Speaking Notes for the Minister of Health Dr Zwelini Mkhize WORLD UNIVERSAL HEALTH COVERAGE DAY 12 December 2020


*All Protocol Observed*

I would like to welcome the presentations made by the previous speakers and convey my sincere gratitude for the insightful contributions made today. This highlights the importance of commemoration days where we are afforded an opportunity to stop and reflect on the progress we are making towards our goals- even as we are facing an immediate crisis that threatens to divert our attention. But, what we all agree on here today, is that the COVID-19 pandemic can be seen as an opportunity, rather than a distraction, to use the crisis as impetus for accelerating our path towards Universal Health Coverage. Dr Yates has articulated this sentiment very well and we are convinced this is the way to go to be able to confront the next crisis.

This year, as we commemorate World UHC Day under the theme “Protect Everyone,” we find ourselves in the midst of a second wave that seems determined to dwarf the first wave. Therefore the theme could not be more resonant at this time. As we are confronted by the heavy storm approaching us, I must take the opportunity to appeal to the public, particularly our youth, to be fully conscious of their agency and the role they must play to protect everyone from the devastation of COVID-19. We, as government, have and will continue to mobilize all the state machinery we have at our disposal to fight COVID-19. But this virus can only be defeated by each and every South African’s sense of duty and compassion.


Only you have the power to stop COVID-19.


The time has come for South Africans to make a choice- life or sickness and death. If we choose life, then we must realize that we have to make sacrifices during this festive season. It will not be possible to celebrate the holidays in the way we are accustomed to. We must now understand that the frivolities that are usually associated with the festive season must make way for the things that really matter- family and friends, caring for one another, physical and spiritual rejuvenation and preserving the spirit of ubuntu. We therefore all need to take action to save lives and protect everyone. We must commit to small gatherings, responsible drinking, frequent sanitizing or washing of hands and surfaces, social distancing and we must never compromise on the correct and consistent wearing of masks.


Universal Health Coverage is a social compact- it captures our collective consciousness as a humanity that understands the importance of protecting one another. It recognizes that the right to quality of life is sacrosanct and it acknowledges that everyone has to partner in their various capacities to ensure that no-one is left behind. We all have a role to play now in the fight against COVID-19 and into the future as we implement the National Health Insurance in South Africa.


As most of you know, in October I signed my performance agreement with His Excellency President Cyril Ramaphosa. This agreement places at the top of its agenda a target of progressively implementing NHI to achieve universal health coverage for at least 90% of all South Africans by 2030. This means that by 2030, in accordance with the World Health Organisation’s definition, we must ensure that at least 90% of South Africans “have access to needed health services (including prevention, promotion, treatment, rehabilitation and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship.”


The preamble to the NHI Bill recognizes the socio-economic injustices, imbalances and inequities of the past; the need to heal the divisions of the past and to establish a society based on democratic values, social justice and fundamental human rights; and the need to improve the quality of life of all citizens and to free the potential of each person. It subsequently enjoins us to achieve the progressive realisation of the right of access to quality personal health care services by making progress towards achieving Universal Health Coverage whilst ensuring financial protection from the costs of health care. The Bill fundamentally sets out to achieve this by pooling public revenue in order to actively and strategically purchase health care services based on the principles of universality and social solidarity. This is what Professor Shisana has so eloquently elaborated upon and also highlighted in previous presentations


Fellow South Africans the President has set out very clear timelines for the progressive implementation of NHI- some key targets include:


  • that the NHI Fund should be established as a key entity and that it is operational by 2021/ 2022
  • That the fund should be purchasing services by 2022/ 2023
  • that 25% of facilities must be fully certified to provide quality services at the standard expected under NHI by 2022 and that 100% of facilities must be certified by 2025


To support these noble and necessary ambitions the agreement also sets clear directives and timelines for the implementation of the Health Market Enquiry recommendations as well as the pillars of the Presidential Health Compact. Collectively these guiding documents provide us with the building blocks for a successful health care system that delivers on the promises of Universal Health Coverage.

