Policy missteps: bizarre tale of a toothbrush and the NHI
|Published
Often an object is not used for what it was initially intended for.
This might lead to new discoveries. However, our government conducts our public business towards new discoveries that are deadly.
The commonsense approach to public affairs is hapless and disgusting to say the least. It reminds me of the lesson I learnt In 1977.
My brother and I attentively listened to a discussion between two nightsoil operators in Mafeteng, Lesotho. Their roaring tractor caused them to talk very loudly, and the voices came distinctly to us from a distance of about 200 metres.
The one was describing how a toothbrush looks and its use to the other. This was the most bizarre explanation on physical design and utility. It left us in stitches.
This is how the conversation went, “There is this stick-like object to which grass like twigs are plucked in at the one end. You see when your gums are swollen, you just brush your teeth with it, and the puss filled blood oozes out and you get good relief.”
So, like the other two designs, the toothbrush was used not for its intended use of the daily brushing of the teeth, but for the occasional addressing of swollen gums.
Meanwhile, in South Africa 2013 there was a surge in the consumption of condoms. The government almost concluded that their safe sex campaign was working. Not until the octogenarian Mrs Moyo said, “A neighbour of mine who saw that I was struggling to walk because of pain from my arthritis, told me that I should try rubbing a condom over the pain”. Only then it was clear that the spike in the use of condoms had nothing to do with safe sex, but a lot to do with treatment of arthritis in the ex-sex octogenarian graduates.
We are not alone. In 1989. Pfizer, through its two scientists, Peter Dunn and Albert Wood, put up sildenafil citrate as a design for treating high blood pressure and angina.
The drug is classified as UK-92480. This drug was ingested by the US military who suffered mental depression because of war experiences, but the side effect was a joyous opposite - a nail strong sexual erection and an unforgettable experience. Viagra is now a fully commercialised go-to design for solving erectile dysfunction.
Of course, the nightsoil operator got relief from the loosely arranged, plug infested set of dentals, just as the soldiers had eternal pleasure, while the grannies had a comfortable sleep away from the clucking pain of knees.
However, this has become the science of South African public affairs. Public policy needs science. I would argue that in South Africa we have deployed common sense in our public policy, but not science.
South Africa did try to take a scientific approach to Covid-19, however, this was undertaken with a degree of policy missteps.
The interface of science and public policy spewed massive looting.
A report by the Special Investigating Unit in 2022 showed that, from April 2020 to September 2021, the state spent more than R152.5 billion in Covid-19 procurement, and the unit investigated graft valued at R14.4bn, or 9.4% of the total spend. This is a sign of unguided design where common sense collides with science.
Our government continues to mismanage our public affairs, which is leading to unnecessary deaths.
What we saw in the Madibeng water plant a decade ago has continued and eventuated in the unnecessary deaths in Hammanskraal, where the whole government in its wisdom gave a nightsoil man an interpretation to the problem of water hygiene.
When there is no science guiding public policy nor science interface with popular public mobilisation, the nation perishes. The nation becomes a victim of looting, abuse and dismal societal dysfunction that we have become accustomed to today.
What we see in the hurried passing of the National Health Insurance (NHI) Bill is a nightsoil man interpretation of a toothbrush.
A decade ago, Dr Aaron Motsoaledi, who was the minister of health, then proposed and implemented a public health system that would deploy at least 30 000 public health officials in preparation for the NHI. This turned sour because the Treasury could not allocate the funds
The minister became a victim of a double jeopardy, one from the Treasury and another from being pitted against the staff he was forced to release. This is the staff that would have been available as the frontline to address Covid-19 and they would be ready to systematically implement the NHI. Public policy designed through a nightsoil man understanding of the function of a toothbrush cannot pass the muster of science.
Dr Pali Lehohla is the director of the Economic Modelling Academy, a Professor of Practice at the University of Johannesburg, a Research Associate at Oxford University, a board member of Institute for Economic Justice at Wits and a distinguished Alumni of the University of Ghana. He is the former Statistician-General of South Africa.
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