Strategies and active responses are needed to reverse the collapse of the health system, rights group Treatment Action Campaign (TAC) said this week. (Waldo Swiegers/Bloomberg via Getty Images)
Strategies and active responses are needed to reverse the collapse of the health system, rights group Treatment Action Campaign (TAC) said this week as celebrated its 25th anniversary.
The call comes after the National Health Insurance (NHI) Bill, which aims to provide universal care through a state-run fund, was approved by the National Council of Provinces last week. It was referred to President Cyril Ramaphosa, who can either sign the bill into law or request that it be amended.
This week, activists marched through the Johannesburg central business district to celebrate the anniversary of TAC, which was founded in 1998 to campaign for access to Aids medication. In 2002 it made headlines nationally and internationally when the constitutional court ordered that the government provide ARVs to stop the transmission of HIV from mothers to their babies during birth.
“We are here today for our celebration next to the constitutional court. The very same court that saved our lives, that agreed with the Constitution of this country to say that everyone has a right to life and treatment,” TAC national chairperson Sibongile Tshabalala said at this week’s event.
Last week, TAC and Ritshidze — developed by people living with HIV and activists to hold the government and aid agencies accountable to improve overall HIV and TB service delivery — hosted a joint community meeting looking at the state of South Africa’s public healthcare system.
Some of the key issues raised included the shortage of healthcare workers, the crisis in emergency medical services, challenges that discourage people living with HIV from staying on ARVs and the prevalence of people being turned away and denied healthcare services.
TAC collected data from Ritshidze’s community-led monitoring across eight provinces, 29 districts and more than 400 public healthcare facilities on challenges identified by TAC’s 280 branches across the country.
This included people living with HIV and TB, people who use drugs, sex workers, LGBTQIA communities and other public healthcare users who testified to their experiences while trying to use the “broken system”.
Speaking to the Mail & Guardian on condition of anonymity after a visit to Johannesburg’s Helen Joseph Mother and Child Hospital, a pregnant woman said the process at healthcare facilities would move faster if there were more staff.
“The nurses get annoyed sometimes and it is because there are not many of them to help us — they try but we still end up waiting because they don’t have enough staff.”
According to the TAC, only 25% of facilities said they had enough staff to meet demand, with 1 334 vacancies reported in its latest statistics.
“[There is also] inadequate clinic infrastructure, with 79% of facilities reporting needing more space, with waiting areas, files, rooms for medical care and private HIV testing/counselling the most common things facilities needed extra space for,” TAC communications manager Xabisa Qwabe said.
The campaign highlighted some of the key issues that are contributing to the “broken” public health system.
Ambulances
Too often ambulances take hours to arrive and critically ill patients and women with pregnancy complications are forced to wait or to hire private transport at prices they cannot afford to take them to the nearest hospital — leading to many avoidable deaths.
Staff attitudes
Eleven percent of people living with HIV said staff shouted at them if they missed or were late for an appointment, while 18% were sent to the back of the queue. Only 4% of staff ask how they could make it easier for patients to stay on treatment.
Treatment literacy levels
Understanding what test results mean supports long-term adherence to treatment, yet only 88% of those surveyed said a healthcare provider had explained their results. This translates to poor understanding. Eighty percent of people understood that an undetectable viral load was good for their health. Only 81% understood that it means they cannot transmit HIV.The department of health observed Tuesday as Universal Health Coverage Day to raise awareness of the “necessity for resilient, equitable, and robust healthcare systems to achieve the Universal Health Coverage theme for 2023 — Health for All: Time to Act.