Rationing healthcare in South Africa : renal replacement therapy - a case in point : correspondence

Publication Type:

Journal Article


South African Medical Journal, Volume 104, p.593 (2014)




The South African Dialysis and Transplant Registry issued its last report on renal replacement therapy (RRT) in South Africa (SA) in 1994, followed by an unfortunate hiatus for 20 years. The recent publication of the long-awaited <span class="jp-italic">South African Renal Registry Annual Report 2012</span> should be highly commended. The private sector deserves to be acknowledged for its financial support of this initiative. Since 1994, the SA population has increased from 40.436 million to 52.275 million and the treatment rate for end-stage renal disease (ESRD) per million population (pmp) has improved from 70 pmp in 1994 to 164 pmp in 2012. The treatment rate in 2012 for the public sector is essentially unchanged at 73 pmp, compared with 620 pmp (of insured persons) in the private sector. In contrast, the low national kidney transplant rate of 4.7 pmp highlights the dire need for organs.

Medical Humanities in Africa

WISER is working to establish the field of medical humanities in South Africa with other partners at Wits and in the region. Medical Humanities took root in the interdisciplinary spaces between social history of medicine, medical sociology, medical anthropology, literary studies, art and film studies, cultural studies, politics, philosophy, legal studies, public health, psychiatry, medical economics and medical ethics. Although initially concerned with contrasting and comparing approaches from the humanities and medical science to themes of health, suffering, therapy, pain and illness, it has grown in ambition to consider the foundational question of what it is to be fully human, inviting debate around vital epistemological problems. The interface of medicine and humanities also demands a broadly interdisciplinary discussion about what constitutes evidence, and this is critical in the formulation of all contemporary political arguments, including health policies. 

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