Achieving the health Millennium Development Goals for South Africa: challenges and priorities.
15 years after liberation from apartheid, South Africans are facing new challenges for which the highest calibre of leadership, vision, and commitment is needed. The effect of the unprecedented HIV/AIDS epidemic has been immense. Substantial increases in mortality and morbidity are threatening to overwhelm the health system and undermine the potential of South Africa to attain the Millennium Development Goals (MDGs). However The Lancet's Series on South Africa has identified several examples of leadership and innovation that point towards a different future scenario. We discuss the type of vision, leadership, and priority actions needed to achieve such a change. We still have time to change the health trajectory of the country, and even meet the MDGs. The South African Government, installed in April, 2009, has the mandate and potential to address the public health emergencies facing the country--will they do so or will another opportunity and many more lives be lost?
Chopra
Mickey
M
Health Systems Research Unit, Medical Research Council, Cape Town, South Africa; School of Public Health, University of the Western Cape, Cape Town, South Africa. Electronic address: mickeychopra28@gmail.com.
Lawn
Joy E
JE
Health Systems Research Unit, Medical Research Council, Cape Town, South Africa; Saving Newborn Lives/Save the Children, Cape Town, South Africa.
Sanders
David
D
School of Public Health, University of the Western Cape, Cape Town, South Africa.
Barron
Peter
P
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Karim
Salim S Abdool
SSA
Centre for the AIDS Programme of Research in South Africa; Department of Epidemiology, Columbia University, New York, NY, USA.
Bradshaw
Debbie
D
Burden of Disease Unit, Medical Research Council, Cape Town, South Africa.
Jewkes
Rachel
R
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa; Gender and Health Research Unit, Medical Research Council, Pretoria, South Africa.
Karim
Quarraisha Abdool
QA
Centre for the AIDS Programme of Research in South Africa; Department of Epidemiology, Columbia University, New York, NY, USA.
Flisher
Alan J
AJ
Division of Child and Adolescent Psychiatry and Adolescent Health Research Unit, University of Cape Town, Cape Town, South Africa.
Mayosi
Bongani M
BM
Department of Medicine, University of Cape Town, Cape Town, South Africa.
Tollman
Stephen M
SM
School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Churchyard
Gavin J
GJ
Aurum Institute for Health Research, Johannesburg, South Africa.
Coovadia
Hoosen
H
Reproductive Health and HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Nelson Mandela School of Medicine, University of Kwazulu-Natal, Durban, South Africa.
D017281:Cost of Illness; D005544:Forecasting; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control; D006292:Health Priorities / Q000458:organization & administration*; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006305:Health Status Indicators; D019456:Health Transition; D006801:Humans; D007857:Leadership; D009313:National Health Programs / Q000458:organization & administration*; D011057:Politics; D011320:Primary Health Care / Q000458:organization & administration; D011634:Public Health / Q000379:methods* / Q000639:trends; D013019:South Africa / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology / Q000517:prevention & control; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control