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AJPH First Look, published online ahead of print Nov 29, 2005
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January 2006, Vol 96, No. 1 | American Journal of Public Health 73-78
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.062679

ATTAINING HEALTH IN AN INEQUITABLE WORLD

Key Challenges to Achieving Health for All in an Inequitable Society: The Case of South Africa

David Sanders, MRCP and Mickey Chopra, MSc

David Sanders is with the School of Public Health, University of the Western Cape, Bellville, South Africa. Mickey Chopra is with the Health Systems Research Unit, Medical Research Council, Cape Town, South Africa.

Correspondence: Requests for reprints should be sent to David Sanders, MRCP, School of Public Health, University of the Western Cape, Bellville 7535, South Africa (e-mail: dsanders{at}uwc.ac.za).

The health inequalities in South Africa are rapidly worsening. Since 1994, the new democratic government has initiated a number of large-scale policies and programs with explicit pro-equity objectives that have improved access to health care and other social resources. However, these policies and programs have been constrained by macroeconomic policies that dictate fiscal restraint and give priority to technical rather than developmental considerations.

We propose an approach to improving health for all that focuses on equity in the allocation of health resources. The implementation of pro-equity policies requires, in addition to technically efficacious interventions, both advocacy initiatives and communication with, and the involvement of, affected communities. The Cape Town Equity Gauge project is presented as one example of a response to the challenge of inequity.






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