The COVID-19 wakeup call: underscoring longstanding inequalities in the South African health system

Globally, COVID-19 has exposed and worsened pre-pandemic inequities across all sectors, inclusive of the health sector (Khazanchi, et al. 2020). It also highlighted many of the longstanding global inequalities that impact health and well-being. At the global level, these inequalities were more illuminated in the political economy of vaccine access. As Rees et al. (2022) note, within high-income countries, vaccine access was significantly higher1, while in many low- or middle-income countries, an average of 10% of the population received a single dose of the COVID-19 vaccine. This evidently had implications for inequalities in health outcomes between high-income and middle to low-income countries. In South Africa specifically, it brought to the fore health and social inequalities that have existed since the apartheid era and put enormous pressure on the already struggling healthcare system. It also highlighted the multiple barriers to healthcare experienced by historically disadvantaged populations.