The stealth, speed and scale of SARS-CoV-2 contagion and mutation have demanded the management of isolation versus exposure, while imposing involuntary introversion when connection is most needed .

A host of old and new challenges, risks and contradictions to healthcare in South Africa have been laid bare, many of them compounding underlying and pre-existing resource constraints, gaps and inertia. and the system analyzed in previous editions of the Health Systems Trust Annual Report South Africa Health Review (SAHR).

The content of the SAHR 2021 Edition − published April 22, 2022 in partnership with the University of KwaZulu-Natal’s Health Economics and AIDS Research Division − addresses the question “Covid-19: what have we learned?” »

Approaches and interventions for policy reform and crisis management in this context must address not only health outcomes following infection with the coronavirus as a biological entity, but – in tandem – to project, assess and model primary and secondary health and economic risk scenarios, while ensuring preparedness for the unquantifiable intensity of infection surges and virus variants, among other future shocks to national systems.

The destabilization caused by the epidemic and the containment measures in South Africa have exposed society to all the difficulties and unmet needs that affect the majority of our population: uunemployment, poverty, food insecurity and hunger, overcrowded housing and public transport, and limited or no access to basic services; the particular vulnerabilities of homeless people, migrants and undocumented people, rural communities, older people, health workers, women, people with disabilities and people with mental disorders, tuberculosis, HIV, drug addiction and non-communicable diseases; and a fiscally constrained environment beset by fiscal crucibles – all of which undermine the quality of care.

Through thoughtful analyzes within their specialties, the authors of the SAHR 2021 chapters have illustrated how health system actors have accepted this uncertainty as normative and have focused on what can be controlled and created – working pragmatically to shape and establish stamps in a range of areas of interest. areas that mitigate structural weaknesses and to aggregate valuable information that expedites important decision-making in a whirlwind of changing health system dynamics and concurrent pressures.

The need for strong, equitable and people-centred health systems, grounded in universal health coverage, has never been more urgent, as Covid-19 has catalyzed days of accountability to determine who is being left behind . As Health Systems Global envisioned in its October 2021 preview of HSR2022 – the 7th Global Symposium on Health Systems Research – “the challenge ahead goes beyond the core function of service delivery and should focus on the role of values ​​such as trust, solidarity, equity and social justice”.

Several of the chapters in this year’s SAHR describe how policies, protocols and service practices are indifferent to vulnerable populations or are not adequately designed to achieve equal access to health care. Covid-19 is driving change towards instilling our healthcare systems with more inclusive and responsive content.

In his article entitled ‘We see you: In honor of the unknown and invisible personalities of the year‘, Mark Heywood points out that in measuring the impact of the pandemic, communities and non-governmental organizations have much to teach us about new ways to share and use information for action. Civil society should not be ignored in this process.

We see you: In honor of the unknown and invisible personalities of the year

Nor can these efforts be piecemeal. Nimako and Kruk, in a Point of view published in The Lancetcall for a holistic approach: “Governments and business leaders, supported by citizens, health professionals and global development partners, have the opportunity to channel the energy, attention and funding that result in meaningful change towards high quality health systems. »

By synthesizing evidence to meet knowledge needs, the SAHR serves as a publishing hub for institutionalized learning on implementation science. Contributing authors are experts in the field working in the formal public health sector, parastatal organizations, scientific councils, nongovernmental organizations, universities, and bilateral and multilateral support agencies, assisted where possible by less experienced researchers as a means of developing capacity.

Throughout this edition, a rich vein of arguments in favor of cross-sector and cross-disciplinary collaboration and integrative governance for coordinated responses to systemic risk, with an emphasis on salient values ​​of community and agency – a response from the whole of society in which we learn and work together.

The challenge of this pandemic is not just the human body’s inability to protect and recover from Covid-19 infection – in a collective sense, it is humanity’s inability to provide a optimal and equitable well-being in society. We are the virus, and its appearance is indicative of the idea that our social, economic, political, environmental and moral immunity has long been compromised.

It is through large-scale synchronized efforts, in which every converging component is reliably effective, that a global enemy can be defeated. While it is tempting to equate the pandemic with a war effort, one should be wary of such metaphors.

In choosing the universal regeneration of human health in a forward trajectory against any risk of pandemic, we should instead use the language and stance of inquiry and enlightenment through transparent engagement and inclusion. SM/MC

To read the full post, Click here and for chapters at a glance, Click here.

Judith King is a content writer at Health Systems Trust.

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