South Africa’s health funding crisis presents an opportunity for a new approach to the budget
The funding crisis that has emerged in the South African healthcare sector as a result of the US aid withdrawals has created an opportunity for the country to review the way it manages and spends on health priorities.
But a R33billion bailout will be required from the National Treasury to alleviate the current pressure on the system and tackle debt in provinces. In addition, strengthened governance mechanisms need to be put in place to ensure that money is spent on the health priorities.
In his State of the Nation Address two weeks ago, President Cyril Ramaphosa prioritised the strengthening of the health system, noting the focus on maternal and newborn care, services for people living with HIV, those with TB, and those suffering from non-communicable diseases such as heart disease, cancer and diabetes.
As Finance Minister Enoch Godongwana prepares to deliver the budget statement tomorrow, the Rural Health Advocacy Project calls on the government to change its approach to health spending to help focus on these priorities.
“The changes in the global political setting provides a chance for the country to rethink how it can buttress itself against future external risks. We need to improve the responsiveness of the state funded system,” says RHAP executive director Russell Rensburg.
Rensburg explains that if South Africa continues on its current trajectory in terms of health spending, the country will erode the capacity of delivering services to those who need it most.
However, a bail out will allow health services to lay a foundation for the broader plan to strengthen public funded health services. The estimated R33billion bailout could allocate the R7 billion to cover the funding gap created by the withdrawals of US funding, an additional R6billion to cover the public sector wage bill and about R20 billion to deal with cumulative annual budget shortfalls that has accrued in provinces as a result of chronic underfunding.
The US funding accounts for 15 000 health workers, of which 8000 are community health workers, 2000 are nurses and 300 are doctors. While The R6billion for the public wage bill would also include commissioning the recently qualified unemployed doctors.
Rensburg warns that provincial capacity has been weakened and any additional resources allocated to health will be used to pay debts that have been accruing due to shortfalls.
To prevent this from happening, RHAP suggests that new funds should be channeled through the District Health Programmes conditional grant with increased conditionalities that guide provinces on how to spend the funds on necessary health priorities.
For more information or for interviews, please contact Palesa Chidi on tchidi@rhap.org.za or on 078 625 0511.