#FeesMustFall and the campaign for universal health coverage

Jane Doherty, Di McInytre


This editorial reflects on how #FeesMustFall highlighted the political and social upheaval that results from extreme income inequity and inequitable access, problems that beset the health sector as well. It presents data showing how per capita health expenditure declined for a decade after 1994, despite the burgeoning HIV/AIDS epidemic, a blow from which the health system is still trying to recover. The underlying reason for this was a macroeconomic policy that placed constraints on taxation and goverment expenditure on social services. The article shows how South Africa (SA)'s tax-to-GDP ratio is much lower than other middle-income countries, and argues that raising this limit is essential for development. Spending on health and education should be seen as an investment in the SA economy. The Department of Health needs to argue this case in Cabinet and demonstrate the effectiveness of health spending through efficient service delivery and fighting corruption.

Authors' affiliations

Jane Doherty, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Di McInytre, Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, South Africa

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Healthcare expenditure; South Africa; Revenue collection; Taxation; Fiscal policy; Fiscal space; Equity

Cite this article

South African Medical Journal 2015;105(12):1014-1015. DOI:10.7196/SAMJ.2015.v105i12.10339

Article History

Date submitted: 2015-11-12
Date published: 2015-11-16

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