The South African healthcare sector is currently experiencing a budget crisis as a result of the USAID withdrawals, which has given the nation a chance to re-evaluate how it allocates funds for health objectives.
This is according to the Rural Health Advocacy Project (Rhap). The latter is a division of the WITS Health Consortium that seeks to promote fair and equal access to quality healthcare for rural communities across the country.
RHAP executive director Russell Rensburg said that to alleviate the current strain on the system and address provincial debt, the National Treasury will need to provide a R33-billion bailout.
2025 national budget speech
Rensburg said this ahead of the 2025 national budget speech that is to be presented by Finance Minister Enoch Godongwana on Wednesday in Pretoria.
He said government needs to change its approach to health spending to help focus on these priorities.
“The changes in the global political setting provide 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,” said Rensburg.
Rensburg explained 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 bailout will allow health services to lay the foundation. And that will help for the broader plan to strengthen publicly funded health services.
R33bn bailout distribution
From the estimated R33-billion bailout, R7-billion would cover the funding gap created by the withdrawals of US funding. An additional R6-billion will cover the public sector wage bill. And about R20-billion will deal with cumulative annual budget shortfalls that have accrued in provinces. These accrued as a result of chronic underfunding.
The US funding accounts for 15, 000 health workers, of which 8 000 are community health workers. A total of 2000 are nurses and 300 are doctors. The R6-billion for the public wage bill would also include commissioning the recently qualified unemployed doctors.
Weakened capacity
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 channelled through the District Health Programmes conditional grant. With increased conditionalities that guide provinces on how to spend the funds on necessary health priorities
