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06 December 2023 | Story Hlumelo Xaba | Photo SUPPLIED
Hlumelo Xaba
Hlumelo Xaba is an intern in the Department of Student Affairs at the University of the Free State (UFS). He holds a BA degree in Governance and Political Transformation from the UFS and was the UFS SRC member for Arts and Culture in 2022.

Opinion article by Hlumelo Xaba, Intern in the Department of Student Affairs, University of the Free State (UFS)

The 2016 South African local government elections heralded the ushering in of a new dimension in the country’s political landscape with regard to constituting governments at local level. For the first time since the inaugural democratic elections of 1994, the governing ANC experienced significant electoral declines, which resulted in the party plummeting below the 50% + 1 prerequisite needed to remain the majority party in various municipalities. 

This loss of support meant the ANC would have to leverage the help of those that would be willing to co-govern with them in various hung councils. At the same time, however, the decline of the ruling party galvanised opposition parties to organise themselves into coalition pacts that would push the ANC into a peripheral position in the local government sphere. Although most of these coalitions have been unstable, the growing likelihood that such arrangements will become part of South Africa’s politics beyond local government necessitates long-term interventions to counter the current political predicaments.

The outcomes of the 2021 local government elections saw the acceleration of the need for coalitions in some local government councils, with a total of 67 hung municipalities across the nine provinces, more than double the number from the 2016 local elections. eThekwini became the new addition to the list of hung metros, even though the ANC managed to retain its governing position through an arrangement with smaller parties. 

Solutions to ever-changing dilemmas

When a certain level of dissatisfaction or disagreement among role-players in a coalition is reached, that partnership is likely to deteriorate, and a new one becomes more likely to be established, based on a new set of preferences and objectives. This has proven to be the case in hung municipal councils including the City of Johannesburg, City of Ekurhuleni, and Nelson Mandela Bay, where DA-led coalitions were replaced by ANC-EFF partnerships that opted for councillors from minority parties to be at the helm as Executive Mayors, while the bigger parties occupy MMC positions, even though it is disputable that these coalitions are premised on common interests aimed at catering for the greater good, rather than serving political agendas and self-interest. 

The climate in South Africa’s local government sphere over the past seven years is a precursor to what the broader citizenry can expect in other spheres of government moving forward, because of the ruling party’s deterioration. With no opposition party being able to make the necessary strides and unseat the ANC on its own, governance of some provincial legislatures – and possibly at national level – after the upcoming 2024 general elections seems likely to require new political formations that demand coalitions. 

Earlier this year, Deputy President Paul Mashatile convened a National Dialogue on Coalition Governments. The dialogue was aimed at responding to the challenges coalitions have faced in the local sphere by formulating a framework that includes a set of principles that will make coalitions function for the greater good in the future. Some of the principles guiding the proposed framework included the following: putting people first in considerations around the formation of coalition governments; such coalition governments must contribute towards building a prosperous society in which people have access to land for productive purposes; and parties to such governments must be bound together by a commitment to good governance and no tolerance for corruption. 

Although a framework of this nature might help in changing the current chaotic status quo, the top-down approach so far used in drafting such an agreement is exclusionary to the electorate. In fact, it may not be reflective of the aspirations and actual needs of the people which it is meant to represent.

Reflect on coalitions and their ramifications 

As the country gears up for the 2024 general elections, political leaders should reflect on coalitions and the ramifications thereof in instances where there was instability for various reasons. The primary focus of coalitions should be on common objectives that will seek to combat socioeconomic ills that citizens face (including poverty, unemployment, crime, and basic service delivery), as well as maintaining stability through good ethical governance that will effectively respond to these challenges. The instability of coalitions across the local government sphere, which has resulted in seemingly insurmountable service-delivery shortfalls due to constant administrative changes, should be seen as a summary of what transpires when there’s a great deal of political interferences in the administrative functions of governments, whether local, provincial, or national.

Although the policies and societal outlook of different political formations are influenced by the ideologies that a party aligns itself to, politicians should be cognisant of the reality that no party can dictate or impose its views on how a coalition should function without considering the inputs of other role-players. Instead, political leaders need to accustom themselves to a culture of maintaining a balance between their own values whilst working with other parties towards common goals that will improve the livelihood of all citizens. This should be done with the aim of ensuring stability in all facets of government, and promoting accountability across all spectrums.

  • Xaba holds a BA degree in Governance and Political Transformation from the UFS and was the UFS SRC member for Arts and Culture in 2022. He writes in his personal capacity.

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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