Ladies and gentlemen, as South Africa, we have endeavoured not to waste the proverbial good crisis as we sought to use the COVID-19 pandemic to inculcate elements of Universal Health Coverage. It is now well recognized that South Africa is one of those nations that has adopted and deployed a highly co-ordinated response to the onslaught of COVID-19. This is because, for the first time in our history, we approached a public health crisis as one unit, through pooling of resources. We paid special attention to strengthening the primary health care system through our community testing and screening campaigns and mobile testing units, amongst other strategies. Whilst government led the response both financially and strategically, ultimately it was through the multi-sectoral working relations that successful expression of social compacting was achieved- the manifestations of which were high awareness of the disease, community mobilization and buy in, active citizenship and a government response based on evidence through high consultation with all key stakeholders.


We are therefore feeling highly encouraged by the progress that has been made towards UHC in this country, even as we faced significant pushback from the advent of COVID-19. Indeed, despite our gallant efforts not to be diverted from our path towards UHC, the pandemic has made its impact felt. However, as government, we remain resolute not to shift goalposts and to stick to the plan, for the sake of our people whose constitutional right to quality health care can never be compromised. Professor van Niekerk was very eloquent in describing how far back this constitutional issue comes from.


I therefore wish to take this opportunity to join the global community in reaffirming the commitments that were made last year at the United Nations High Level Meeting on Universal Health Coverage in New York. This year the State of Commitment to Universal Health Coverage Synthesis has been launched by the United Nations as an urgent call to action that political leaders must undertake to ensure that we do not deviate from the Political Declaration of UHC, 2019. Specifically, it calls on all nations to, and I quote:


  • Prioritize UHC to tackle and recover from the COVID-19 pandemic, allay anxiety and rebuild trust.
  • Address the systemic inequities that are widening with COVID-19 by creating stronger social and financial safety nets and prioritizing equity every step of the way.
  • Expand and strengthen UHC legislation and regulations, set clear targets, and communicate better to bring people together.
  • Support, protect and care for health workers, and innovate to improve and maintain quality during emergencies.
  • Invest in public health and primary health care as a joint effort of health and finance ministers, and local governments, to ensure the continuity of essential health services and provide first-line defence against outbreaks.
  • Build partnerships through genuine civil society engagement.
  • Empower women, who are proving to be highly effective leaders in health emergencies.
  • Give UHC principles more weight in every crisis response, and build emergency preparedness into all health system reforms.

We reaffirm our commitment to these ideals and call on our peers in political leadership to work together with us to ensure the integrity and success of Universal Health Coverage worldwide.

Finally, we wish to acknowledge that there is no system without the dedication and workmanship of a capable and diligent workforce. I pay tribute to all health care workers who have shone a light of hope and excellence during one of the most challenging eras in the history of humanity. I want us all to take moment and reflect on the lived experience of our health care workers, who carried us through the first wave and, without having rested or recovered, now find themselves in the midst of a second wave. For many health care workers in many countries around the world, they have had to dig deep to find the strength to fight an emboldened enemy the second time around, after a testing first battle. May I request that we observe a moment of silence for the brave soldiers we have lost along the way all around the world.

We thank our health care workers for their bravery, commitment, passion, brilliance and service.

We are all in this together.

We will protect one another and we will prevail over COVID-19 and any other insult that may come to meet us in the future.

We will do this by ensuring that we build resilient health care systems through the roll-out of universal health coverage across the globe.

Here in this country, we look forward to continuing the parliamentary hearings as the nation deliberates on the details of the Bill. We know that all South Africans want Universal Health Coverage and that the NHI represents the hopes and dreams of the majority of South Africans for achieving UHC. As government, we are always ready to listen to our people as they express their desires and concerns regarding the Bill. We continue to encourage citizens to use all opportunities to engage the Bill and ensure that, when it is ultimately ascended to law, it fully expresses the will of the people.

We know that UHC, through the implementation of NHI, is the best investment we can make for the people of our nation and for our economy. Ours is to invest into healthier populations for more vibrant economy.

I thank you