When it comes to health-related news, South Africa is usually a source of grim tales and bleak statistics, from the declining life expectancy rates to the escalating threat of HIV/TB co-infection.
A just-published series of articles in The Lancet documents, in relentless detail, the health challenges that South Africa currently faces. But the Lancet articles also spell out the potential for change, writing in an opening commentary: “Not since the first democratic elections in 1994 has there been so much hope and expectation for a better health system, with improved health outcomes for all, in South Africa. The country is at an important crossroads.”
The Lancet series probes the state of maternal and child health, HIV/TB co-infection, and chronic non-communicable diseases, among other problems, and it is a goldmine of startling facts and interesting analysis, as well as some solutions and “urgent action points.”
In the article on co-infection, Salim S Abdool Karim and colleagues write that the twin threats of HIV and TB present one of “the greatest challenges facing post-apartheid South Africa.”
And they don’t sugar coat the reasons: “Until recently, the South African Government’s response to these diseases has been marked by denial, lack of political will, and poor implementation of policies and programmes,” they write. “Nonetheless, there have been notable achievements in disease management, including substantial improvements in access to condoms, expansion of tuberculosis control efforts, and scale-up of free antiretroviral therapy (ART).”
One element that does not get a lot of attention in the series is the role of donor countries in helping South Africa at this “crossroads.” That’s an important question at a time when there is some uncertainty about the Obama Administration’s vision for the US global AIDS program.
The series is available online at http://www.thelancet.com/series/health-in-south-africa.