Background

The major health care challenge for the new South Africa is to provide equity in basic health care to all South Africans and, in the process, to rectify the underlying inequalities in health service provision brought about by apartheid. Before 1994, South Africa had a highly fragmented public health system designed to service the different population groups separately. Fragmentation, curative focus, and lack of community participation resulted in a large, majority population which was deprived of even basic primary health care. The rationale for supporting the development of an integrated primary health care system is based on the government’s identification of primary health care as the cornerstone of the new South Africa’s health services.

Among the biggest challenges South Africa faces today are the dual epidemics of HIV/AIDS and tuberculosis (TB). With a 20% HIV infection rate among adults and an estimated 5 million adults and children living with HIV/AIDS, South Africa is among the worst-affected countries in the world.  Every day, 1,700 people acquire HIV and 600 die of AIDS-related illness. Almost half of these deaths are caused by tuberculosis (TB). In sub-Saharan Africa, only Nigeria and Ethiopia have worse TB epidemics than South Africa; every month, TB kills 1 000 people. Even though TB is 100% curable, only half of South Africa’s TB patients complete treatment.

USAID Program

USAID collaborates with the Government of South Africa to respond to the various health challenges facing the country. To this end, USAID’s program with South Africa aims to increase access to an integrate package of primary health care (PHC), improve the quality of services, and strengthen the capacity of institutions to provide services in a sustainable manner. USAID also collaborates with the Government to improve prevention services and care and support for those infected and affected by HIV/AIDS.

HIV/AIDS Activities

Since 2000, USAID assistance to the national HIV/AIDS program has grown substantially and is based on three inter-related activities:

1) Building institutional and human capacity, especially at the provincial level;

2) Identifying and scaling up better practices; and

3) Conducting research to design and improve health interventions.

To implement its comprehensive health care package, USAID provides technical assistance to the South African Government’s health program through a variety of projects that support the National Department of Health:

The EQUITY in Integrated Primary Health Care Project

Condom Logistics

Behaviour Change

Quality Assurance Project

USAID also supports various non-governmental organizations (NGOs):

Chris Hani Baragwanath Hospital Perinatal HIV/AIDS Research Unit

Reproductive Health Research Unit (RHRU)

Hope Worldwide

Nelson Mandela Children’s Fund

Right to Care