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03 March 2025 Photo Supplied
Dr Harlan Cloete
Dr Harlan Cloete is an engaged scholar and research fellow in the Centre for Gender and Africa Studies at the UFS.

Opinion article by Dr Harlan Cloete, Centre for Gender and Africa Studies, University of the Free State.
 President Cyril Ramaphosa delivered the State of the Nation Address (SONA) as the first president without an ANC majority in Parliament. He addressed several critical issues, committing his Government of National Unity (GNU) departments to take decisive action to tackle the persistent challenges of unemployment, poverty, and inequality. The strategy involves prioritising inclusive growth, job creation, poverty alleviation, and building a capable, ethical, and developmental state. Additionally, the president emphasised the need for national dialogue and pledged to reform local governance through a review of the 1998 White Paper on Local Government.

The current White Paper defines developmental local government as a system committed to working with citizens and community groups to find sustainable ways to meet social, economic, and material needs while enhancing the quality of life. It emphasises targeting marginalised and excluded groups within communities, such as women, people with disabilities, and those living in extreme poverty. Highlighting the central role of local government, South African Local Government Association (Salga) president Bheki Stofile noted that local governments are responsible for delivering 46% of public services, including water supply, electricity, sanitation, and refuse removal, yet receive only 10% of national revenue. At the same time, municipalities have accumulated a staggering total debt of R386.5 billion and owe creditors R117.5 billion.

To say that local government is in crisis would be an understatement. The 30-year government review reveals that economic, political, spatial, and institutional disparities hinder municipalities’ ability to deliver services. An estimated 29% of municipalities are on the verge of operational collapse, pointing to systemic dysfunction rooted in governance failures and limited capacity. Research conducted by the Centre for Gender and Africa Studies at the University of the Free State in partnership with the Local Government Seta over the past three years confirms the poor state of knowledge management, the lack of evidence-based human resource development practices, persistent barriers facing women in local government, and challenges in implementing the Municipal Staff Regulations. Simply increasing fiscal allocations to local government without addressing the root causes of these failures would be like pouring money down the drain.

The case for local dialogues

Any conversation about building a capable state must begin with functional, ethical, and developmental local governance. This requires shifting from a national dialogue to local dialogues that can feed into a national dialogue. For the past 25 years, local governments have produced five-year Integrated Development Plans (IDPs) in partnership with communities, yet the outcomes have been disappointing. We have failed to transform data into actionable knowledge that can tackle challenges in a participatory manner. The marginalised and poor have become passive spectators in a system meant to empower them. They lack agency and have lost confidence in local government and the ward committee system, which was designed to be the functional backbone of participatory democracy. Meanwhile, the middle class, equipped with agency and resources, has become increasingly disengaged. What we are witnessing is a form of “wicked compliance” — a tick-box approach to democracy that echoes the late Malcolm X’s critique: “We do not have a democracy... we have hypocrisy.”

To move beyond this, the local government review must be accompanied by local dialogues, led by community members, businesses, academia, and local government, as envisioned in the National Development Plan (NDP). However, these dialogues should not be led by local government but rather by the collective. This represents a shift from traditional government (top-down) to governance (co-created), as advocated by sociologist Francois Theron. Such co-created spaces allow communities to craft pragmatic future visions and strategise from the future backward. These dialogues should encourage genuine and innovative conversations about the future, positioning local government as a co-creator and collaborator, rather than simply another participant in a talk shop.

Framework for future-focused local dialogues

A future-focused local dialogue should be addressed using the Governance 5iQ framework that asks five fundamental governance questions:

1. Why do we do what we do? (Vision)
2. How do we do what we do? (Mission)
3. How do we know we are on track? (Monitoring and Evaluation)
4. What do we do if we are not on track? (Consequence Management)

5. How do we lead and learn? (Knowledge Management)

For local governance to be effective, policies must be implemented by committed, competent, and caring individuals. Additionally, policies should be reviewed to assess whether they create opportunities for the poor and the youth. If local economic development is to succeed, then supply chain processes must be aligned with developmental objectives. A valuable case study is Daleel Jacobs, Supply Chain Manager at Stellenbosch Municipality, whose master’s thesis demonstrates innovative ways to fulfil the spirit of the law while delivering tangible outcomes.

Addressing political interference and embracing digital transformation

Research conducted across 32 municipalities in all nine provinces reveals that political interference is a significant barrier to effective implementation. Politicians are frequently accused of meddling, overstepping their boundaries, and lacking both insight and foresight. As coalitions become more common post-2026 elections, political parties must adopt transparent candidate-vetting processes. The Coalition Bill could provide much-needed stability by introducing an executive committee system where power is proportionally distributed in the absence of a majority party. Moreover, local governments must leverage digital transformation. In August 2024, the government launched the National Artificial Intelligence Policy Framework. Local governments should harness AI tools to enhance efficiency and effectiveness. Following the example of the University of Kehl in Germany, which introduced a degree in Digital Public Management five years ago, South African institutions should also prepare the next generation of public managers for a digital future.

Leading into the future

South Africa's vibrant democracy is mirrored by the volatility, uncertainty, complexity, and ambiguity that characterise local governance. Leaders are tasked with bringing clarity and certainty, eliminating contradictions, and fostering a compelling vision of the future. However, crafting a vision is not enough; we must actively work towards and embody this preferred future.

The president may deliver the SONA, but the true state of the nation depends on all of us. By prioritising local dialogues and a collaborative governance model, we can lay the foundation for sustainable local governance that truly serves the people.

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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