Access to health is not just a privilege, it is a fundamental part of our human rights and for living a life in dignity. In theory, access to health ensures that every individual has the right to enjoy the highest attainable standard of physical and mental health, without discrimination of any kind. These rights encompass a range of essential health services, including preventive, curative, and palliative care, as well as access to essential medicines and vaccines. It also extends beyond the absence of disease to include factors such as nutritious food, clean water, safe housing, and sanitation, which are crucial determinants of health.

First articulated in the 1946 Constitution, the World Health Organization (WHO) defines ‘health’ as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.  As per the United Nations and WHO, the key aspects of the right to health are:

  • The right to health is an inclusive right
  • The right to health contains freedoms
  • The right to health contains entitlements
  • Health services, goods and facilities must be provided to all without any discrimination
  • All services, goods and facilities must be available, accessible, acceptable and of good quality.

Ensuring universal access to health requires addressing systemic barriers and inequalities that prevent individuals and communities from enjoying good health. This includes addressing social, economic, and political factors that contribute to disparities in health outcomes, such as poverty, gender inequality, discrimination, and inadequate healthcare infrastructure. Ultimately, the right to access health is not just a moral imperative; it is a legal obligation of governments and societies to ensure the well-being and dignity of all individuals.

Despite progress in global health efforts, we still have not achieved universal access to health, particularly in low- and middle-income countries where people often carry the highest burden of disease.

In South Africa, several barriers contribute to limited access to healthcare, particularly among marginalized populations. Poverty and income inequality are significant barriers to accessing healthcare in South Africa. The vast majority of individuals cannot afford private healthcare and rely on the public healthcare system, which although of high standard, is under-resourced and overcrowded. The public healthcare system in South Africa faces various challenges, including shortages of healthcare workers, insufficient infrastructure, and equipment, and long waiting times for services. These challenges contribute to delays in accessing healthcare and can affect the quality of care received. In rural and remote areas, access to healthcare facilities becomes further limited due to long distances and lack of transportation infrastructure, and face financial barriers, due to unafforable transportation costs to reach healthcare facilities. Furthermore, those without formal identification documents may encounter difficulties accessing healthcare services. This poses challenges for individuals seeking medical care, especially in emergencies or for illnesses and disease requiring chronic care.

In addition, yet not unique to the South African context, stigma and discrimination related to certain health conditions, such as HIV/AIDS and mental illness, can deter individuals from seeking healthcare services. Cultural beliefs and practices may also influence healthcare-seeking behaviour and access to certain services, particularly among marginalized communities.

Addressing these barriers requires comprehensive strategies that focus on improving healthcare infrastructure, increasing healthcare financing, addressing socioeconomic inequalities, strengthening primary healthcare services, and promoting culturally sensitive and patient-centered care.