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The National Education Health and Allied Workers’ Union (NEHAWU), joins the global community in the commemoration of this important Universal Health Coverage Day. A day of the anniversary of the first unanimous United Nations resolution calling on countries to provide affordable, quality health care to every person, everywhere – a commitment in every country to move towards of what in South Africa is called the National Health Insurance (NHI) which has received overwhelming support in two successive general elections.

Through the NHI, South Africa seeks to practicalise this historic and unanimous United Nations resolution in terms of which the world said in unison that everyone including the poorest and most vulnerable must access the quality health services they need without financial hardship. That such access and protection must be the full range of essential health services, including prevention, treatment, hospital care and pain control. And that the costs would be “shared among entire population through pre-payment and risk-pooling, rather than shouldered by the sick. Access should be based on need and unrelated to ability to pay.”

It is in this spirit that NEHAWU welcomes the release of a study Health workforce: A global supply chain by the International Labour Organization (ILO) last Friday. This study heralds a major paradigm shift not only in reference to the hitherto dominant but myopic Neoliberal view that regards spending on health employment as a cost, but also in a sense that it takes a comprehensive approach to work in the health systems beyond the clinical or medical occupations.

Thus, according to this study, “the data reveal that jobs in national health economies play an important role in achieving full employment, particularly due to the significant multiplier employment effects of investments in health protection and the role of workers in non-health occupations supporting medical workers in achieving health objectives.”

In the South African case these non-health occupations would include the ten-thousands of Community Health Workers and others, often women, who are forced to give up formal employment to provide care to older or sick family members given the lack of a comprehensive social security system. Globally, these workers make up 70 per cent of the health economy workforce, comprising the 57 million unpaid family workers and 45.5 million ranging from the low-paid community health and social care workers, to workers in institutions doing cleaning and administrative support.

Last week the Central Executive Committee of NEHAWU resolved amongst other things to fight for the absorption of the Community Health Workers into the public service as part of strengthening the primary health care system in building the NHI. And in response to the 2016 MTBPS, we also vowed to fight against the closure of vacancies in key sites of the delivery of public services such as hospitals and clinics where the already under-staffed nursing cadre is forced to do the work of the cleaners and potters in addition to their already huge responsibilities that they carry in their duties.

This ILO study actually empirically validates and strengthens the Final report of the expert group to the UN High-Level Commission on Health Employment and Economic that was launched in September and that was co-chaired by President François Hollande and President Jacob Zuma. The South African government cannot make immensely honourable commitments internationally that it would not have courage or commitment to practicalise at home. Both the UN report and ILO study support the creation of the NHI, decent jobs in health and recognise the economic benefits of such measures and thus dismiss the dogmatic Neoliberal logic that our National Treasury is still trapped in.

NEHAWU is going to mount a fight for the Community Health Workers and the defense of jobs in key public services in 2017.

Issued by NEHAWU