Ep15 (part 2) - The South African Experience with HIV, Sagie Pillay

The Pursuit of Health Podcast

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On Part 2 of this three-part special episode of the Pursuit of Health Podcast, we continue our first foray outside the US. Our host, Dr. Fethke, continues the discussion with Mr. Sagie Pillay from Johannesburg, South Africa.
Mr. Pillay has an extensive worldwide education in healthcare policy and administration. He has served South Africa and the African continent through many leadership roles. He currently is the Chief Operations Officer at Wits Health Consortium, in Johannesburg, South Africa.
Mr. Pillay explains that during Apartheid the arrival of HIV in the 1980’s was not a priority for the minority ruling government. They considered it to be an affliction of the under class - the poor, the gay and the “non-white” community. As Apartheid fell and the new democratic government was forming, HIV was continuing to spread in the background. He stresses that, to best promote a strong healthcare system, the people of a democracy must put aside politics and be engaged in establishing their nation’s policies. He also recognizes the invaluable role that the private sector and international donations played to encourage the new government to step up to the plate and invest in public health and a healthcare infrastructure on behalf of everyone.
Through the 1990’s, HIV in South Africa rose to staggering levels compared to the rest of the world. Gradually the concerted efforts of many institutions, including those lead by Mr. Pillay, came together. Mr. Pillay emphasizes that South Africa now lays claim to the largest nationally-run medical diagnostic system of any country. South Africa rose to the challenge as these diagnostic testing services supported one of the world’s most successful antiretroviral therapy programs and their HIV-related death toll began to significantly drop.
Dr. Fethke and Mr. Pillay conclude the second part of this discussion by drawing attention to the perseverance that allowed the many disparate components of this young nation’s healthcare system to ultimately and recently come together as an effective weapon against infectious disease. They had to overcome so many concurrent obstacles including a relatively inexperienced new government, presidential denial of the realities of HIV, continued social inequities based on longstanding racial barriers and economic hardships. They both conclude that the HIV experience of the U.S. and South Africa should have served as a strong launching platform to address future pandemics such as Covid-19.
In the upcoming final Part 3 of Episode 15, we dive deep into the current Covid-19 pandemic. Join us to see if these young nations applied or ignored our HIV legacy when addressing Covid-19.

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