- On 22 August South Africa’s second — and highly controversial — presidential health compact was signed by the government and various sectors.
- The first health compact, titled “Strengthening the South African health system towards an integrated and unified health system” was signed on 25 July 2019.
- The second compact, titled “Accelerating health system strengthening and National Health Insurance (NHI) implementation”, is controversial because prominent organisations that served on the steering committee of the drafting of the first compact refused to sign it.
- Business Unity South Africa (Busa) and the South African Medical Association (Sama) declined to sign the compact because they say they weren’t consulted on its contents, which require them to endorse the NHI in its current form.
- Read the second presidential health compact that was signed on 22 August and the full 110-page compact report that was released on 27 August.
On 22 August South Africa’s second — and highly controversial — presidential health compact was signed by the government and various sectors. This comes after delegates from the government, health professional organisations, labour, business, civil society, patient groups, statutory bodies, academia, health entities and traditional healer and allied health professional organisations met in Boksburg on 4 and 5 May 2023 for the country’s second presidential health summit.
A health compact is an agreement among sectors — for example, business, government, labour, patient groups, civil society, health professions organisations, statutory bodies and academia — to work towards a common goal and sets out what each industry has to contribute.
The first health compact, under the title “Strengthening the South African health system towards an integrated and unified health system” was signed on 25 July 2019, after the country’s first presidential health summit was held on 19 and 20 October 2018.
The second compact, titled “Accelerating health system strengthening and National Health Insurance (NHI) implementation”, is controversial because prominent organisations that served on the steering committee of the drafting of the first compact refused to sign it.
MIA MALAN SPEAKS TO KAYA FM ABOUT THE PRESIDENTIAL HEALTH COMPACT
Business Unity South Africa (Busa) and the South African Medical Association (Sama) declined to sign the compact because they say they weren’t consulted on its contents, which require them to endorse the NHI in its current form.
Sama has about 12 000 doctors as members and Busa is the country’s largest federation of business organisations.
Where references to the NHI in the first compact were few — the agreement had nine pillars and the NHI is mentioned in three, and only in relation to future implementation — the draft document that was circulated for input last week has 16 sections, called articles, and the NHI, as a clear policy to which all signatories commit, is mentioned in 12. For instance, the NHI is referred to as “a lodestar” for the “voyage” towards universal health coverage.
Busa and Sama refused to sign the compact based on a draft document that was circulated. The final document is word-for-word the same as the draft document, but Busa says the final document was never shared with them.
The implication is that there are fewer partners to formally work together to improve South Africa’s health system. In the case of the first health compact, 363 partners worked together — 48 were business organisations recruited by Busa and 76 health professional organisations assembled by Sama.
But the second time around, only 14 partners, plus the World Health Organisation, signed the compact. Three of the partners were the president, health minister and minister of science and innovation. No health entity signed the compact, while eight such entities — including medical schemes such as Discovery Health (the country’s largest private medical aid) and Momentum Health — signed the first compact.
Read the second presidential health compact that was signed on 22 August.
Read the full 110-page second presidential health compact report that was released on 27 August.
Mia Malan is the founder and editor-in-chief of Bhekisisa. She has worked in newsrooms in Johannesburg, Nairobi and Washington, DC, winning more than 30 awards for her radio, print and television work.
