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Illustrative image | Sources: Sharon Seretlo / Gallo Images / Getty Images | Gallo Images / Dino Lloyd
When the history books are written, 2020 will be remembered as the year of Covid-19. But, in the world of healthcare, a lot of other things have happened, or didn’t. We tried to summarize a tumultuous year in just a thousand words.
On the first day of January 2020, only a few people knew of a worrisome new infection in Wuhan, China. By the end of the year, the infection had spread around the world, causing more than 1.6 million confirmed deaths (actual deaths will be significantly higher).
On the one hand, the history of coronavirus disease 2019 (Covid-19) During the last 12 months, it was one of massive blockades and people who died in hospitals that were subjected to immense stress. On the other hand, it was also a year of remarkable scientific achievement. By the end of November, preliminary data, although convincing, had shown that three vaccinations offer protection against Covid-19. Before that, some treatments and interventions were found to improve survival: local work in high flow nasal oxygen was notable, while some highly publicized treatments, such as hydroxychloroquine, were shown do not work.
the Government of South AfricaThe response to the pandemic has been mixed.
the early blocking was the correct moveand the formation of a strong scientific advisory group showed good intentions. But some lock regulations no wonder it came under wide review, and transparency has been spotty at best. The failure of the National Health Laboratory Service to meet the demand for tests at the peak of the pandemic was disappointing, particularly after guarantee that I had enough capacity.
Worst of all, however, was the human toll the pandemic took people, and especially in health workers across the country, particularly in the Eastern Cape, where the pandemic found a healthcare system that has already been on the ropes for years.
In South Africa, the Covid-19 confirmed death the count was approaching 25,000 in mid-December, but the actual number could end up exceeding 50,000. By comparison, the HIV and TB death counts for 2019 are estimated at 74,000 and 58,000 respectively (although there is a significant overlap with people who have HIV and TB).
Either way, suggestions from some quarters that only a few thousand would die in South Africa and that Covid-19 would be “just another flu” turned out to be incorrect.
Meanwhile, Covid-19 and the related lockdown have hit almost every aspect of our public health system hard. Less people tested for TB this year. Less medical circumcisions they took place. In February, an ambitious plan to make HIV prevention pills available across all healthcare facilities, only for Covid-19 to pour cold water on these ambitions a month later. Some HIV and tuberculosis catch-up plans are underway, but much more will be needed in 2021.
Figures published in November showed that South Africa will meet the 2020 targets set by UNAIDS regarding HIV testing and viral suppression, but that the country will fall short of its treatment coverage target with only seven out of ten people diagnosed with HIV receiving treatment. In October, new figures from the World Health Organization suggested that around 20% more people got sick with TB in South Africa than previously thought – National TB Prevalence Survey believed to confirm these figures have not been released, despite being ready in February. Either way, the numbers we have point to worrying gaps in our responses to both HIV and TB.
Perhaps the biggest HIV news of the year came in November, when a HIV prevention injection given every two months was shown to be very effective in preventing HIV infection in young women. However, as with Covid-19 vaccines, HIV prevention pills, and a new tuberculosis prevention regimen, scientific advancement is of course only the first step. Making the new product widely available to people who need it is another matter.
If you asked us earlier in the year what the top health focus of 2020 would be, we would have told you National Health Insurance (NHI). In large part due to Covid-19, the NHI bill is still stuck in Parliament and will likely remain there well into 2021, if not longer. Even more solidly stagnant this year have been the reforms to the regulation of the private health sector proposed in the Competition Commission. Consultation on the health market.
In some respects, the pandemic may have provided the ideal opportunity to experiment with some private sector contracting the kind we will surely see under NHI. And, while there have been some hires (for testing, for example), any benefits that may have emerged have been overshadowed by the sheer scale of Covid-19-related corruption we’ve seen in 2020. There are some glimpses of We hope that the Special Investigation Unit is investigating corruption in the health sector, but only time will tell if there will be convictions.
In health governance in general, things remain bleak, a situation compounded by painful budget cuts just when we can least afford it. Many provincial health departments remain dysfunctional. In some departments, incompetent but politically connected people remain in place, while more competent and principled people discontinued or unwilling to return to an often toxic and mediocre public service. In pockets of excellence Healthcare workers have done an amazing job responding to the pandemic, but they often did it despite the department’s support and not because of it.
A new national strategy for health resources obtained by Highlight at the beginning of the year he projected that health worker shortage it will get worse in the years to come if the government fails to increase investment dramatically. Whether there is the capacity and political will to implement the strategy remains an open question.
Ultimately, in many provincial health departments, and perhaps even the national department, the dream of a new dawn and a capable state often still plays a secondary role in cadre patronage and deployment. As it was a decade ago, this rejection of professionalism in favor of political and personal expediency remains the sand in the cogs of our public health system.
Covid-19 may have turned the world upside down in 2020, but some things have unfortunately not changed. DM / MC
