South Africa needs to strengthen its focus on prevention, adopt evidence-based harm reduction approaches and recognise the economic benefits of investing in healthier communities, according to discussions at a health and wellness colloquium hosted by the Progressive Business Forum (PBF) in Johannesburg on Thursday.
The colloquium, held under the theme “Investing in Health and Wellness: Advancing Economic Prosperity, Prevention and Sustainable Development”, brought together policymakers, health professionals and business representatives to examine how prevention, community-based interventions and collaboration between government and industry can contribute to better health outcomes and economic prosperity.
A central theme emerging from the discussions was the need to move beyond approaches that focus predominantly on treating illness, towards policies and interventions that prevent disease, reduce avoidable harm and address the underlying social and economic factors affecting health.
ANC Treasurer-General and PBF Chairperson Dr Gwen Ramokgopa highlighted the importance of industry investment in health and initiatives aimed at reducing harm, linking improved health outcomes to sustainable economic growth and prosperity.
She welcomed the willingness of industries to engage with society and take an active role in addressing public health challenges, acknowledging those that are stepping forward to contribute to harm reduction efforts. She emphasised the importance of collaboration between government, business and communities in developing practical solutions that improve health outcomes and support economic development.
Gauteng’s Health MEC, Faith Mazibuko, drew attention to the considerable pressure on the province’s public healthcare system, highlighting the millions of patients accessing hospitals, clinics and other healthcare services. She emphasised the importance of strengthening primary healthcare and community outreach programmes to improve access to services and alleviate pressure on hospitals.
Minister of Trade, Industry and Competition Parks Tau highlighted the relationship between poverty, inequality, substance dependence and economic participation.
He noted that the impact of substance use is not experienced equally across society, with poorer communities often exposed to particularly harmful substances and the associated social and economic consequences.
Tau emphasised the importance of targeted interventions that reduce substance dependence and enable greater participation in economic activity.
“We have to and are working on programmes that reduce dependence on these substances as a means to ensure greater economic activity,” he said.
He also questioned whether enforcement alone could adequately address substance dependence, arguing that interventions should be informed by scientific evidence and an understanding of the circumstances affecting individuals.
Reflecting on approaches that rely on forcing people to stop using harmful substances, Tau said: “For as long as we think we’re going to force you, that you will stop because we forced you, science suggests that it does not work that way.”
His remarks reinforced the need for evidence-informed policies that address the underlying causes of substance dependence, while recognising the connection between health, employment, economic opportunity and the social conditions in which people live.
Harm reduction and differentiated risk
Health policy expert and clinician Dr Confidence Moloko argued that harm reduction should be recognised as an important component of public health policy, drawing attention to international approaches that seek to reduce the negative consequences associated with substance use.
Moloko noted that international organisations, including the World Health Organization (WHO), UNAIDS and the United Nations Office on Drugs and Crime, recognise harm reduction as an important component of public health responses to addiction.
However, he questioned what he described as an inconsistency between this recognition and the approach taken under the WHO Framework Convention on Tobacco Control, arguing that harm reduction principles should also be considered in addressing tobacco dependence.
Referring to international approaches, Moloko said: “Now, we cannot have a good approach being reserved for developed countries and not being used in the developing countries.”
His comments came amid broader discussions about the importance of recognising different levels of risk associated with substances, particularly tobacco, and the need for public health policies to respond accordingly.
With the Tobacco Products and Electronic Delivery Systems Control Bill currently before Parliament, Moloko was asked about product differentiation. In response, he pointed to South Africa’s taxation framework as an example of policy that, in his view, already recognises differential harm.
He said the structure of the taxation regime provided an opportunity to examine how differing levels of harm are recognised in policy.
Professor Monique Marks, who addressed the social and economic impact of community-based health and wellness interventions, argued that South Africa’s healthcare system places too much emphasis on treatment rather than prevention, lifestyle management and sustained recovery.
She called for a more integrated approach that considers physical and mental health, social circumstances and the underlying causes of substance dependence.
Marks emphasised the importance of “reducing harm without moralising”, arguing that practitioners should work collaboratively with individuals to identify underlying problems and support measurable improvements in their health and wellbeing.
Drawing on her experience with community-based harm reduction programmes, Marks highlighted how such interventions can improve quality of life and encourage people to access essential healthcare services.
She also argued that investing in lifestyle management and early intervention could reduce avoidable hospital admissions and the long-term costs associated with chronic illness.
The colloquium considered a series of proposed actions to translate discussions into practical interventions.
These included establishing a multisectoral task team involving government, business, academic institutions and the PBF; strengthening public-private partnerships in employee wellness and community health; advancing research into the economic benefits of prevention; and integrating mental health and harm reduction principles into broader health policy.
The discussions highlighted a broader policy challenge: ensuring that South Africa’s response to preventable illness and substance-related harm is informed by evidence, recognises differing risks and prioritises interventions that can improve health outcomes while reducing the long-term economic burden.
