-advised counsel and political agendas. Estimates are that 330 000 lives could have been saved if reason had prevailed.
Yet we dont seem to learn. The dynamics between politics, science and medicine continue, he says as he reflects on the Life Esidimeni tragedy . His investigation, as health ombud, concluded that a high-level decision to terminate the Gauteng health departments existing contract with the appointed healthcare provider was taken precipitously, with disastrous consequences : 144 people died and 1 418 faced torture, trauma and poor care, and 44 lives are still unacccounted for.
As we gear up to vote later this month, drawing on Makgobas experiences and insights helps us understand where things went awry and what can be done better.
Despite having seen many things in the countrys health system going wrong , I dont feel that I should lose hope, he says.
Heres 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.
Mia Malan (Malan): Weve had six health ministers over the past 30 years. How has that impacted on health policy?
Malegapuru Makgoba (Makgoba): Each one has left a fingerprint in that portfolio. First, we had Nkosazana [Dlamini-]Zuma, who set the blueprint for the national health system by amalgamating the different systems from the homelands and the various provinces into a single one. She was followed by Manto Tshabalala-Msimang, who was part of the Aids denialism era , and almost [set] us back in trying to address HIV/Aids by pronouncing funny [treatment] remedies . Then it was, briefly, Barbara Hogan, who terminated Aids denial . Aaron Motsoaledi followed, who, one can say, is largely responsible for promoting the national health insurance (NHI), appointing the national health ombud and promoting the largest antiretroviral programme in the world , [thereby] improving the lifespan of South Africans [with HIV]. He was followed by Zweli Mkhize, who was responsible for appointing the ministerial advisory committee that assisted our country to [deal with] the COVID pandemic, and [now] Joe Phaahla, who has managed to get the NHI [Bill] approved [by parliament] .
Malan: There have been great things in terms of policy during these ministers tenure over the past 30 years, such as tobacco legislation and legalising termination of pregnancy , but there have also been bad things, like the Sarafina scandal and corruption during the COVID pandemic . How does corruption impact our health system ?
Makgoba: We put a lot of ideas into how the new health system should be, but its in the implementation of those policies that we ha
