..... The top 10% of South Africans earn 58% of the total annual national income, whereas the bottom 70% combined earn a mere 17%. These disparities, the widest in the world, are associated with diseases of poverty. The persistence of such disparities is incompatible with improvements in population health........
....... South Africa, with 0.7% of the world's population, accounts for 17% of the global burden of human immunodeficiency virus (HIV) infection.....
...... South Africa has one of the worst tuberculosis epidemics in the world. Driven in recent decades by the spread of HIV infection, the incidence of tuberculosis increased from 300 per 100,000 people in the early 1990s to more than 600 per 100,000 in the early 2000s and to more than 950 per 100,000 in 2012....
...... Multidrug-resistant (MDR) tuberculosis accounts for 1.8% of all new cases of tuberculosis and 6.7% of retreatment cases. Since a study involving patients with extensively drug-resistant (XDR) tuberculosis in rural South Africa made international headlines, South Africa reports the most XDR tuberculosis cases in the world. Annual notifications increased from 298 in 2005 to 1545 in 2012,...
..... Annual per capita expenditure on health ranges from $1,400 in the private sector to approximately $140 in the public sector, and disparities in the provision of health care continue to widen...
..... The national public health sector, staffed by some 30% of the doctors in the country, remains the sole provider of health care for more than 40 million people who are uninsured and who constitute approximately 84% of the national population......
...... Approximately 16% of South Africans (8 million people) have private health insurance that provides access to health care from the remaining 70% of doctors who work full-time in the private sector......
...... Up to 25% of uninsured people pay out of pocket for private-sector care. In recent years, permission for senior full-time staff in the public sector to spend a limited proportion of their time working in the private sector has diluted their public-service activities.......
....... Many of the state hospitals are in a state of crisis, with much of the public health care infrastructure run down and dysfunctional as a result of underfunding, mismanagement, and neglect. This has been most visible in the Eastern Cape province but is also striking in other regions......
..... The number of graduating doctors increased by 18% between 2000 and 2012, with a shift from gender parity to more women, more black Africans and persons of mixed ancestry, and fewer whites and Indians....
....... South Africa and eight other sub-Saharan African countries have lost more than $2 billion (in U.S. dollars) in investment from the emigration of domestically trained doctors to Australia, Canada, the United Kingdom, and the United States. South Africa incurs the highest costs for medical education and the greatest lost returns on investment for all doctors currently working in such destination countries. Previous studies indicate that up to 30% of South African doctors have emigrated and that 58% were intending to emigrate to Western countries.......
....... Working toward the goal of national health insurance to provide more equitable access to high-quality individual health services has reemerged as a popular notion, and a draft plan has been developed....
...... At a time characterized by local and global crises that engender much despondency, and when it seems that we are probably collectively unable to recognize the dire nature of our mutual predicament, it is appropriate to recollect how President Nelson Mandela's attitude of magnanimity and reconciliation (despite 27 years in prison) spearheaded peaceful progress toward a new South Africa....