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The UFS Centre for Gender and Africa Studies, in conjunction with the South African Institute of Race Relations (IRR), recently hosted the fifth instalment of the Africa Dialogue Series. The webinar series – established by Prof Hussein Solomon – has rapidly grown in stature. The latest discussion on the SA Election Aftermath: Economic, Security and Political Considerations drew high-profile international attendance that included several ambassadors, military attachés, and representatives of security communities.

“Part of the success of the Africa Dialogue Series,” Prof Solomon says, “is that we include a variety of speakers in each discussion. This ensures that the conversation remains relevant.” 

Economic challenges amid coalition governments

Prof Philippe Burger, Dean of the UFS Faculty of Economic and Management Sciences, opened the discussion by highlighting the complexities of coalition governments in South Africa – especially given the country’s lack of experience with such political arrangements. Prof Burger further pointed out the difficulty of managing coalitions amid economic stagnation, high unemployment, poverty, and mounting debt. At the time, Prof Burger forecast that a coalition with the Democratic Alliance (DA) might push for pro-market reforms, but that such an agreement could still suffer from instability due to ideological differences. Prof Burger predicted a ‘rocky five years’ ahead for any coalition government.

A shift in security strategy

Transitioning to security matters, Eeben Barlow, Chairman and CEO of Executive Outcomes, stressed the paramount importance of a robust national security strategy for the new government's stability and South Africa's interests. He advocated for a comprehensive reassessment of the current strategy, urging a shift from reactive policies to a proactive, pre-emptive approach. Barlow underscored the need to align intelligence, law enforcement, and military efforts within this revamped strategy through proper structuring, training, and resourcing. He warned that without comprehensive security planning and decisive implementation, South Africa risks further instability, economic decline, and international reputational damage.

Political fragmentation

Next, Terence Corrigan, Project and Publication Manager at the IRR, offered a sobering analysis of the election results. He noted the severe weakening of the previously dominant ANC, which no longer serves as the nation's ‘moral voice’. Despite this, the opposition failed to capitalise decisively, with the DA potentially reaching its voter ceiling. Corrigan expressed concern over the rise of anti-constitutional parties such as the EFF and MK, which exploit public grievances and pose a ‘populist challenge’ to democratic institutions. He predicted increased political fragmentation and ‘fractious politics’ as South Africa navigates this political landscape.

Legislative gridlock and electoral reform

Adding to the discussion of political challenges, Marius Roodt, Deputy Editor of Daily Friend, noted the worrying decline in voter turnout, and reiterated the concerns regarding South Africa’s fragmented politics. Roodt warned that this fragmentation could lead to legislative gridlocks from minority governments or unstable coalitions unable to pass laws. To address these issues, he proposed electoral reforms, including minimum vote share thresholds, extended time frames for forming governments, binding coalition agreements, and restrictions on motions of no confidence. While some view gridlock as a check against radical policies, Roodt acknowledged that an inability to pass the necessary laws could hamper investment.

Broader political implications

Concluding the presentations, Sanet Solomon, a political analyst and lecturer at UNISA, provided an overarching analysis of South Africa's political landscape post-elections. She called attention to the historic significance of three decades of democracy and fluctuating voter turnout influenced by various challenges and achievements. Solomon emphasised the critical nature of policy alignment in coalitions, particularly the ANC's collaboration with the DA. She also discussed the complexities of maintaining macroeconomic stability, the urgent need for rule of law and anti-corruption measures, and the importance of strategic, cohesive policy making in the nation's future.

The webinar underscored the multifaceted challenges facing South Africa's new coalition government, highlighting the need for strategic economic, security, and political planning to navigate the uncertain road ahead.

Click to view documentClick here to watch the full dialogue.

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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