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Executive Forecast

“We didn’t’ see this coming”

– Bill Gates in last year’s annual letter as Chairman of the Gates Foundation.

No, he wasn’t talking about COVID-19; Gates was referring to other surprise megatrends in global healthcare, one of the most complex, regulated and challenging sectors, which demands principled executives who can safely helm our Mission Health. Gates’ worthy list informs the 2020 edition of Executive Forecast’s South Africa report which covers a greater understanding of the true economic impact of health, redefines the catch-all term of “access,” and explores financing mechanisms, breakthrough technologies, and empowerment of the historically disadvantaged.

Mission Health highlights how we can work together to navigate the complexities in restoring investor confidence, attracting investment, and ultimately, achieving the “triple bottom line” in a South African context.

Strong Health, Stronger business

If we needed any greater evidence of the massive impact of health on the economy, witness the single biggest market decline since the Great Recession of 2008, sparked by the COVID-19 pandemic. But the impact can also go the other way: investing in health is always good business. South Africa’s business and government communities understand that you can’t invest in what you don’t plan for—and you won’t invest in what you don’t understand. Together, they’re driving planning and greater understanding through formal and informal channels.

“We are a proactive government and prioritize the people’s needs. We are creating platforms for the private sector to participate and invest in the country.”

Thembi Siweya, Deputy Minister of the Planning Department.


“We have been pushing for investment and growth which is a critical issue in South Africa, as nothing happens without them,” says Cas Coovadia, Director of Business Unity South Africa (BUSA). “It is a matter of changing the narrative and it is in our hands to do this, government, business and labor together. We need leadership that understands our role in the global economy and what needs to be done to get our economy going.” Stavros Nicolaou, Chairman of Pharmisa, a South African industry trade-group stresses the importance of implementing structural reforms, and that the business community is fully behind President Ramaphosa’s drive to restore governance, liquidity, and sustainability in state-run enterprises.

Risenga Maluleke, Statistician-General and Head of Statistics South Africa, emphasizes the importance of knowing as much as possible about the population you’re planning for. “We collect data from households, from industry, from administrative records from schools, clinics and police. Statistics must be independent, facts can be stubborn!” Maluleke asserts. “There have been several initiatives championed by the President to encourage Foreign Direct Investment into the country,” says Thulisile Manzini, CEO of Brand South Africa. “These include the launch of the South African Investment Conference with a clear target of U$68 billion over 5 years. Of the inaugural U$17 billion investment, approximately U$14 billion worth of projects is in the implementation phase across different sectors. Last year’s SA Investment Conference also saw an investment commitment of U$21 billion pledges made from various investors.” Manzini also points towards a new “One Stop Shop” concept which removes red tape for investors by providing more coordinated, streamlined, and professional services to companies, bringing together special economic zones, provincial investment agencies, local authorities, and government departments. Talking about economic spillover, “there is a whole domino effect in coming up with innovative medicines and treating patients,” says Dr Konji Sebati, CEO of IPASA, the Innovative Pharmaceutical Association of South Africa. “We create a virtuous cycle of life. Few people are aware of the contribution that pharmaceutical companies make to human welfare. Not only do their medicines save lives, it improves health, and prolongs and enhances quality of life, but medicines also reduce overall healthcare costs.”



Shifting disease maps

Africa has historically been the epicenter of a multitude of global health initiatives. Notably, the world’s largest publicly-funded antiretroviral (ARV) program, increasing life expectancy by over a decade, an unprecedented achievement that has led to unprecedented business opportunities. However, partly as a result of its successes, the disease profile of the continent has been shifting—and its healthcare system along with it. South Africa must continue to develop expertise in managing both communicable diseases and non-communicable diseases, whose treatments must coexist in a fragile balance. Through collaborative know-how and coordinated effort between public and private initiatives, people on both sides of the equation believe it’s possible to re-engineer the country’s healthcare system. The National Health Insurance (NHI), is a universal health coverage scheme being implemented over a 14-year period starting in 2012.

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