South Africa’s path to universal health coverage: a new Presidential Health Compact

South Africa is taking steady steps towards UHC with the government and Ministry of Health working in solidarity with a range of stakeholders and the Presidential Health Compact, aiming to improve the country’s health care. 

In July 2019, the President of South Africa, Mr. Cyril M Ramaphosa, launched the ‘Presidential Health Summit Compact – Strengthening the South African health system towards an integrated and unified health systems’, which lays out a five-year roadmap for health systems strengthening reforms under the ‘9 pillars’ for accelerating UHC in South Africa. 

“Currently, the vision of growing South Africa together is taking shape once more in the vital area of health where Section of 27 of our Constitution affirms the right of all for all people to have access to health care services, including reproductive health care, sufficient food and water, and social security including appropriate social assistance.” 

“To give effect to this right, government and social partners have engaged intensively and collaboratively in a national effort to create one health system and introduce universal health coverage in the form of National Health Insurance (NHI). For NHI to be successful, it has to be implemented simultaneously with a quality improvement programme,” said Matamela Cyril Ramaphosa President of the Republic of South Africa

The President and Minister of Health-South Africa signed the Presidential Health Compact along with representatives of various stakeholder groups who agreed to work collectively on 9 pillars for a stronger health system capable of providing access to quality health services for all South Africans. 

The Compact originated from months of extensive consultative deliberations between key stakeholders following the Presidential Health Summit in October 2018.  Stakeholders included government, health and allied health professionals, labour, business community, academics and researchers, statutory bodies, traditional health practitioners and public health entities. The premise was that the health system cannot be fixed by the Health Department alone, but requires a focused, holistic and collaborative approach. 

The Compact outlines the roles of all key stakeholder groups in implementation of critical tasks related to UHC and National Health Insurance in South Africa, such as updating quality improvement plans, developing a human resources for health operational plan, improving public finance management, increasing access to essential medicines, upgrading infrastructure, and using information technology through public private partnerships for scaling up initiatives to strengthen health systems.

Putting the Compact into practice

The Presidential Health Compact will be instrumental in accelerating progress towards UHC over the next five years. “The Department of Health will work collaboratively with the other sectors to achieve the targets in the Compact. We hope that this approach would herald the beginning of a new era in our response to challenges in the health system. I appreciate the contribution made by all these Government Departments and the stakeholders who have committed themselves to improve the quality of the health system. No health system can be significantly enhanced without a deep involvement of other sectors and key stakeholders,” said Dr Zwelini Mkhize, Minister of Health. 

“The implementation of the compact is expected to contribute significantly towards improving the healthcare system in the country leading to many more South Africans having access to quality health services. We believe that it is the path to South Africa’s acceleration towards Universal Health Coverage, which will ensure that the country contributes to Sustainable Development Goals, especially Goal 3 on Health, aimed at ensuring healthy lives and promoting wellbeing for all at all ages,” said Dr Brian Chirombo, Acting WHO Representative to South Africa.

More information and links

This article draws upon: 
WHO Africa Regional Office news report 
Commentary on the launch of the Presidential Health Compact  
Speech of the President