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South African Health Review 2021

​When it comes to service delivery and access in both the public and private health sectors, COVID-19 has put everything to the test. It has demonstrated how central public health security is to health and livelihoods, and how pandemic health emergencies expose the weaknesses and vulnerabilities of health systems, costing lives and causing immeasurable damage to economies. Few could have imagined the impact of COVID-19 when this pandemic reached our shores in March 2020.

But it has also created opportunities for rapid innovation, and out of sheer necessity, has increased and enabled cross-sectoral collaboration, and public−private partnership initiatives. It is against this backdrop that Health Systems Trust (HST) in collaboration with the Health Economics and AIDS Research Division (HEARD) − a research unit based at the University of KwaZulu-Natal − launches its special edition of the South African Health Review.

This edition considers the government’s and broader health sector’s response to COVID-19, explores the current challenges facing the health system at this unprecedented time, and reflects on lessons learnt for future for public health emergencies. The chapters offer information on, inter alia, the challenges of balancing lives with livelihoods, and the impact of COVID-19 on different cadres of healthcare workers, especially Community Health Workers who found themselves at the forefront of our COVID-19 response. Other areas covered include the impact of COVID-19 on vulnerable populations like children, persons with disabilities, farmworkers, migrants, and the poorest in our society.

We thank HEARD, as well as members of the Editorial Advisory Committee, for their contribution in guiding the content of the Review towards featuring these multiple perspectives, thereby adding to the publication's richness and diversity. We also extend our thanks to the Ministerial Advisory Committee on COVID-19 for their contribution to this edition, and to the Johnson & Johnson Foundation for their generous support for its production.

Developing this edition in the midst of loss and uncertainty has been difficult, and its completion is due in large part to the tenacity and dedication of all those who contributed to its delivery.

On behalf of the Board of Health Systems Trust, I thank the authors, reviewers, Editorial Advisory Committee members, editorial team, and administrative personnel who worked tirelessly to produce this Review. Your commitment and expertise have collectively ensured another excellent edition of the South African Health Review − a valuable resource for the health sector and the country. We thank you for your contribution.

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