Open Letter to Dr Zweli Mkhize and Mr Tito Mboweni

The document argues that austerity budgets have severely undermined South Africa's public health system, leading to critical staffing shortages, unaffordable medicines, and deteriorating infrastructure. It calls for increased state investment, the removal of wage expenditure ceilings, and reforms to patent law and the private health market to achieve Universal Health Care through National Health Insurance.

• Austerity budgets implemented during the 5th democratic administration have undermined the public health system and the viability of National Health Insurance (NHI). Between 2015/16 and 2019/20, spending per uninsured person grew by an average of only 1% annually, failing to keep pace with medical price inflation and the burden of disease.
• Budget cuts and the use of wage expenditure ceilings by the National Treasury have created a crisis in human resources for health. In May 2018, 38,000 public health posts remained vacant. The letter cites Keimoes Hospital in the Northern Cape as an example, where only two nurses and their assistants manage a 28-bed facility.
• Chronic underfunding and staffing shortages have contributed to a surge in medico-legal claims, which rose from R28.6 billion in 2015 to R80.4 billion in 2018. These claims now exceed half of some provincial health budgets.
• Health infrastructure is in a state of decay, particularly in areas ignored during apartheid. Despite a 2018 commitment to prioritize upgrades, the 2019 budget reduced expenditure on facilities management and maintenance by 2.7% in real terms. The document notes the looting of the old De Aar hospital in the Northern Cape after its sudden closure.
• High costs of life-saving medications, particularly for cancer patients, create significant barriers to access. For example, a year of medication for Multiple Myeloma can cost R900,000. The authors urge the government to reform the Patents Act to balance healthcare access with pharmaceutical interests.

APA

Institute for Economic Justice (n.d.). Open Letter to Dr Zweli Mkhize and Mr Tito Mboweni. https://iej.org.za/wp-content/uploads/2019/06/Open-letter-to-Ministers-of-Health-and-Finance-06-06-2019-FINAL-min.pdf

Chicago

Institute for Economic Justice. Open Letter to Dr Zweli Mkhize and Mr Tito Mboweni. n.d. https://iej.org.za/wp-content/uploads/2019/06/Open-letter-to-Ministers-of-Health-and-Finance-06-06-2019-FINAL-min.pdf.

Wikipedia

{{cite press release |author=Institute for Economic Justice |title=Open Letter to Dr Zweli Mkhize and Mr Tito Mboweni |url=https://iej.org.za/wp-content/uploads/2019/06/Open-letter-to-Ministers-of-Health-and-Finance-06-06-2019-FINAL-min.pdf |access-date=23 October 2026 |via=Climate Insights Directory}}

BibTeX

@misc{instituteforeconomicjusticendopen, author = {{Institute for Economic Justice}}, title = {{Open Letter to Dr Zweli Mkhize and Mr Tito Mboweni}}, publisher = {Institute for Economic Justice}, url = {https://iej.org.za/wp-content/uploads/2019/06/Open-letter-to-Ministers-of-Health-and-Finance-06-06-2019-FINAL-min.pdf}, urldate = {2026-10-23}, note = {Indexed by Climate Insights Directory} }