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Health advocacy group, the Treatment Action Campaign (TAC) has urged political parties to declare war against the broken healthcare system around the country. 

TAC secretary general, Anele Yawa, said that while South Africa has the largest number of HIV positive people in the world, we have fallen behind many countries in the region in addressing the challenges they are faced with. 

On Thursday, the organisation launched its People’s Health Manifesto, which outlines serious health issues and challenges political parties to answer questions it poses ahead of the local government elections next month.

The manifesto’s inaugural launch in Marshalltown, Johannesburg, will be followed by launches in different regions around the country where the TAC is present, starting in Orlando, Soweto on Friday. “While we were busy with the Ritshidze project over the past few months, we have found that community clinics around the country are in a dire situation. The toilets are broken and have faulty smells. People have also told us that they are scared to go to these health facilities because of the bad treatment they suffer at the hands of healthcare workers. We need this to change,” Yawa told Elitsha.

According to the manifesto, 405 health facilities were monitored between August and September this year, and 25% of these were found to be in a poor condition. “62 were old buildings that needed renovation. 41 had broken or cracked walls, roofs or floors. 25 broken windows or doors. 21 had broken furniture. 57% of health facilities monitored had toilets in bad condition. 191 had no soap. 165 had no toilet paper. 31 had water at all. 67 were out of order and 59 were broken. 69 had no lights.”

In terms of finding out whether political parties will prioritise health infrastructure, the manifesto asked the following: 

“Will you or your party prioritise improving the infrastructure of healthcare facilities, as buildings and toilets in a bad condition hinder people from accessing healthcare?

Will you or your party ensure that facility renovation projects do not face undue negative political influence at local level that hinder progress on construction?”

According to the manifesto, the shortage of healthcare workers is also a major challenge seen throughout the country. While provincial departments of health use between 60 to 70% of their budgets on human resources, healthcare facilities are still deplorably understaffed. 

Out of 30,396 public healthcare users surveyed by the Ritshidze project, only 34.8% said that staff were always sufficient to meet patients’ needs. “Staff shortages also increase waiting times. Out of 10,260 patients interviewed in August and September 2021, 65% thought queues were long. Messy and disorganised filing systems only compound this problem, as reported by 15% of patients interviewed. There is also a need for additional male healthcare workers. Fewer men access HIV, TB or other health services than women,” says the manifesto.

Yawa said that another of their challenges regards people who, while stable on their chronic medication, are given just one-month supply of medication. “They are calling for a multi-month supply, either four to six months. Also those who are stable on HIV treatment don’t understand why they are forced to go to these overcrowded clinics. They are calling for additional pick up points. The other problem is the issue of stigmatisation and discrimination of those with HIV. They are shouted at and get punished by nurses; these are some of the issues we want addressed through clinic committees,” said Yawa.

The TAC said that stockouts and shortages of ARVs, TB medicines, contraceptives and other medicines cause disruption, confusion, cost, and can detrimentally affect long-term treatment adherence. However, the organisation says while conducting the Ritshidze project, it found that stockouts continue to be a major challenge across the country. Yawa said that one of the calls they are making is for the government to extend working hours of clinics, and to also open for one day during weekends. 

“Another thing we observed is the fact that when communities are experiencing difficulties with the healthcare system, you never see any political party present. We’re now appealing to people to vote with their minds and not their hearts. If the government is committed to fixing the broken healthcare system in the country, we want to see the national department of health dealing with those implicated in corruption,” added Yawa.

TAC national chairperson, Sibongile Tshabalala said that one of the issues they want the government to address is corruption, which has engulfed the national department of health. “President Cyril Ramaphosa must do as he says. He can’t keep thieves in his cabinet while he always says he can’t stand corruption. None of the people that have been implicated in corruption at the national department of health have been arrested yet. We are tired of this and we demand action,” said Tshabalala.

On Monday, 18 October 2021 the TAC will host a day of action and march to the Union Buildings in Pretoria to hand over a memorandum of demands to the president.