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21 July 2021 | Story Prof Philippe Burger | Photo Sonia Small (Kaleidoscope Studios)
Prof Philippe Burger is Pro-Vice-Chancellor (Pro-VC): Poverty, Inequality and Economic Development at the University of the Free State.

Government needs to see the private sector as a true partner, whose expertise and capital can leverage its plans

Opinion article by Prof Philippe Burger, Pro-Vice-Chancellor (Pro-VC): Poverty, Inequality and Economic Development, University of the Free State

Many South Africans watched in disbelief last week as KwaZulu-Natal and Gauteng descended into looting, chaos, and destruction after Jacob Zuma’s imprisonment. Though probably instigated by disgruntled pro-Zuma supporters, it is clear that the protests very quickly spun out of control.

In newspapers, the question was repeatedly asked: did we see the hungry poor looting for food, or the opportunistic middle-class turning up in cars and bakkies to grab big-screen TVs and fridges? While images and videos clearly show that the latter were present in large numbers, the sight of other people – including gogos – ransacking supermarkets and running off on foot with loaves of bread and bags of maize meal, point to the former. In short, if people had jobs and hope that their lives would improve, I doubt we would have seen such anarchy.

Only a matter of time before protests and unrest occurred

With official unemployment above 30% and the broad unemployment rate – which includes discouraged work-seekers – in excess of 40%, it was only a matter of time before protests and unrest occurred. Zuma’s imprisonment was surely incidental. If it hadn’t been that, something else would have triggered the chaos.

COVID-19 also aggravated the situation, with 1,4 million people losing their jobs as a result of lockdown measures. In addition, the R350 COVID-relief grant expired at the end of April, leaving many with less food on the table.

A number of people argue that, in light of what has happened, we should bring back the relief grant; government may not have much choice now, given the lingering effect of 16 months of COVID restrictions on levels of unemployment and poverty. It will simply have to rearrange its budget to do so. However, we can’t stop at grants.

Even though a grant puts a bit of food in your stomach, it does not give you hope that the future will look better than today. It’s that bleak-looking future, that sense of nothing to lose, that fuels the looting and gives unsavoury politicians leverage for their selfish interests. Contrast this behaviour with that of taxi drivers, who came out to protect malls and chase away looters. They did so because they have something to lose, a stake in the economy to protect.

Every South African has a stake in the economy

We need to ensure that every South African has a stake in the economy. That way, people will have a sense of belonging, they will have options and agency, and they will have resources to improve their lives. They will have hope that the future will look better than the present. A person with a stake in the system is unlikely to break that system. 

We therefore need to seriously reconsider our policies, speed up much-needed change, and start building a believable message of hope – hope stemming from real concern for the plight of the poor, and serious implementation of policy. To help the poor, we need to create jobs, and for that we need investment.

Analysis of economic data shows that for every percentage point rise in private investment as percentage of GDP, we lift GDP growth by a third of a percentage point. And, on average, for every percentage point that GDP grows, employment increases by 1%. In recent years, private investment has averaged a mere 12% of GDP. If we can lift it to 15%, or even to 18%, GDP can grow by an extra one or two percentage points. It might not sound much, but after a decade or two it makes a big difference.

However, for this to happen, the government will have to see the private sector as a true partner whose expertise and capital can leverage the state’s plans. With such an approach, for instance, it would not be necessary for government to own and run an airline – a private operator will fill the gap in the market with its own capital, saving government billions of rands. And the government could long ago have let the private sector play a key role in the generation of electricity, instead of resisting change and only belatedly agreeing to lift the cap on private generation capacity from 1 MW to 100 MW.

Build communities where people escape poverty and have hope

The type and location of investment is also important. Data from the Council for Scientific and Industrial Research shows that SA’s urban population will have increased to between 50 million and 52 million by 2035. This is an increase of 12 million to 14 million compared to 2018.

We must use the opportunity to build green industries. It will save money and build a better environment. In short, as a growth strategy, we need a green, urban-driven investment strategy that caters for SA’s burgeoning urban population.

That way, we can build communities where people have a stake in the economy, where they have jobs and businesses, escape poverty, and have hope that their future and that of their children will improve.

• The article was first published in Business Day


News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

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