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SA: Sibongiseni Dhlomo: Address by Deputy Minister of Health, on Policy Dialogue on Universal Health Coverage in South Africa. Universal Health Coverage Day: “Build the World We Want: A Healthy Future for All” (12/12/2022)

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SA: Sibongiseni Dhlomo: Address by Deputy Minister of Health, on Policy Dialogue on Universal Health Coverage in South Africa. Universal Health Coverage Day: “Build the World We Want: A Healthy Future for All” (12/12/2022)

13th December 2022

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Programme Director and Director-General, National Department of Health, Dr Sandile Buthelezi
Minister of Health, Honorable Dr MJ Phaahla
Honorable Members of the Portfolio Committee present led by Dr Kenneth Jacobs
Dr Owen Kaluwa, the Country Representative of the World Health Organization
MECs of Health,
Provincial Heads of Department
Esteemed speakers for the Policy Dialogue
Other Senior Government Officials
International Development Partners present
Distinguished guests
Ladies and gentlemen 
Good morning.

Let me once again thank you for availing yourselves to participate in this Universal Health Coverage (UHC) Policy Dialogue.

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The World Health Organisation defines UHC as ensuring that "people have access to the health services they need, when and where they need them, without financial hardship. It includes the full range of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care."

Globally, millions of people lack access to healthcare. According to WHO, at least half the world’s population is not covered by essential services. This is more so in developing countries. There is a wide health gap between the rich and the poor, with weakened health systems made worse by the COVID-19 pandemic. In addition, increasing health costs is pushing millions of people into poverty. UHC is important to ensure equity in access to quality health services without the financial hardship. Achieving UHC will bring about human dignity and social justice. We also know that a healthy population is necessary to building a thriving economy and a competitive nation.

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In 2015, all the United Nations member states (of which South Africa is one) adopted the 2030 Agenda for Sustainable Development. The Sustainable Development Goals (also referred to as SDGs) are at the heart of this sustainable development agenda and they are an urgent call to action for all member states for global partnership. 

South Africa, among other countries, endorsed the most ambitious and comprehensive political declaration on health in history at the United Nations High-Level Meeting on Universal Health Coverage in September 2019. This declaration placed universal health coverage at the heart of the 2030 Agenda for Sustainable Development. 

In terms of universal health coverage we declared that we “Recognize that universal health coverage is fundamental for achieving the Sustainable Development Goals related not only to health and well-being, but also to eradicating poverty in all its forms and dimensions, ensuring quality education, achieving gender equality and women’s empowerment, providing decent work and economic growth, reducing inequalities, ensuring just, peaceful and inclusive societies and to building and fostering partnerships, while reaching the goals and targets included throughout the 2030 Agenda for Sustainable Development is critical for the attainment of healthy lives and well-being for all, with a focus on health outcomes throughout the life course;”

As leaders in African Union, we have committed to the Addis Ababa Call to Action that aims to close the funding gap and achieving universal health coverage as we build towards the Africa we want.

Universal health coverage systems are not new and are certainly not a South African invention. In fact, South Africa is one of the extremely few countries that does not have a universal, tax funded, health system.

From a historical perspective, the first move towards a national health insurance system was launched in Germany in 1883, with the Sickness Insurance Law. In New Zealand, a universal health care system was created in a series of steps, from 1938 to 1941. The Nordic countries implemented universal health systems between 1955 and 1964, while universal health insurance was introduced in Japan in 1961.

Single payer healthcare systems were introduced in Finland in 1972, followed by Portugal in 1979 and others preceding the change of millennium. Switzerland introduced their universal health system based on an insurance mandate in 1994. Universal health coverage has been introduced in some Asian countries, including Thailand, which implemented their reforms in 2001.

South Africa’s Dr Henry Gluckman, who served as Minister of Health from 1945 until 1948, proposed the first National Health System which would be financed by a health tax, but his proposal wasn’t ultimately adopted by government as his successor A.J. Stals and the National Party pursued a very different future which led to entrenched statutory apartheid.

UHC is aligned to South Africa’s values of justice, fairness and social solidarity. In line with the 2030 National Development Plan, we aim to achieve Universal Health Coverage through the implementation of the National Health Insurance (NHI). This is going to ensure that no one is left behind, and that all South Africans can live a long and healthy life.

Our health care is in our hands: we must continue to lay the foundations for truly universally accessible healthcare as we build the country we all want.

I Thank you

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