South Africa has always been a country that tries to maintain a balance between opportunity and struggle. Twenty years into democracy, the health landscape is undeniably very different from the one inherited by the first democratic government.
Great strides have been made in Primary Health Care [PHC] for children and pregnant women, access to life-saving anti-retroviral treatment (ART) has improved, life expectancy has increased, and there is improved awareness around other health issues such as diabetes and heart disease. In addition, the health ombudsperson envisioned in the National Health Amendment Act (Act 12 of 2013) should go some way to improving problem situations as they arise, allowing more people to access quality care and prevent poor service.
At the same time, maternal mortality and child mortality remain higher than the ideal, not enough people are successfully cured of TB, and the ordinary South African still struggles to access high-quality medical care. HIV remains a significant health challenge. In a recent study, the KwaZulu-Natal Province was found to have one of the highest HIV infection rates in the world. It is clear therefore, that achieving the Department of Health’s three goals of ‘zero new HIV infections’, ‘zero discrimination’ and ‘zero AIDS-related deaths’ is imperative to ensuring that South Africans are able to fully enjoy their constitutional right to health.
A shared responsibility
The primary responsibility for the health of South African citizens lies with the State through the national and provincial Departments of Health. At the same time a partnership is required between the people and the government to work towards these health goals. Policies are only useful when implemented, and when people undertake to lead healthier lifestyles.
Non-Governmental Organisations (NGOs) and Civil Society Organisations (CSOs) often play a key role in expanding the reach of health care services and raising awareness about healthy practices. They operate within communities and are well-placed to identify context specific opportunities and challenges to ensure that National and Provincial policies and initiatives are effective.
Funding challenges in the sector
For many Non-Governmental Organisations in South Africa, operating under restricted finances is nothing new. However, post-recession previously strained budgets must be stretched even further. Instead of a reliance on international donors or the Department of Health, many NGOs must now seek funding from both, sometimes in addition to seeking assistance from the private sector.
In addition, many local NGOs are at the point where they would like to define their programme agendas rather than respond to externally imposed ones and so this financial constraint can also become the spring board for new and innovative solutions.
So what next?
Collaboration will necessarily become a central feature of the future of NGO work within the country. Whether this relates to shared applications for funding, or convergence in programmatic focus, it will require a shift. Of course, communities and provinces have their own context specific challenges, but there remains the opportunity for thinking about how NGOs can come together to address these.
JPS Africa places great emphasis on partnerships – between health professionals and communities, between individuals and the state. Through collaboration, innovative research and policy, as well as cutting-edge programmes, JPS Africa is well-placed to be the bridge between parties, and to ensure that efforts to address HIV/AIDS are effective and responsive.