“The world is facing a medical emergency far graver than what we have experienced in over a century.”

These were the strong words that President Cyril Ramaphosa used in his address to the nation on Sunday evening to announce government’s response to the Covid-19 pandemic. Much about the virus remains uncertain, but we know that it poses an immense danger to public health in SA, particularly to immuno-compromised people. The virus could not have come at a worse time.

The drastic measures necessary to prevent the rapid spread of Covid-19 will lead to a significant downturn in the global and the national economy, already in recession. It is at times of crisis like these that people look to their government for support and assurance.Citizens’ trust in a government’s ability to respond decisively will determine whether the public adheres to the prescripts of authority.

Covid-19 presents a challenge to South Africans’ trust in our government. As the number of cases continue to climb without any sign of abating, do South Africans believe that the state will be able to sufficiently handle the outbreak? Public opinion surveys that probe South Africans’ perceptions on issues of governance, service delivery and access to medical care allow some insight into the national opinion on whether or not South Africans trust the state to contain the virus.

Public opinion on health 

The SA Reconciliation Barometer, a nationally representative public opinion survey conducted by the Institute for Justice and Reconciliation (IJR), asks South Africans several questions relating to their access to goods and services. In 2019, when respondents were asked if they or anyone in their family had gone without medicines or medical treatment in the past year, only 51 percent of South Africans said their household always had access to medical treatment.  Close to 40 percent of respondents said they went without medical treatment a few or several times over the past year. The remaining 10 per cent of respondents went without treatment many times or always in 2019.

Access to medical care varies across the country. Respondents in the Western Cape reported the lowest incidence of going without medical treatment, while a majority of respondents in KwaZulu-Natal, Northern Cape, Eastern Cape and Limpopo reported going without access to treatment at least once over the previous year. These findings suggest that a significant share of the population report being isolated from access to medical care and are extremely vulnerable in a public health crisis.

Afrobarometer, another nationally representative survey conducted by IJR, asks South Africans several questions relating to the quality of medical services. In 2018, when asked how easy or difficult it was to obtain the medical care they needed, respondents expressed negative sentiments about access to health services. More than one in four respondents reported that they only received medical care after a long time. On a positive note, close to half of South Africans believe their ability to access medical care when they need it is better now than it was a few years ago.

Building trust, saving lives 

Both public opinion surveys paint a bleak picture of South Africans’ access to medical care and their trust in health services. But the government’s initial response to the outbreak of Covid-19 has been commendable. Each day, the Health Department provides public updates on new cases with detailed information on the place of infection. In many countries, the transmission of this information is slow or untrustworthy. The sweeping measures introduced to contain the virus – travel bans from high-risk countries, restrictions on public gatherings, closing schools -are proactive and timely.

Covid-19 has yet to cause any casualties in South Africa, but the old saying holds true: prevention is better than cure. By contrast, Italy only closed schools when over 3 000 cases had been reported and the spread of the virus was already expanding rapidly. Italy’s total number of infections is now second only to China, with hundreds of new casualties and thousands of cases announced each day. In his message to the nation, Ramaphosa emphasised that “this epidemic will pass, but it is up to us to determine how long it will last, how damaging it will be, and how long it will take our economy and our country to recover”.

We are undoubtedly at the opening stages of a national crisis.

The next few days and weeks will be era-defining for the country and for Ramaphosa’s legacy. For the state to succeed in handling the Covid-19 outbreak, public confidence in institutions and health services must be restored. This is an opportunity for the president to demonstrate decisive leadership, for the state to exercise its capacity to provide essential services, and for society, despite our divisions, to come together for a common goal. Ramaphosa’s closing remarks remind us that trust in our government and each other is central to resolving social ills: “If we act together, if we act now, and if we act decisively, we will overcome it.”

Mikhail Moosa is the Project Leader for the SA Reconciliation Barometer at the Institute for Justice Reconciliation

Article first published on News24