This paper describes progress and challenges in efforts to improve the health of South Africans since 1994. It reviews the state of health and the health care system, identifies major accomplishments and shortcomings, and outlines some opportunities for new gains in national health priorities.
The purpose of the paper is to help inform discussion of macro health policy and planning by identifying key priorities and opportunities for consideration.
Although restructuring of the public health sector post’1994 achieved substantial improvements in terms of access, rationalisation of health management and more equitable health expenditure, fifteen years later these early gains have been eroded by a greatly increased burden of disease related to HIV/AIDS, generally weak health systems management and low staff morale. The result is poor health outcomes relative to total health expenditure.
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