The year  2022  should mark the end of the second phase of South Africa’s transition towards the full implementation of the National Health Insurance. We are also 9 years away from the target set to achieve Universal Health Coverage by 2030 as stipulated in the United Nations’ Sustainable Development Goals. As a result of the outbreak of the coronavirus COVID-19, the past two years have seen a disruption in the pursuit to achieve these developmental goals for all countries.

According to the World Bank’s report on High-Performance Health Financing for Universal Health Coverage, there was in 2019 approximately 3.6 billion people globally who do not have access to the most essential health services they need, coupled with about 100 million people who are pushed into poverty from using out-of-pocket financing for health services. It is obvious that in 2021, these numbers have significantly increased, this meaning that many more people have been pushed to increasing levels of poverty and vulnerability.

While the South African health system is one of the best in the continent, as per the nature of all health systems globally, it has also been confronted with some challenges. The most recent being the COVID-19 virus, which has not only challenged the capacity of global health systems but has claimed millions of lives over a short space of time. The COVID-19 pandemic takes place within a context where the health sector has previously suffered disinvestments as a result of shifting global priorities, partly informed by the stability of health interventions that have produced positive results especially in the management of HIV and TB epidemics.

It is however unfortunate that the stability that had been established over the past few years has seen some regression because of the pandemic in areas such as Maternal Mortality, HIV, and TB treatment to name a few. The observation made in this regard is that numbers in Maternal Health Child and Women’s Health, HIV, and TB have risen as a result of the lockdown restrictions and limitations to accessing care due to the interventions that have been put in place to curb the spread of the COVID-19 virus since its emergence in South Africa.

Although this may be the case, it is important that we take into consideration the work done over the years, and recently by that the National and Provincial Departments’ of Health to improve primary health care services and access thereof. The inroads made in achieving the first 90 of the 90-90-90 HIV strategy, the rollout of the first phase of the transition to the NHI, and the ideal clinic framework are a few cases in point. In Gauteng, one of the main achievements also including the progress made in the implementation of the Central Chronic Medicine Dispensing and Distribution program.

The current pandemic has as such highlighted that strengthening health infrastructure is important and that more needs to be done to equip primary health- care facilities in such a way that these are able to continue to function optimally, even in contexts such as those created by COVID-19. In other words, the pandemic has presented evidence in support of the necessity for Universal Health Coverage, and the importance of the National Health Insurance in South Africa. Specifically, it has shown that maximizing health financing that improves access to quality health services and financial protection of everyone, especially the poor and vulnerable is one of the key cornerstones of sustainable development and improving livelihoods.

Of course, some will continue to make the case that the implementation of the National Health Insurance should not be a priority, it is, therefore, the responsibility of justice-loving people to continue to defend and raise the banner for the implementation of the NHI. It is indeed critical to note, that the pandemic presented an opportunity for utilizing a moment of crisis to strengthen the health system, this as a contribution to preparing for achieving Universal Health Coverage by 2030. While we note COVID-19 limitations that have resulted in restricting the program of passing the NHI Bill, it is important that we continue to build a strong South African health system that is both equitable and of high quality from the position of complexity that is confronting the global health system.

As such, National Treasury, the Health Ministry, and other relevant stakeholders should at this conjuncture, take this moment to seriously reflect on and consider solutions of how to take the country forward as it concerns the NHI. There is arguably a missed opportunity in the budget as presented by the Minister of Finance in so far as it concerns maximizing on capacitating the NHI project.

The NHI Bill having not been yet passed should not mean that meaningful interventions cannot be made towards the strengthening of the South African health system. The reality is that the global goal for achieving Universal Health Coverage by 2030 remains, our national goal for the implementation of the NHI by 2026 while compromised by the global pandemic should remain as the focus for improving health outcomes and livelihoods in South Africa. We cannot afford to surrender the cause for health justice in our lifetime.