Investment in development: our best defence

Investment in development: our best defence

Protection from health crises requires consistent investment in health and social services – and a spirit of solidarity

Good health is a fundamental goal of all societies and a prerequisite for sustainable development. Investment in health and social services is also inextricably tied to sustainable and inclusive economic growth, human capital development, employment generation, social protection and women’s empowerment.

This has been starkly illustrated by the impact that the COVID-19 pandemic has had on societies across the world. As a global health emergency, it has had – and continues to have – far-reaching social and economic consequences.

Like most other countries, South Africa has not been spared the impact of COVID-19. However, consistent investment over the past two decades in dealing with key determinants of health has mitigated its effects on our people.

Since the advent of democracy in 1994, successive administrations have invested in the provision of services that positively affect health outcomes. They include an increase in access to potable water, which now reaches 89% of households; in the provision of electricity, now reaching over 84% of households; and in access to basic sanitation, now at over 82% of households.

We have broadened access to education, especially basic education, and scaled up the provision of free primary health care. We continue to provide an extensive social security net for children and for people who are elderly, indigent or vulnerable. This ‘social wage’ has significantly improved the quality of life of vulnerable South Africans.

The extent of inequality

Despite these investments, the epidemic has underlined the extent of inequality in our society. It is the poor who have been most susceptible to the economic disruption caused by the pandemic.

To delay the transmission of the COVID-19 virus and to give us time to prepare the health system to respond, the South African government has had to take drastic and urgent steps. Foremost among these was the imposition of a nationwide lockdown in March 2020, coupled with border closures and the implementation of a mass detection, screening and testing programme.

The lockdown exerted a heavy toll on our already fragile economy. This led to increased unemployment as many employers shed workers. In response, the government implemented several measures to strengthen the social security net, including making funding available to support struggling companies and their employees. In addition, the Solidarity Fund was established with significant contributions by the private sector, philanthropies and individuals to assist the health and social sectors to respond to the pandemic.

As current chair of the African Union, South Africa has also worked regionally to strengthen Africa’s ability to respond to the pandemic.

The AU has established the COVID-19 Response Fund, and four envoys were appointed to mobilise funding from continental and international sources. Funds are also being used to support the Africa Centres for Disease Control and Prevention.

In addition, the Africa Medical Supplies Platform was established to ensure African countries have access to products needed to fight the pandemic. The purpose of this platform is to create a single online marketplace to enable the supply of COVID-19–related critical medical equipment to countries on the continent.

In partnership with like-minded organisations and individuals, the AU has called for global unity to fight the pandemic. As long as any country has significant transmission of the virus, no country is safe. This means that we must work together in the tradition of social solidarity.

In practical terms, this means we need to ensure that all tools necessary to halt transmission and protect the global and national economies are made available to all, and that no country is left behind. We wholly endorse the call made by several global leaders for equity in access to medical equipment, diagnostics and therapeutics, including a vaccine when it becomes available.

Collective lessons

It should never come to pass that some countries have greater access to vaccines and medicines only because they are richer, better resourced or more influential on the world stage. Such would only entrench inequities and erode solidarity among the nations of the world.

We have gleaned many collective lessons from this pandemic. We must sharpen our resolve to address the social and economic determinants of health. We must move to implement universal health coverage.

The reality is that without strong health systems, without governments working alongside their citizens and without greater equity in access to resources, we will be overwhelmed by future global health emergencies.

By far the greatest lesson we have learnt is on the importance of cooperation and social solidarity. South Africa’s first democratic president, Nelson Mandela, believed fervently in the importance of solidarity. He said: “A fundamental concern for others in our individual and community lives would go a long way in making the world the better place we so passionately dreamt of.”

This is what has been demonstrated during COVID-19. As the arduous task commences of rebuilding our economies and societies in the wake of the pandemic, may the spirit of solidarity continue and endure.